Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis : protocol for a randomised controlled trial

O'Grady, Kerry-Ann, Grimwood , Keith, Cripps, Allan, Mulholland, Edward K., Morris, Peter, Torzillo, Paul J., Wood, Nicholas, Smith-Vaughan, Heidi, Revell, Amber, Wilson, Andrew, Van Asperen, Peter, Richmond, Peter, Thornton, Ruth, Rablin, Shereen, & Chang, Anne B. (2013) Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis : protocol for a randomised controlled trial. Trials, 14(282).

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Abstract

Background

Recurrent protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis are characterised by a chronic wet cough and are important causes of childhood respiratory morbidity globally. Haemophilus influenzae and Streptococcus pneumoniae are the most commonly associated pathogens. As respiratory exacerbations impair quality of life and may be associated with disease progression, we will determine if the novel 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) reduces exacerbations in these children.

Methods

A multi-centre, parallel group, double-blind, randomised controlled trial in tertiary paediatric centres from three Australian cities is planned. Two hundred six children aged 18 months to 14 years with recurrent PBB, CSLD or bronchiectasis will be randomised to receive either two doses of PHiD-CV or control meningococcal (ACYW(135)) conjugate vaccine 2 months apart and followed for 12 months after the second vaccine dose. Randomisation will be stratified by site, age (<6 years and >= 6 years) and aetiology (recurrent PBB or CSLD/bronchiectasis). Clinical histories, respiratory status (including spirometry in children aged >= 6 years), nasopharyngeal and saliva swabs, and serum will be collected at baseline and at 2, 3, 8 and 14 months post-enrolment. Local and systemic reactions will be recorded on daily diaries for 7 and 30 days, respectively, following each vaccine dose and serious adverse events monitored throughout the trial. Fortnightly, parental contact will help record respiratory exacerbations. The primary outcome is the incidence of respiratory exacerbations in the 12 months following the second vaccine dose. Secondary outcomes include: nasopharyngeal carriage of H. influenzae and S. pneumoniae vaccine and vaccine-related serotypes; systemic and mucosal immune responses to H. influenzae proteins and S. pneumoniae vaccine and vaccine-related serotypes; impact upon lung function in children aged >= 6 years; and vaccine safety.

Discussion

As H. influenzae is the most common bacterial pathogen associated with these chronic respiratory diseases in children, a novel pneumococcal conjugate vaccine that also impacts upon H. influenzae and helps prevent respiratory exacerbations would assist clinical management with potential short- and long-term health benefits. Our study will be the first to assess vaccine efficacy targeting H. influenzae in children with recurrent PBB, CSLD and bronchiectasis.

Impact and interest:

8 citations in Scopus
10 citations in Web of Science®
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ID Code: 64706
Item Type: Journal Article
Refereed: Yes
Additional Information: 216CM--
Times Cited:0--
Cited References Count:64--
http://WOS:000324258800001
Keywords: bronchiectasis, child, chronic suppurative lung disease, non-typeable haemophilus influenzae, pneumococcal conjugate vaccines, protracted bacterial bronchitis, randomised controlled trial, respiratory exacerbations, streptococcus pneumoniae, cystic fibrosis bronchiectasis, chronic wet cough, serotype-specific hyporesponsiveness, australian indigenous children, obstructive pulmonary-disease, clinical-practice guidelines, acute otitis-media, streptococcus-pneumoniae, nasopharyngeal carriage, young-children
DOI: 10.1186/1745-6215-14-282
ISSN: 1745-6215
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Funding:
Copyright Owner: Copyright 2013 O’Grady et al.
Copyright Statement: licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Deposited On: 26 Nov 2013 01:07
Last Modified: 21 Jun 2017 14:48

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