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Antimicrobial Agents and Chemotherapy, February 1998, p. 298-305, Vol. 42, No. 2
Pasteur Mérieux Connaught, Lyon,
France,1 and
INNOVEX Biodesign, D-79114
Freiburg, Germany2
Received 11 April 1997/Returned for modification 24 July
1997/Accepted 1 November 1997
In a monocentric, double-blind, randomized trial, we examined the
safety and pharmacokinetic profile of a new, pasteurized, human tetanus
immunoglobulin (P-HTIG). As part of the purification process, P-HTIG
has undergone a heat treatment step (10 h at 60°C) and the removal of
Merthiolate. Forty-eight adults with a history of tetanus vaccination
were randomized into four groups (n = 12 per group) to
receive one of two different batches of this P-HTIG simultaneously with
either tetanus-diphtheria (Td) vaccine (sham, postexposure prophylaxis
of tetanus) or placebo. Local reactions at the injection site were
followed for the first 3 days after injection, and systemic reactions
were followed during the entire study period, i.e., up to 42 days
posttreatment. Blood samples for tetanus antibody titer determination
(enzyme-linked immunosorbent assay method) were drawn prior to
treatment on day 0 and on days 1, 2, 3, 7, 14, 21, 28, 35, and 42. A
normalization of tetanus antibody titers (subtraction of the day 0 value for each subject at each time period) was performed to assess the
additive effect of P-HTIG on tetanus antibody titers. The
pharmacokinetic parameters were determined by both a compartmental
analysis (modelization) and a noncompartmental analysis. No severe
adverse reactions were reported. The rate of local reactions at the
P-HTIG injection site was 27%. All local reactions were mild and
resolved within 2 days. In contrast, local reactions at the vaccine
injection site were seen in 79% of the subjects. The rate of systemic
reactions was similar in the P-HTIG plus Td vaccine group (33%) and in
the P-HTIG plus placebo group (21%), and all these reactions were mild. In the P-HTIG plus placebo group, tetanus antibody titers rose to
a maximum of 0.313 ± 2.49 IU/ml after 4.4 days; in the P-HTIG
plus Td vaccine group, a maximum concentration of 15.2 ± 2.42 IU/ml was reached 19 days postinjection. In both groups, 100% of the
patients had seroprotective levels of tetanus antibodies (
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Evaluation of the Safety and Pharmacokinetic
Profile of a New, Pasteurized, Human Tetanus Immunoglobulin
Administered as Sham, Postexposure Prophylaxis of Tetanus
0.01 IU/ml)
2 days following treatment. An anamnestic response to Td vaccine
appeared 7 days postimmunization. In conclusion, P-HTIG has a good
safety and pharmacokinetic profile. Our results confirm that
immunoglobulin should be associated with vaccine in the treatment of
tetanus-prone wounds.
*
Corresponding author. Mailing address: Medical
Department, Pasteur Mérieux Connaught, 58 avenue LECLERC, Lyon,
France. Phone: 33 04.72.73.70.36. Fax: 33 04.72.73.78.13. E-mail:
jlang{at}fr.pmc-vacc.com.
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