Application of Transthoracic Echocardiography for Cardiac Safety Evaluation in the Clinical Development Process of Vaccines Against Streptococcus pyogenes.


Journal

Drugs in R&D
ISSN: 1179-6901
Titre abrégé: Drugs R D
Pays: New Zealand
ID NLM: 100883647

Informations de publication

Date de publication:
18 Mar 2024
Historique:
accepted: 07 01 2024
medline: 18 3 2024
pubmed: 18 3 2024
entrez: 18 3 2024
Statut: aheadofprint

Résumé

Superficial infections with Streptococcus pyogenes (Strep A), pharyngitis and impetigo can induce acute rheumatic fever, an autoimmune sequela manifesting mostly with arthritis and rheumatic carditis. Valvular heart damage can persist or advance following repeated episodes of acute rheumatic fever, causing rheumatic heart disease. Acute rheumatic fever and rheumatic heart disease disproportionately affect children and young adults in developing countries and disadvantaged communities in developed countries. People living with rheumatic heart disease are at risk of experiencing potentially fatal complications such as heart failure, bacterial endocarditis or stroke. Transthoracic echocardiography plays a central role in diagnosing both rheumatic carditis and rheumatic heart disease. Despite the obvious medical need, no licensed Strep A vaccines are currently available, as their clinical development process faces several challenges, including concerns for cardiac safety. However, the development of Strep A vaccines has been recently relaunched by many vaccine developers. In this context, a reliable and consistent safety evaluation of Strep A vaccine candidates, including the use of transthoracic echocardiography for detecting cardiac adverse events, could greatly contribute to developing a safe and efficacious product in the near future. Here, we propose a framework for the consistent use of transthoracic echocardiography to proactively detect cardiac safety events in clinical trials of Strep A vaccine candidates. Throat and skin infections caused by certain types of bacteria, named Streptococcus pyogenes, are frequent worldwide; however, in many children from less developed countries and disadvantaged communities, infections with S. pyogenes lead to a condition called acute rheumatic fever, which usually affects the joints and the heart. Damage to the heart valves may evolve to rheumatic heart disease, a permanent condition with often life-threatening complications. Rheumatic heart disease is an important health problem in places and communities where S. pyogenes infections occur frequently. A vaccine against these bacteria would help lower the number of people with valvular heart disease; however, no such vaccine exists yet. Research on vaccines against S. pyogenes was on hold for almost 30 years because of initial concerns that vaccinated children might develop acute rheumatic fever more frequently. Recently, researchers started working again on vaccines against S. pyogenes, but concerns about the safety of such vaccines persist. Doctors can reliably use echocardiography to diagnose cases of rheumatic carditis (as a sign of acute rheumatic fever) and rheumatic heart disease. Here, we propose a simple approach for the consistent use of echocardiography in clinical research of vaccines against S. pyogenes that will allow the detection of any potential heart-related side effects of the vaccine.

Autres résumés

Type: plain-language-summary (eng)
Throat and skin infections caused by certain types of bacteria, named Streptococcus pyogenes, are frequent worldwide; however, in many children from less developed countries and disadvantaged communities, infections with S. pyogenes lead to a condition called acute rheumatic fever, which usually affects the joints and the heart. Damage to the heart valves may evolve to rheumatic heart disease, a permanent condition with often life-threatening complications. Rheumatic heart disease is an important health problem in places and communities where S. pyogenes infections occur frequently. A vaccine against these bacteria would help lower the number of people with valvular heart disease; however, no such vaccine exists yet. Research on vaccines against S. pyogenes was on hold for almost 30 years because of initial concerns that vaccinated children might develop acute rheumatic fever more frequently. Recently, researchers started working again on vaccines against S. pyogenes, but concerns about the safety of such vaccines persist. Doctors can reliably use echocardiography to diagnose cases of rheumatic carditis (as a sign of acute rheumatic fever) and rheumatic heart disease. Here, we propose a simple approach for the consistent use of echocardiography in clinical research of vaccines against S. pyogenes that will allow the detection of any potential heart-related side effects of the vaccine.

Identifiants

pubmed: 38494581
doi: 10.1007/s40268-024-00452-y
pii: 10.1007/s40268-024-00452-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. GlaxoSmithKline Biologicals S.A.

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Auteurs

Usman Nakakana (U)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy. usman.n.nakakana@gsk.com.

Alimamy Serry-Bangura (A)

Vaccines Global Safety, GSK, Siena, Italy.

Bassey Effiom Edem (BE)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.
Janssen Biologics BV, Leiden, the Netherlands.

Pietro Tessitore (P)

Vaccines Global Safety, GSK, Siena, Italy.

Leonardo Di Cesare (L)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.

Danilo Gomes Moriel (DG)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.

Audino Podda (A)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.
Independent consultant, Siena, Italy.

Iris Sarah De Ryck (IS)

Vaccines Global Safety, GSK, Siena, Italy.

Ashwani Kumar Arora (AK)

Vaccines Institute for Global Health (Global Health Vaccines R&D), GSK, Siena, Italy.

Classifications MeSH