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Published in: Clinical Drug Investigation 5/2024

Open Access 25-04-2024 | Shingles | Original Research Article

Differential Utility Losses in Herpes Zoster Cases Between Vaccinated and Unvaccinated Subjects: A Meta-analysis of Three Clinical Trials

Authors: Nikolaos Giannelos, Bernard Francq, Desmond Curran

Published in: Clinical Drug Investigation | Issue 5/2024

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Abstract

Background and Objective

Recombinant zoster vaccine (RZV) is approved in adults for the prevention of herpes zoster. The effect of RZV in moderating the severity of breakthrough cases of herpes zoster has been noted but not explicitly quantified before. In this study, a meta-analysis was undertaken to estimate differential utility losses between unvaccinated (Placebo) and vaccinated (RZV) subjects in breakthrough cases of herpes zoster from three RZV clinical trials.

Methods

Differential utility losses between the two groups were estimated in units of quality-adjusted life-years (QALYs), leveraging aggregate patient data from the ZOE-50 (NCT01165177), ZOE-70 (NCT01165229), and ZOE-HSCT (NCT01610414) clinical trials. Differential utility losses and the ratio of mean utility losses were analyzed using random-effects and fixed-effects meta-regression models.

Results

The mean QALY loss differences between the unvaccinated (Placebo) and vaccinated (RZV) groups were 0.008, 0.004, and 0.011 in the ZOE-50, ZOE-70, and ZOE-HSCT studies, respectively, yielding an overall estimated difference of 0.007 (95% confidence interval 0.002–0.012) QALYs. Quality-adjusted life-year loss in the vaccinated group was estimated to be 35.5% of the value in the placebo group. A sensitivity analysis estimated an overall difference of 0.005 (95% confidence interval 0.001–0.009) QALYs, corresponding to 48.6% of the QALY loss value in the placebo group.

Conclusions

Recombinant zoster vaccine is effective in alleviating disease severity in breakthrough cases of herpes zoster. The results may be useful in distinguishing QALY losses between vaccinated and unvaccinated cohorts in health economics studies, particularly cost-effectiveness analyses.
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Literature
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go back to reference Curran D, Matthews S, Rowley SD, Young JH, Bastidas A, Anagnostopoulos A, et al. Recombinant zoster vaccine significantly reduces the impact on quality of life caused by herpes zoster in adult autologous hematopoietic stem cell transplant recipients: a randomized placebo-controlled trial (ZOE-HSCT). Biol Blood Marrow Transplant. 2019;25(12):2474–81. https://doi.org/10.1016/j.bbmt.2019.07.036.CrossRefPubMed Curran D, Matthews S, Rowley SD, Young JH, Bastidas A, Anagnostopoulos A, et al. Recombinant zoster vaccine significantly reduces the impact on quality of life caused by herpes zoster in adult autologous hematopoietic stem cell transplant recipients: a randomized placebo-controlled trial (ZOE-HSCT). Biol Blood Marrow Transplant. 2019;25(12):2474–81. https://​doi.​org/​10.​1016/​j.​bbmt.​2019.​07.​036.CrossRefPubMed
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Metadata
Title
Differential Utility Losses in Herpes Zoster Cases Between Vaccinated and Unvaccinated Subjects: A Meta-analysis of Three Clinical Trials
Authors
Nikolaos Giannelos
Bernard Francq
Desmond Curran
Publication date
25-04-2024
Publisher
Springer International Publishing
Keyword
Shingles
Published in
Clinical Drug Investigation / Issue 5/2024
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-024-01355-1

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