Evaluation of Shingrix vaccine against Herpes Zoster

173 p.
ill.
1 BACKGROUND 18 -- 1.1 HERPES ZOSTER .18 -- 1.2 TREATMENT .20 -- 1.3 VACCINE .21 -- 2 RESEARCH QUESTIONS .22 -- 3 BURDEN OF DISEASE OF HZ IN BELGIUM .22 -- 3.1 METHODS 22 -- 3.2 INCIDENCE OF HZ 22 -- 3.2.1 Belgian data 23 -- 3.2.2 International data .34 -- 3.2.3 Risk of recurrence 42 -- 3.2.4 Discussion 42 -- 3.3 INCIDENCE OF POSTHERPETIC NEURALGIA (PHN) .43 -- 3.3.1 Belgian data 43 -- 3.3.2 International data .44 -- 3.3.3 Discussion 50 -- 3.4 OTHER COMPLICATIONS 51 -- 3.4.1 Ocular complications 51 -- 3.4.2 Cerebrovascular and cardiac complications 51 -- 3.4.3 Other complications 55 -- 3.5 HOSPITALISATION 55 -- 3.5.1 Belgian data 55 -- 3.5.2 International data .66 -- 3.5.3 Discussion 66 -- 3.6 MORTALITY RATES .67 -- 3.6.1 Belgian data 67 -- 3.6.2 International data .69 -- 3.6.3 Discussion 70 -- 3.7 QUALITY OF LIFE 72 -- 3.7.1 Disease-specific instruments .72 -- 3.7.2 Generic Instruments 74 -- 3.8 VACCINE-TARGETABLE RISK FACTORS 76 -- 3.8.1 Age 76 -- 3.8.2 Immunosuppression 76 -- 3.8.3 Other risk factors 78 -- 4 VACCINE EFFICACY AND SAFETY 79 -- 4.1 METHODS 79 -- 4.1.1 Information sources and literature search 80 -- 4.1.2 Screening process 80 -- 4.1.3 Data items and abstraction process 80 -- 4.1.4 Quality appraisal and risk of bias assessment 81 -- 4.1.5 Statistical approach .81 -- 4.2 RESULTS 81 -- 4.2.1 Literature search 81 -- 4.2.2 Quality appraisal/risk of bias 83 -- 4.3 CLINICAL EFFICACY AND SAFETY IN IMMUNOCOMPETENT INDIVIDUALS (PIVOTAL ZOE-50 -- AND ZOE-70 TRIALS) .83 -- 4.3.1 Prevention of Herpes Zoster 87 -- 4.3.2 Prevention of Post Herpetic Neuralgia (PHN) 89 -- 4.3.3 Prevention of other complications and hospitalisations 91 -- 4.3.4 Adverse events .91 -- 4.3.5 Immunogenicity .93 -- 4.3.6 Discussion 94 -- 4.4 CLINICAL EFFICACY AND SAFETY IN IMMUNOCOMPROMISED PATIENTS .95 -- 4.4.1 Haematopoietic Stem Cell Transplantation 98 -- 4.4.2 Haematological Malignancies 98 -- 4.4.3 Renal transplant 99 -- 4.4.4 Solid tumour 99 -- 4.4.5 HIV-infected patients 100 -- 4.4.