<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Hannah M Garcia Garrido</style></author><author><style face="normal" font="default" size="100%">Bridget van Put</style></author><author><style face="normal" font="default" size="100%">Cornelis A de Pijper</style></author><author><style face="normal" font="default" size="100%">Cornelis Stijnis</style></author><author><style face="normal" font="default" size="100%">Martin P Grobusch</style></author><author><style face="normal" font="default" size="100%">Abraham Goorhuis</style></author></authors><secondary-authors><author><style face="normal" font="default" size="100%">Sanne Terryn</style></author><author><style face="normal" font="default" size="100%">Steven Van Gucht</style></author></secondary-authors><tertiary-authors><author><style face="normal" font="default" size="100%">Geert R D'Haens</style></author></tertiary-authors><subsidiary-authors><author><style face="normal" font="default" size="100%">Phyllis I Spuls</style></author><author><style face="normal" font="default" size="100%">Marleen G Van de Sande</style></author></subsidiary-authors></contributors><titles><title><style face="normal" font="default" size="100%">Immunogenicity and one-year boostability of a 3-dose intramuscular rabies pre-exposure prophylaxis schedule in adults receiving immunosuppressive monotherapy: a prospective single-Centre clinical trial.</style></title><secondary-title><style face="normal" font="default" size="100%">J Travel Med</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2022 Dec 08</style></date></pub-dates></dates><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;BACKGROUND: &lt;/b&gt;For immunocompromised patients (ICPs), administration of rabies immunoglobulins (RIG) after exposure is still recommended regardless of prior vaccination, due to a lack of data. We aimed to assess the one-year boostability of a 3-dose rabies pre-exposure prophylaxis (PrEP) schedule in individuals using immunosuppressive monotherapy.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;In this prospective study, individuals on immunosuppressive monotherapy with a conventional immunomodulator (cIM) or a TNF-alpha inhibitor (TNFi) for a chronic inflammatory disease received a 3-dose intramuscular PrEP schedule (days 0,7,21-28) with 1&amp;nbsp;mL Rabipur®, followed by a 2-dose simulated post-exposure prophylaxis (PEP) schedule (days 0,3) after 12&amp;nbsp;months. Rabies neutralizing antibodies were assessed at baseline, on Day 21-28 (before 3rd PrEP dose), Day 60, Month 12 and Month 12 + 7&amp;nbsp;days. The primary outcome was one-year boostability, defined as the proportion of patients with a neutralizing antibody titre of ≥ 0.5&amp;nbsp;IU/mL at Month 12 + 7&amp;nbsp;days. Secondary outcomes were geometric mean titres and factors associated with the primary endpoint.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;We included 56 individuals, of whom 52 completed the study. The one-year boostability was 90% (47/52) with a GMT of 6.16 (95% CI 3.83-9.91). All participants seroconverted at some point in the study. Early response to PrEP (at day 21-28) was significantly associated with 100% boostability (Odds ratio 51; 95% confidence interval [5.0-6956], p &amp;lt; 0.01). The vaccination schedule was safe and well tolerated. No vaccine-related serious adverse events occurred.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;CONCLUSION: &lt;/b&gt;In patients using immunosuppressive monotherapy, a 3-dose rabies PrEP schedule followed by a 2-dose PEP schedule is immunogenic, with all patients seroconverting at some point in the study. Although boostability 7&amp;nbsp;days after PEP was not 100%, nobody would wrongly be denied RIG when only administered to those who responded early to PrEP, while reducing administration of RIG by 73%.&lt;/p&gt;
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