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Splenectomised PatientsPhase 2SPLENEVAC-2NCT03873727

Revaccination With PPS23 Boosted or Not by PCV13 in Splenectomised Patients.

A Phase 2 study testing Prevenar13 (PCV13) and Pneumovax (PPS23) and Blood sample in people with Splenectomised Patients, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This research is a multi-center French randomized and double blind phase IIb clinical trial evaluating 2 revaccination strategies against pneumococcal infections among splenectomised patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Splenectomised Patients
What is being tested?
Prevenar13 (PCV13) and Pneumovax (PPS23) and Blood sample
Type of treatment
Vaccines
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
39 participants
Where
1 siteFrance
Study dates
27 Aug 2019to 16 May 2024
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Splenectomised patients.
  • For patients not enrolled in SPLENEVAC clinical trial: presence of Jolly Body at blood smear and spelenectomy confirmation by abdominal ultrasound.
  • Vaccinated according to the schedule of SPLENEVAC clinical trial (PCV13 / PPS23 two months later (until +4 months)), enrolled or not from this study. Vaccination of PPS23 must have been administered 5 years - 6 months/+ 1 year before inclusion.
  • Patients will be followed during the 24 months from the inclusion visit.
  • Patients must give written informed consent prior to any trial procedure.
  • Women of childbearing age must have an effective contraception during the first 13 months of the study.
  • Patients must be covered by social security regimen or equivalent.

Who cannot join

  • History of pneumococcal revaccination in the last five years.
  • Having received any another vaccines within 4 weeks prior to enrolment or who is planning to receive any vaccine (for example: ZOSTAVAX®) within the first 13 months of the study (excepted seasonal influenza vaccine which is permitted 4 weeks before and after each vaccination visit of the study and then allowed at any time during the study follow up. Furthermore, the vaccination against Sars-CoV-2 is allowed during the study with a minimum interval of 14 days between pneumococcal vaccine and Sars-Cov-2 vaccine injection)
  • History of known allergies to any component of both study vaccines (active substances, excipients or diphtheria toxoid).
  • History of anaphylactic reaction following vaccination.
  • Infusion of immunoglobulins within the three months preceding the inclusion.
  • Any pathology or condition that may impair the immune response, apart from splenectomy: immunosuppressive therapy in progress or in the 6 months prior to inclusion, hematopoietic stem cells allo / autograft, primary immunodeficiency, nephrotic syndrome, progressive neoplasia, evolutive cancer, cirrhosis, known infection to HIV and / or hepatitis B virus (HBV) (HBs Ag +) and / or hepatitis C virus (HCV), taking corticosteroids > 10mg for more than 14 days within the month preceding the inclusion , inhaled corticosteroid and cutaneous topical being allowed.
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  • Coagulation disorder contra-indicating intramuscularly injections.
  • Acute respiratory tract infection or severe acute febrile illness or systemic reaction which could represent a significant risk in case of vaccination within the month before inclusion.
  • Pregnancy, breastfeeding or positive pregnancy test up to 13 months after inclusion.
  • History of suspected or documented invasive pneumococcal infection within the year before inclusion.
  • Immunosuppressive factors associated.
  • Enrolment in any other clinical trial during the whole trial period except observational study.
  • Adults under protection

Trial locations and contacts

1 site in 1 country.

France1 site
  • CIC 1417 Cochin-Pasteur - GH Broca-Cochin-Hôtel-Dieu

    Paris, 75014

Other trials in France

About this study

Official title: Evaluation of Immunological Response Following a Revaccination With PPS23 Boosted or Not by PCV13 in Splenectomised Patients

This research is a multi-center French randomized and double blind phase IIb clinical trial evaluating 2 revaccination strategies against pneumococcal infections among splenectomised patients. The main objective is to evaluate at M13 the immunological response of 2 pneumococcal revaccination strategies (combined revaccination by a boost dose of PCV13 following 12 months later by PPS23, versus PPS23 alone) in splenectomised adults.

Read the detailed description

For the prevention of invasive pneumococcal diseases, two polysaccharide vaccines are currently available: a non-conjugate vaccine, Pneumovax® (PPS23), and a conjugate vaccine, Prevenar13® (PCV13), inducing protection against 23 and 13 pneumococcal serotypes, respectively. The PPS23 is considered weakly immunogenic, especially in infants, elderly and immunocompromised patients, while PCV13 is now available for adults. In France, in April 2017, the new recommendations for at risk patients including asplenic patients are to revaccinate by PPS23 at least five years after the previous PPS23. However a phenomenon of vaccine hyporesponsiveness and a risk of immune tolerance to pneumococcus after repeated administrations of PPS23 are described. Large doses of polysaccharide antigens recruit memory and naive B cells, resulting in the production of low and high avidity antibodies, while low doses only stimulate memory B cells, inducing high affinity antibodies. Because of that, Swiss current recommendations are to revaccinate with PCV13 at 5 years the splenectomised patients. The recommendations of revaccination by PPS23 for USA or PCV13 for Switzerland have never been evaluated in clinical trial. Moreover, using combined PCV13/PPS23 could increase serotype coverage. Studying the immune response following combined revaccination by a boost dose of PCV13 following by PPS23 versus PPS23 alone will help to document and improve the vaccine recommendations.

The main objective is to evaluate at M13 the immunological response of 2 pneumococcal revaccination strategies (combined revaccination by a boost dose of PCV13 following 12 months later by PPS23, versus PPS23 alone), in splenectomised adults.

The primary endpoint is the proportion of patients responding to a minimum of 5 of the 9 serotypes analysed (9 serotypes among the 12 common serotypes to both PPS23 and PCV13: 1, 3, 6B, 7F, 9V, 14, 19A, 19F, and 23F) at M13 in each arm. A responder to a serotype is defined as a four-fold increase of the rate of OPA (OpsonoPhagocytic Assay) compared to baseline and titer ≥ LLOQ (Lower Limit of Quantification).

Being tested
Prevenar13 (PCV13) and Pneumovax (PPS23), Placebo / Pneumovax (PPS23), Blood sample
Keywords
Vaccination / Re-vaccination, Asplenic patient, Splenectomy, Pneumococcal infections, immunological response, Pneumovax, Prevenar13
Medical subject headings
Pneumococcal Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Prevenar13 (PCV13) and Pneumovax (PPS23)Biological

    One dose of PCV13 at Month 0 and one dose of PPS23 at Month 12

  • Placebo / Pneumovax (PPS23)Biological

    One dose of Placebo at Month 0 and one dose of PPS23 at Month 12

  • Blood sampleBiological

    an additional 5 mL sample of blood at one of the visits, preferably at the first visit, concerning patients included in Parisian centers who did not participate in SPLENEVAC 1 study.

Study groups in NCT03873727
Study groupRoleWhat they receive
Prevenar13/ PneumovaxExperimentalPrime-boost strategy combining a single dose of 13-valent pneumococcal conjugate vaccine (Prevenar 13, PCV13) at month 0 (M0) followed by a single dose of 23-valent unconjugated vaccine (Pneumovax, PPS23) at month 12 (M12).
Receives: Biological: Prevenar13 (PCV13) and Pneumovax (PPS23); Biological: Blood sample
Placebo / PneumovaxPlacebo comparatorStandard strategy combining a single dose of placebo vaccine (Prevenar 13 placebo) at month 0 (M0) followed by a single dose of 23-valent unconjugated vaccine (Pneumovax, PPS23) at month 12 (M12)
Receives: Biological: Placebo / Pneumovax (PPS23); Biological: Blood sample

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Immunogenicity

    Immune response at M13 against minimum of 5 of the 9 serotypes analysed (9 serotypes among the 12 common serotypes to both PPS23 and PCV13: 1, 3, 6B, 7F, 9V, 14, 19A, 19F, and 23F) in each arm.

    A responder to a serotype is defined as a four-fold increase of the rate of OpsonoPhagocytic Assay (OPA) compared to baseline (M0) and titer ≥ Lower Limit of Quantification (LLOQ).

    Measured: at Month 13

Secondary outcomes (12)
  1. Enzyme-linked immunosorbent assay (ELISA) antibody dosages

    ELISA antibody concentration against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F), and, the proportion of positive serotypes: serotype is considered positive if the immunoglobulin G (IgG) antibody concentration in ELISA shows a two-fold increase from baseline (M0) in each arm from baseline.

    Measured: Month 0 to Month 24

  2. Enzyme-linked immunosorbent assay (ELISA) antibody dosages

    ELISA antibody concentration against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F), and, the proportion of positive serotypes: serotype is considered positive if the IgG antibody concentration is ≥ 1μg/ml in each arm from baseline.

    Measured: Month 0 to Month 24

  3. Enzyme-linked immunosorbent assay (ELISA) antibody dosages

    ELISA antibody concentration against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F), and, the proportion of positive serotypes: serotype is considered positive if the IgG antibody concentration shows a two-fold increase from baseline (M0) in each arm and IgG ≥ 1μg/ml from baseline.

    Measured: Month 0 to Month 24

  4. Titration of OPA -

    OPA titers against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F) and the proportion of positive serotype: serotype is considered positive if the antibody titer shows a four-fold increase from baseline (M0).

    Measured: at Month 0, Month 13 and Month 24

  5. Titration of OPA -

    OPA titers against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F) and the proportion of positive serotype: serotype is considered positive if the antibody titer ≥ LLOQ.

    Measured: at Month 0, Month 13 and Month 24

  6. Titration of OPA -

    OPA titers against 9 common serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F) and the proportion of positive serotype: serotype is considered positive if the antibody titer shows a four-fold increase from baseline (M0) and titer ≥ LLOQ.

    Measured: at Month 0, Month 13 and Month 24

  7. ELISA antibody dosages

    ELISA antibody concentration against 3 uncommon specific serotypes of PPS23 (12F, 10A and15B) and the proportion of positive serotypes: serotype is considered positive if the IgG antibody concentration shows a two-fold increase from baseline (M12) in each arm and IgG ≥ 1 μg/ml

    Measured: at Month 12, Month 13 and Month 24

  8. ELISA antibody dosages

    ELISA antibody concentration against 3 uncommon specific serotypes of PPS23 (12F, 10A and 15B) and the proportion of positive serotypes: serotype is considered positive if the IgG antibody concentration shows a two-fold increase from baseline (M12) in each arm.

    Measured: at Month 12, Month 13 and Month 24

  9. ELISA antibody dosages

    ELISA antibody concentration against 3 uncommon specific serotypes of PPS23 (12F, 10A and 15B) and the proportion of positive serotypes: serotype is considered positive if the IgG antibody concentration in ELISA is ≥ 1μg/ml in each arm.

    Measured: at Month 12, Month 13 and Month 24

  10. Sustainability and evolution of the immune response

    Measure of ELISA concentration and OPA titers for the 9 PCV13 serotypes in each arm.

    Measured: at Month 0 and Month 24

  11. ELISA antibody dosages

    ELISA antibody concentration against 9 common specific serotypes (1, 3, 6B, 7F, 9V, 14, 19A, 19F and 23F) and the proportion of positive serotype: serotype is considered positive if the IgG antibody concentration in ELISA and shows a two-fold increase from baseline (M0) in each arm in SPLENEVAC 1

    Measured: at Month 3

  12. Percentage of patients presenting local or systemic reactions post-immunization

    Number of subjects with local and systemic reactions following vaccinations (tolerability) in each arm.

    Measured: Month0 to Month 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Mar 2019
  2. Study start27 Aug 2019
  3. Primary completion24 May 2022
  4. Study completion16 May 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
39 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03873727
Sponsor's protocol ID
P170934J
Other IDs
2018-003068-29, 2018
Acronym
SPLENEVAC-2
Status last verified
Jun 2026
First submitted
12 Feb 2019
Last updated
1 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Prevenar13 (PCV13) and Pneumovax (PPS23) and Blood sample in people with Splenectomised Patients, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Immunogenicity (time frame: at Month 13). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jul 2026.

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