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AzTrials

VaccinePhase 4TACTICNCT07818356

Comparative Study of Two Vaccination Schedules for the Subunit Herpes Zoster Vaccine in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disease Patients Treated With Anti-CD20 Therapy: an Open-label Randomised Controlled Trial

A Phase 4 study testing Two-dose M0-M2 vaccination schedule and Two-dose M0-M6 vaccination schedule in people with Vaccine and Varicella-zoster Virus, run by University Hospital, Toulouse at 24 sites in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Immunocompromised individuals, such as patients with multiple sclerosis (MS) or diseases of the neuromyelitis optica spectrum (NMOSD) treated with an anti-CD20 monoclonal antibody, present an increased risk of shingles. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Two-dose M0-M2 vaccination schedule and Two-dose M0-M6 vaccination schedule
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
24 sitesFrance
Study dates
20 Oct 2026to 30 Nov 2030
Phase
Phase 4
Are there results?
Not yet: the study is under way

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

  • Patients with Multiple Sclerosis (any clinical form) or Neuromyelitis optica spectrum disease seropositive for aquaporin-4 antibodies (AQP4+)
  • Aged 18 years or more
  • Treated with anti-CD20 mAbs (Rituximab IV or Ocrelizumab IV or SC) since < 2 years with dosing intervals of 6 months (and for Rituximab, treated with 1g per infusion)
  • Planned to receive the same anti-CD20 mAbs with dosing intervals of 6 months during the 13 months of the study (and for Rituximab, planned to receive 1g per infusion)
  • Known history in the medical file of varicella, or VZV IgG serology known to evidence a prior infection
  • Affiliated or beneficiary of a social security scheme
  • Written and informed consent
  • Understands and agrees to comply with the study procedures

Who cannot join

  • Temporary contraindication to vaccination (concurrent episode of acute fever >38.5°C)
  • Shingles in the last 12 months or VZV vaccination in the last 5 years
  • Patients already treated or supposed to be treated with Ofatumumab (another anti-CD20 mAbs but delivered with a monthly subcutaneous injection)
  • Patients who received high dose corticosteroids (methylprednisolone at a dose of ≥ 500 mg, administered over 1 to 5 days) in the 3 months prior to inclusion
  • Patients who have been exposed to Cladribine in the prior 12 months
  • Patients who received or were scheduled to receive any vaccination, except for influenza and SARS-CoV-2 vaccines during the epidemic season, within 2 weeks prior to the 2 RZV injections and up to 4 weeks after the second RZV injection
Show all 12Show fewer
  • Hypersensitivity to the active substance or to one of the excipients
  • Patient protected by the law (guardianship, curatorship)
  • Pregnancy or breast-feeding
  • Women of childbearing potential (WOCBP) without effective contraception throughout the duration of the trial
  • Criteria related to the use of ancillary anti-CD20 treatments (Rituximab and Ocrelizumab):
  • Hypersensitivity to the active substance or to any of the excipients Severe, active infections Severe immunodeficiency Severe heart failure or severe uncontrolled heart disease Known progressive malignancies

Trial locations and contacts

24 sites in 1 country. Contact the study team or a site near you to ask about taking part.

24 sites in 1 country

France24 sites
  • Jean Minjoz University Hospital

    Besançon, 25 000

    Eric Berger, MD, 03 81 66 80 98 ext. +33, eberger@chu-besancon.fr

    Eric Berger, MD

  • Pellegrin Hospital Group

    Bordeaux, 33 000

    Aurélie Ruet, PHD, 05 56 79 55 21 ext. +33, aurelie.ruet@chu-bordeaux.fr

    Aurélie Ruet, PHD

  • Côte de Nacre University Hospital

    Caen, 14 033

    Pierre Branger, MD, 02 31 06 46 17 ext. +33, branger-p@chu-caen.fr

    Pierre Branger, MD

  • Gabriel Montpied Hospital

    Clermont-Ferrand, 63 000

    Pierre Clavelou, PHD, 04 73 75 22 01 ext. +33, pclavelou@chu-clermontferrand.fr

    Pierre Clavelou, MD

  • GCS CHIC Henri Mondor

    Créteil, 94 000

    Alain Creange, PHD, 01 49 81 23 15 ext. +33, alain.creange@hmn.ap-hop-paris.fr

    Alain Creange, PHD

  • Dijon Hospital University

    Dijon, 21 000

    Thibault Moreau, PHD, 03 80 29 37 53 ext. +33, thibault.moreau@chu-dijon.fr

    Thibault Moreau, PHD

  • Nord Hospital - Grenoble University Hospital

    Grenoble, 38 700

    Olivier Casez, MD, 06 63 58 02 77 ext. +33, ocasez@chu-grenoble.fr

    Olivier Casez, MD

  • Libourne Hospital Center

    Libourne, 33 500

    Arnaud Gagnol, MD, 05 57 55 70 05 ext. +33, arnaud.gagnol@ch-libourne.fr

    Arnaud Gagnol, MD

  • Roger Salengro Hospital - Lille University Hospital

    Lille, 59 037

    Hélène Zephir, PHD, 03 20 44 57 65 ext. +33, helene.ZEPHIR@chu-lille.fr

    Hélène Zephir, PHD

  • Catholics Institut Hospitals Group

    Lille, 59 400

    Arnaud Kwiatkowski, PHD, 03 20 87 49 01 ext. +33, Kwiatkowski.Arnaud@ghicl.net

    Arnaud Kwiatkowski, PHD

  • Lyon Civil Hospices

    Lyon, 69 002

    Sandra Vukusic, PHD, 04 72 68 13 13 ext. +33, sandra.vukusic@chu-lyon.fr

    Sandra Vukusic, PHD

  • Gui de Chauliac Hospital - Montpellier University Hospital

    Montpellier, 34 295

    Xavier Ayrignac, PHD, 04 67 33 95 18 ext. +33, x-ayrignac@chu-montpellier.fr

    Xavier Ayrignac, PHD

  • Laennec Hospital

    Nantes, 44 800

    Sandrine Wiertlewski, MD, 02 40 16 52 85 ext. +33, sandrine.wiertlewski@chu-nantes.fr

    Sandrine Wiertlewski, MD

  • Pasteur Hospital

    Nice, 06 000

    Mikael Cohen, PHD, 04 92 03 79 01 ext. +33, cohen.m@chu-nice.fr

    Mikael Cohen, PHD

  • Nimes University Hospital

    Nîmes, 30 900

    Eric Thouvenot, PHD, 04 66 68 32 61 ext. +33, eric.thouvenot@chu-nimes.fr

    Eric Thouvenot, PHD

  • 15/20 Hospital

    Paris, 75 012

    Dalia Dimitri-Boulos, MD, 01 40 02 16 29 ext. +33, ddimitriboulos@15-20.fr

    Dalia Dimitri-Boulos, MD

  • Pitié Salpetrière Hospital

    Paris, 75 013

    Céline Louapre, PHD, 01 42 16 57 66 ext. +33, celine.louapre@aphp.fr

    Céline Louapre, PHD

  • Adolphe de Rothschild Hospital

    Paris, 75 019

    Marine Boudot de La Motte, MD, 01 48 03 68 52 ext. +33, mboudotdelamotte@for.paris.fr

    Marine Boudot de La Motte, MD

  • Intercommunal Hospital Center of Poissy Saint-Germain

    Poissy, 78 300

    Olivier Heinzlef, MD, 01 39 27 41 92 ext. +33, olivier.heinzlef@ght-yvelinesnord.fr

    Olivier Heinzlef, MD

  • La Miletrie University Hospital

    Poitiers, 86 000

    Amélie Dos Santos, MD, 05 49 44 44 44 ext. +33, Amelie.DOS-SANTOS@chu-poitiers.fr

    Amélie Dos Santos, MD

  • Pontchaillou Hospital

    Rennes, 35 000

    Laure Michel, PHD, 02 99 28 42 66 ext. +33, Laure.MICHEL@chu-rennes.fr

    Laure Michel, PHD

  • Charles Nicolle Hospital

    Rouen, 76 000

    Maxime Guillaume, MD, 02 32 88 89 90 ext. +33, Maxime.Guillaume@chu-rouen.fr

    Maxime Guillaume, MD

  • Purpan Hospital

    Toulouse, 31 300

    Jonathan Ciron, MD, 05 61 77 91 06 ext. +33, ciron.j@chu-toulouse.fr

    Jonathan Ciron, MD

  • Tours Hospital University

    Tours, 37 000

    Inès Doghri, MD, 02 47 47 80 23 ext. +33, I.DOGHRI@chu-tours.fr

    Inès Doghri, MD

Other trials in France

About this study

Immunocompromised individuals, such as patients with multiple sclerosis (MS) or diseases of the neuromyelitis optica spectrum (NMOSD) treated with an anti-CD20 monoclonal antibody, present an increased risk of shingles. The immunogenicity - and therefore the clinical effectiveness - of the recombinant vaccine against the varicella zoster virus based on glycoprotein E, recently recommended according to two-dose schedule two months apart in immunocompromised patients aged ≥ 18 years, could be significantly decreased when administered one month before and one month after the infusion of anti-CD20.

We hypothesize that, in patients with MS or NMOSD treated with anti-CD20 administered every six months, a two-dose M0-M6 vaccination schedule consisting of deferring the second dose six months after the first infusion, that is, five months after the anti-CD20 infusion, could improve vaccine immunogenicity and, consequently, the effectiveness of the vaccine.

Read the detailed description

Shingles, caused by reactivation of varicella zoster virus (VZV), is a common condition in immunocompromised people. Its prevention, which has long remained a medical need unmet among these patients, was improved thanks to the availability of the recombinant glycoprotein-based VZV vaccine E (gE). Based on demonstrated clinical efficacy and safety profile in the general population as well as in immunocompromised patients, this vaccine is recommended in France according to a two-person schedule doses spaced two months apart in immunocompromised patients aged ≥ 18 years. However, further studies are needed in order to optimize vaccination strategies according to the different types of immunosuppression.

Patients with MS or NMOSD, who are at increased risk of herpes zoster, are extensively treated with anti-CD20 monoclonal antibodies, which are known to significantly alter immune responses to vaccines, in particular when vaccination is carried out early after the infusion of anti-CD20.

We hypothesize that in patients with MS or NMOSD treated with anti-CD20 administered every six months, a two-dose M0-M6 vaccination schedule, consisting of deferring the second dose to six months after the first, that is, five months after the anti-CD20 infusion, could improve vaccine immunogenicity and, consequently, the effectiveness of the vaccine.

In this phase IV randomized, controlled, open-label, parallel-group trial, we will compare, within a homogeneous population of patients with MS or NMOSD receiving antiCD20, the humoral response induced by a two-dose vaccination schedule administered at 2 months (M0-M2, "2-month" or standard group) or 6 months (M0-M6, "6-month" or experimental group). After the screening and inclusion phase, patients randomized to the M0-M2 (standard) and M0-M6 (experimental) groups will receive a first dose of recombinant herpes zoster vaccine (RZV) one month before the next scheduled infusion of anti-CD20 monoclonal antibodies (M1). The second dose of RZV will be given at either 2 months ("2-month group", M2) or 6 months ("6-month group", M6). Patients will receive their usual anti-CD20 monoclonal antibody infusions at the appropriate time M1, M7 and M13. The primary outcome will be evaluated one month after the second vaccine dose (M3 for the "2 months" group and M7 for the "6 months" group). The kinetics, intensity, and persistence of humoral and cellular immune responses, as well as safety, will be analyzed as criteria for secondary judgments during the scheduled follow-up visits until M13.

Being tested
Two-dose M0-M2 vaccination schedule, Two-dose M0-M6 vaccination schedule
Keywords
herpes zoster, immunosuppression, anti-CD20 therapy, vaccination, immunogenicity, optimization
Medical subject headings
Chickenpox, Multiple Sclerosis, Herpes Zoster

What participants receive

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

  • Two-dose M0-M2 vaccination scheduleBiological

    Patients randomized to the "2 months" vaccination group will receive their first dose of RZV vaccine one month before the next scheduled infusion anti-CD20 monoclonal antibody (M0 corresponding to the visit during the first dose of vaccine, M1 at the time of scheduled anti-CD20 infusion).

    The second dose of RZV vaccine will be administered 2 months later. Patients will receive their regular anti-CD20 infusions at times M1, M7, and M13.

  • Two-dose M0-M6 vaccination scheduleBiological

    Patients randomized to the "6 months" vaccination group will receive their first dose of RZV vaccine one month before the next scheduled infusion anti-CD20 monoclonal antibody (M0 corresponding to the visit during the first dose of vaccine, M1 at the time of scheduled anti-CD20 infusion).

    The second dose of RZV vaccine will be administered 6 months later. Patients will receive their regular anti-CD20 infusions at times M1, M7, and M13.

Study groups in NCT07818356
Study groupRoleWhat they receive
2 months armActive comparatorPatients will receive the standard vaccination schedule in two doses in 2 months.
Receives: Biological: Two-dose M0-M2 vaccination schedule
6 months armExperimentalPatients will receive a vaccination schedule in two doses in 6 months.
Receives: Biological: Two-dose M0-M6 vaccination schedule

What is being measured

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

  1. Humoral vaccine response rate for IgG anti-VZV gE response

    It will be defined as the proportion of patients with at least a 4-fold increase in anti-VZV gE antibody titers (measured by ELISA) at 1 month after the 2nd vaccine dose compared to baseline (M0), or seroconversion for those who were seronegative at M0.

    Measured: 3 months for the " 2 months " group and 7 months for the " 6 months " group

Secondary outcomes (5)
  1. The humoral response in terms of Geometric Mean Titer (GMT) at 1 month after the 2nd vaccine dose.

    It will be assessed by the ratio (M0-M6 versus M0-M2 groups) of the adjusted Geometric Mean Titer (GMT) of anti-VZV gE IgG at 1 month after the 2nd vaccine dose.

    The adjusted GMT will correspond to the GMT at 1 month after the 2nd vaccine dose conditionally to the means of the log transformed GMT before vaccination at baseline (M0) calculated across the treatment groups.

    Measured: 3 months for the " 2 months " group and 7 months for the " 6 months " group

  2. Composite criteria of the humoral response up to M13

    The kinetics, intensity and persistance will be assessed by the Geometric Mean Titer (GMT) of anti-VZV gE IgG measured at baseline (M0) and up to M13: before the 2nd vaccine dose, 1 month after the 2nd vaccine dose, and prior to the next anti CD20 infusions at M7 and M13.

    Measured: 13 months

  3. Composite criteria of the cellular response at 1 month after the 2nd vaccine dose

    It will be assessed by the cellular vaccine response rate for gE-specific CD4[AIM+] T response measured 1 month after the 2nd vaccine dose.

    The cellular VRR is defined as the proportion of patients with a proportion of gE-specific CD4[AIM+] T cells at least 2 times above the cutoff after vaccination.

    The proportion of gE-specific CD4[AIM+] T cells among CD4 T cells is defined by the proportion of CD4 T cells expressing at least one Activation-Induced Marker (AIM), as detected by flow cytometry, following in vitro stimulation with a peptide pool covering the entire ectodomain of gE. The AIM include CD69, CD25, OX40, CD40L, and CD137. We will determine the cut-off of gE-specific CD4[AIM+] T cells by assessing cellular immune responses across a range of non-vaccinated, healthy individuals.

    Measured: 3 months for the " 2 months " group and 7 months for the " 6 months " group

  4. Composite criteria of the cellular response at M13

    The kinetics, intensity and persistance of the cellular response up to M13 will be assessed by the proportion of gE-specific CD4[AIM+] T cells among CD4 T cells measured at baseline (M0) and up to M13 : before the 2nd vaccine dose, 1 month after the 2nd vaccine dose, and prior to the next anti-CD20 infusions at M7 and M13.

    Measured: 13 months

  5. The vaccine safety

    The safety will be assessed by the adverse events including serious adverse events collected during the study.

    Measured: from M0 to month 13

Timeline

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

  1. First posted14 Sep 2026
  2. Study start20 Oct 2026 (estimated)
  3. Primary completion20 Jun 2030 (estimated)
  4. Study completion30 Nov 2030 (estimated)

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
160 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07818356
Sponsor's protocol ID
RC31/25/0535
Other IDs
PHRC 24-0185, 2025-525106-37-00, 2025
Acronym
TACTIC
Status last verified
Sep 2026
First submitted
7 Sep 2026
Last updated
14 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Two-dose M0-M2 vaccination schedule and Two-dose M0-M6 vaccination schedule in people with Vaccine and Varicella-zoster Virus, run by University Hospital, Toulouse at 24 sites 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 12 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: opening soon, as of the sponsor's last update on 14 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites 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. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Jonathan Ciron, MD (05 61 77 91 06 ext. +33, ciron.j@chu-toulouse.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Humoral vaccine response rate for IgG anti-VZV gE response (time frame: 3 months for the " 2 months " group and 7 months for the " 6 months " group). 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 14 Sep 2026.

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