美国大学2015开始的试验，抗疟疾药物对狂犬病疫苗的影响，认为与其他两种药物相比，氯喹有明显抑制抗体的作用。

美国大学2015开始的试验，抗疟疾药物对狂犬病疫苗的影响，认为与其他两种药物相比，氯喹有明显抑制抗体的作用。

Effect of Antimalarial Drugs to Rabies Vaccine for Post-exposure Prophylaxis. (MALRAB)

https://clinicaltrials.gov/ct2/show/results/NCT02564471

 

 

 

 

 

 2020 Mar 2;221(6):927-933.

 doi: 10.1093/infdis/jiz558.

Effect of Antimalarial Drugs on the Immune Response to Intramuscular Rabies Vaccination Using a Postexposure Prophylaxis Regimen

Timothy P Endy 1 2, Paul B Keiser 3, Don Cibula 4, Mark Abbott 1, Lisa Ware 1, Stephen J Thomas 1, Mark E Polhemus 1

Affiliations expand

• PMID: 31743394
•  
• DOI: 10.1093/infdis/jiz558

Abstract

Background: Chloroquine can impair the immune responses to intradermal rabies vaccination. Current guidelines recommend an extra intramuscular dose be given for postexposure prophylaxis in previously unvaccinated persons taking any antimalarial drug.

Methods: We conducted a randomized, open-label, single-site study in 103 previously unvaccinated healthy adults age ≥18 to ≤60 years old to evaluate the effects of chloroquine, atovaquone/proguanil (Malarone), and doxycycline on the antibody response to a purified chick embryo cell vaccine, given on a postexposure prophylaxis schedule. All treatment groups received antimalarials 14 days prior to and during vaccination.

Results: All subjects achieved accepted neutralizing antibody titers of ≥0.5 IU/mL following the second rabies vaccination dose and maintained this protection through the duration of the study. We observed a reduction in rabies antibody geometric mean titer in the chloroquine versus control groups 28 days after vaccination: 2.3 versus 6.87 IU/mL, respectively (P < .001, t test). A significant difference was not observed for those taking Malarone or doxycycline.

Conclusions: We conclude that there is no reduction of rabies antibody response in subjects taking Malarone or doxycycline, but a significant reduction in those taking chloroquine; however, accepted antibody levels were achieved for all 3 antimalarials.

Clinical trials registration: NCT02564471.

Keywords: antimalarial drugs; prophylaxis; rabies; vaccination.

https://pubmed.ncbi.nlm.nih.gov/31743394/