PEPtalk2: results of a pilot randomised controlled trial to compare VZIG and aciclovir as postexposure prophylaxis (PEP) against chickenpox in children with cancer

Jessica Bate, Stephen Baker, Judith Breuer, Julia C. Chisholm, Juliet Gray, Sophie Hambleton, Aimee Houlton, Mark Jit, Stephen Lowis, Guy Makin, Catherine O'Sullivan, Soonie R. Patel, Robert Phillips, Neil Ransinghe, Mary Elizabeth Ramsay, Roderick Skinner, Keith Wheatley, Paul T. Heath

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4 Citations (Scopus)
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Abstract

Objective
To determine the likely rate of patient randomisation and to facilitate sample size calculation for a full-scale phase III trial of varicella zoster immunoglobulin (VZIG) and aciclovir as postexposure prophylaxis against chickenpox in children with cancer.

Design
Multicentre pilot randomised controlled trial of VZIG and oral aciclovir.

Setting
England, UK.

Patients
Children under 16 years of age with a diagnosis of cancer: currently or within 6 months of receiving cancer treatment and with negative varicella zoster virus (VZV) serostatus at diagnosis or within the last 3 months.

Interventions
Study participants who have a significant VZV exposure were randomised to receive PEP in the form of VZIG or aciclovir after the exposure.

Main outcome measures
Number of patients registered and randomised within 12 months of the trial opening to recruitment and incidence of breakthrough varicella.

Results
The study opened in six sites over a 13-month period. 482 patients were screened for eligibility, 32 patients were registered and 3 patients were randomised following VZV exposure. All three were randomised to receive aciclovir and there were no cases of breakthrough varicella.

Conclusions
Given the limited recruitment to the PEPtalk2 pilot, it is unlikely that the necessary sample size would be achievable using this strategy in a full-scale trial. The study identified factors that could be used to modify the design of a definitive trial but other options for defining the best means to protect such children against VZV should be explored.

Trial registration number
ISRCTN48257441, EudraCT number: 2013-001332-22, sponsor: University of Birmingham.
Original languageEnglish
Article number10.1136
Pages (from-to)25-29
Number of pages5
JournalArchives of Disease in Childhood
Volume104
Early online date5 May 2018
DOIs
Publication statusPublished - 13 May 2018

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