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Nurdin A, Movieta Nency Y, Maddeppungeng M, Sekartini R, Mulia Sari R, Surachman F, Fitry Yani F, Raveinal, Anggrainy F, Hafiz A, Linosefa, Machmud R, Awaliyah Deza P, Rujiana V, Bella Rahimi M, Farhanah N, Gundi Pramudo S, Hapsari R, Tri Anantyo D, Mulyono, Mahati E, Maharani N, Darma S, Husni Esa Darussalam A, Shakinah S, Nasrum Massi M, Soedjatmiko. Immunogenicity and safety of SARS-CoV-2 recombinant protein subunit vaccine (IndoVac) adjuvanted with alum and CpG 1018 in Indonesian adults: A phase 3, randomized, active-controlled, multicenter trial. Vaccine 2024; 42:3009-3017. [PMID: 38575433 DOI: 10.1016/j.vaccine.2024.03.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Bio Farma has developed a recombinant protein subunit vaccine (IndoVac) that is indicated for active immunization in population of all ages. This article reported the results of the phase 3 immunogenicity and safety study in Indonesian adults aged 18 years and above. METHODS We conducted a randomized, active-controlled, multicenter, prospective intervention study to evaluate the immunogenicity and safety of IndoVac in adults aged 18 years and above. Participants who were SARS-CoV-2 vaccine-naïve received two doses of either IndoVac or control (Covovax) with 28 days interval between doses and were followed up until 12 months after complete vaccination. RESULTS A total of 4050 participants were enrolled from June to August 2022 and received at least one dose of vaccine. The geometric mean ratio (GMR) of neutralizing antibody at 14 days after the second dose was 1.01 (95 % confidence interval (CI) 0.89-1.16), which met the WHO non-inferiority criteria for immunobridging (95 % CI lower bound > 0.67). The antibody levels were maintained through 12 months after the second dose. The incidence rate of adverse events (AEs) were 27.95 % in IndoVac group and 32.15 % in Covovax group with mostly mild intensity (27.70 %). The most reported solicited AEs were pain (14.69 %) followed by myalgia (7.48 %) and fatigue (6.77 %). Unsolicited AEs varied, with each of the incidence rate under 5 %. There were no serious AEs assessed as possibly, probably, or likely related to vaccine. CONCLUSIONS IndoVac in adults showed favourable safety profile and elicited non-inferior immune response to Covovax. (ClinicalTrials.gov: NCT05433285, Indonesian Clinical Research Registry: INA-R5752S9).
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Affiliation(s)
| | | | | | - Rini Sekartini
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | | | | | - Raveinal
- Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | | | - Al Hafiz
- Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | - Linosefa
- Faculty of Medicine, Universitas Andalas, Padang, Indonesia
| | | | | | | | | | - Nur Farhanah
- Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | | | | | | | - Mulyono
- Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Endang Mahati
- Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Nani Maharani
- Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Sidrah Darma
- Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia
| | | | | | | | - Soedjatmiko
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Jonny J, Putranto TA, Yana ML, Sitepu EC, Irfon R, Ramadhani BP, Sofro MAU, Nency YM, Lestari ES, Triwardhani R, Mujahidah, Sari RK, Soetojo NA. Safety and efficacy of dendritic cell vaccine for COVID-19 prevention after 1-Year follow-up: phase I and II clinical trial final result. Front Immunol 2023; 14:1122389. [PMID: 37404828 PMCID: PMC10315914 DOI: 10.3389/fimmu.2023.1122389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/24/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction Interim analysis of phase I and phase II clinical trials of personalized vaccines made from autologous monocyte-derived dendritic cells (DCs) incubated with S-protein of SARS-CoV-2 show that this vaccine is safe and well tolerated. Our previous report also indicates that this vaccine can induce specific T-cell and B cell responses against SARS-CoV-2. Herein, we report the final analysis after 1 year of follow-up regarding its safety and efficacy in subjects of phase I and phase II clinical trials. Methods Adult subjects (>18 years old) were given autologous DCs derived from peripheral blood monocytes, which were incubated with the S-protein of SARS-CoV-2. The primary outcome is safety in phase I clinical trials. Meanwhile, optimal antigen dosage is determined in phase II clinical trials. Corona Virus Disease 2019 (COVID-19) and Non-COVID-19 adverse events (AEs) were observed for 1 year. Results A total of 28 subjects in the phase I clinical trial were randomly assigned to nine groups based on antigen and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) dosage. In the phase II clinical trial, 145 subjects were randomly grouped into three groups based on antigen dosage. During the 1-year follow-up period, 35.71% of subjects in phase I and 16.54% in phase II had non-COVID AEs. No subjects in phase I experienced moderate-severe COVID-19. Meanwhile, 4.31% of subjects in phase II had moderate-severe COVID-19. There is no difference in both COVID and non-COVID-19 AEs between groups. Conclusions After 1 year of follow-up, this vaccine is proven safe and effective for preventing COVID-19. A phase III clinical trial involving more subjects should be conducted to establish its efficacy and see other possible side effects.
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Affiliation(s)
- Jonny Jonny
- Installation of Cellcure Development, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
- Faculty of Medicine University of Pembangunan Nasional “Veteran” Jakarta, Jakarta, Indonesia
| | - Terawan Agus Putranto
- Installation of Cellcure Development, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
| | - Martina Lily Yana
- Installation of Cellcure Development, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
| | - Enda Cindylosa Sitepu
- Installation of Cellcure Development, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
| | - Raoulian Irfon
- Installation of Cellcure Development, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
| | | | | | - Yetty Movieta Nency
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Endang Sri Lestari
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Ria Triwardhani
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Mujahidah
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Retty Karisma Sari
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Nur Alaydrus Soetojo
- Dr. Kariadi Hospital/Faculty of Medicine, Diponegoro University, Semarang, Indonesia
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Gunawan RA, Widyastiti NS, Ariosta A, Pratiwi R, Retnoningrum D, Ngestiningsih D, Nency YM. The differences of lactate dehydrogenase and activin A levels among thalassemia major and non-thalassemia. Bali Med J 2021. [DOI: 10.15562/bmj.v10i3.2241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Caroline POL, Widyastiti NS, Ariosta A, Pratiwi R, Retnoningrum D, Ngestiningsih D, Nency YM. The differences of 25-Hydroxyvitamin D and malondialdehyde levels among thalassemia major and non-thalassemia. Bali Med J 2021. [DOI: 10.15562/bmj.v10i2.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ramadhania FA, Asmara Putri RI, Setiawati E, Nency YM. Senam Sehat Anak Indonesia Improve Peak Expiratory Flow Rate in Children with Obesity. Sains Medika 2021. [DOI: 10.30659/sainsmed.v11i2.7598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction: Excessive fat accumulation in the obese child causes complex problems in the respiratory system. Respiratory system function can be improved by exercise. One exercise model that is suitable for children is Senam Sehat Anak Indonesia (SSAI). The quality of the respiratory function system is measured using Peak Expiratory Flow Rate (PEFR).Objective: to validate the PEFR’s differences in obese children before and after performing SSAI.Methods: This research using one group pre-posttest experimental design with total sample of 20 obese children using purposive sampling method. The research instrument uses weight scale, height scale, and peak flow meter. SSAI was given to all subjects twice a week for six weeks. Paired T Test statistical analysis was used to examine the PEFR’s differences before and after performing SSAI, considered significant if p<0.05.Results: The PEFR’s mean of all subjects before performing SSAI was 258.25 ± 39.51 L∕minute, while PEFR’s mean after performing SSAI twice a week for 6 weeks was 282.50 ± 43.03 L∕minute, (p=0,000).Conclusion: The PEFR’s mean of obese children was increase significantly after performing SSAI twice a week for 6 weeks
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Nency YM, Sumanti D. Latar Belakang Penyakit pada Penggunaan Transfusi Komponen Darah pada Anak. SP 2016. [DOI: 10.14238/sp13.3.2011.159-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Latar belakang.Aplikasi transfusi darah dalam klinis sehari-hari dapat sebagai terapi pengganti maupun suportif. Sesuai pertimbangan risiko dan manfaat tranfusi komponen darah seperti thrombocyt concentrate(TC) packed red cell(PRC), fresh frozen plasma(FFP), platelete rich plasma (PRP), dan cryoprecipitate/kriopresipitat lebih direkomendasikan daripada whole blood(WB). Tujuan.Mengetahui hubungan antara latar belakang penyakit dengan penggunaan transfusi komponen darah.Metode.Penelitian retrospekstif dilakukan di Ruang Anak Rumah Sakit Dr Kariadi Semarang. Data diperoleh dari register bank darah rumah sakit tahun 2008-2010. Latar belakang penyakit ditentukan dengan mengidentifikasi diagnosis pada setiap kasus transfusi. Komponen darah yang diteliti PRC, TC, FFP, PRP, dan kriopresipitat. Utilisasi dengan menghitung total jumlah komponen darah yang dipakai per diagnosis penyakit, dan rerata pemakaian produk darah per jumlah kasus terindikasi transfusi per tahun. Analisis uji statistik hubungan dengan menggunakan Chi square.Hasil.Terdapat peningkatan rerata utilisasi darah 5678 unit darah per tahun. Terdapat peningkatan penggunaan selama 3 tahun terakhir, secara berurutan adalah 3751, 6496, dan 6787 unit darah (p<0.001). Komponen darah yang paling banyak digunakan berturut-turut adalah TC 3228 unit, PRC 1682 unit, FFP 295 unit, PRP 224 unit, dan cryo133 unit. Pasien leukemia merupakan pengguna komponen darah terbanyak dengan rerata pemakaian per tahun 2098 unit, diikuti oleh sepsis 893 unit, dan thalassemia 568 unit. Rasio kebutuhan PRC terbanyak untuk kasus penyakit jantung (2,23) diikuti penyakit ginjal (2,25) dan thalassemia (1,7). Untuk penggunaan TC, terbanyak berturut-turut adalah ITP (14,70 unit), anemia aplastik (9,8 unit), dan leukemia (6 unit). Terdapat hubungan antara diagnosis penyakit dengan penggunaan transfusi komponen PRC, TC, dan plasma (p<0,001).Kesimpulan.Terdapat hubungan antara latar belakang penyakit penyebab dengan penggunaan transfusi komponen darah. Leukemia, sepsis, dan thalassemia adalah latar belakang penyakit yang paling banyak menggunakan transfusi komponen darah. Berturut turut komponen darah yang banyak digunakan adalah konsentrat trombosit, komponen sel darah merah, serta plasma darah segar.
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Utami AA, Putranti AH, Nency YM, Sudijanto E. Initial brain CT scan and shunting outcomes in children with hydrocephalus. PI 2013. [DOI: 10.14238/pi53.4.2013.200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Hydrocephalus is one of the most common clinicalconditions affecting the central nervous system, with a congenitalhydrocephalus incidence of 3-4 per 1000 births. Incidence ofacquired types of hydrocephalus is unknown. Brain computerisedtomography (CT) scan can be used to assess the size of ventriclesand other structures. Shunting has long been performed toalleviate hydrocephalus. Shunting has dramatically changed theoutlook of children with hydrocephalus, with many of them havingnormal life expectancies and attaining normal intelligence.Objective To determine the outcomes of shunting in childrenwith hydrocephalus based on initial brain CT scan.Methods We performed a cross-sectional study in Dr. KariadiHospital. Initial brain CT scan data were collected from themedical records of children admitted to the Neurosurgery Wardfor ventriculoperitoneal (VP) shunt surgery from January 2009to December 2010. We studied the brain CT scan findings beforeVP shunt surgery and the outcomes of the children after VP shuntsurgery. Radiological findings were determined by a radiologistresponsible at that time.Results This study consisted of 30 subjects, 19 boys and 11girls. Initial brain CT scans to assess disease severity revealed thefo llowing conditions: lateral ventricle dilatation in 7 subjects,lateral and third ventricle dilatation in 16 subjects, and lateral,third and fourth ventricle dilatation in 7 subjects. After VPshunt surgery, 3 subjects in the lateral, third and fourth ventricledilatation category died. They were grouped according to theircondition. Group 1 consisted of subjects with only lateral ventricledilatation and subjects with lateral and third ventricle dilatation(23 subjects), while group 2 consisted of subjects with lateral,third and fourth ventricle dilatation (7 subjects). More survivorswere found in group 1 than those in group 2.Conclusion Less severe initial brain CT scan findings areassociated with better shunting outcomes children withhydrocephalus.
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Anita Utami A, Hikmah Putranti A, Movieta Nency Y, Sudijanto E. Initial brain CT scan and shunting outcomes in children with hydrocephalus. PI 2013. [DOI: 10.14238/pi53.4.2013.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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