women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo- controlled phase 1b trial”. [13] This is a randomised, single-blind, placebo-controlled phase 1b trial involving 93 healthy women receiving the ExPEC4V ® vaccine and 95 healthy women receiving placebo. The results show that although there are no serious adverse effects, 60% of the patients receiving treatment and 49% of the placebo group report adverse effects, probably related to intramuscular administration. In terms of effectiveness, immunoactive prophylaxis shows significant IgG responses for all serotypes that are maintained for up to 270 days. Although they show no reduction in the incidence of E. coli infections of the serotypes included in the vaccine, they do show a lower rate of E. coli urine infections of any serotype in the immunoactive prophylaxis group compared to
those receiving placebo, 0.207 episodes versus 0.463, respectively. Thus, the authors conclude that immunoprophylaxis may confer cross- immunity. Finally, the authors also postulate that the parenteral route of administration may be more effective in more severe cases than in mild cases. The conclusions are as follows: • R ecurrent UTIs have a significant impact on the quality of life of patients who suffer from them. • The first point of treatment is to control possible aetiological factors leading to the development of UTIs. • Non-antibiotic measures should be used as much as possible to prevent the development of UTIs. • Immunoprophylaxis is a useful tool to reduce the number of recurrent UTIs.
infections: a meta-analysis. Int J Antimicrob Agents. 2009;33(2):111-9. 6. Lorenzo-Gómez MF, Padilla-Fernández B, García- Cenador MB, Virseda-Rodríguez ÁJ, Martín-García I, Sánchez-Escudero A, et al. Comparison of sublingual therapeutic vaccine with antibiotics for the prophylaxis of recurrent urinary tract infections. Front Cell Infect Microbiol. 2015;5:50. 7. Lorenzo-Gómez MF, Foley S, Nickel JC, García-Cenador MB, Padilla-Fernández BY, González-Casado I, et al. Sublingual MV140 for Prevention of Recurrent Urinary Tract Infections. NEJM Evid [Internet]. 2022;1(4). 8. Lorenzo-Gómez MF, Padilla-Fernández B, García- Criado FJ, Mirón-Canelo JA, Gil-Vicente A, Nieto- Huertos A, et al. Evaluation of a therapeutic vaccine for the prevention of recurrent urinary tract infections versus prophylactic treatment with antibiotics. Int Urogynecology J. 2013;24(1):127-34. 9. Ramírez Sevilla C, Gómez Lanza E, Manzanera JL, Martín JAR, Sanz MÁB. Active immunoprophylaxis with uromune® decreases the recurrence of urinary tract infections at three and six months after treatment without relevant secondary effects. BMC Infect Dis. 2019;19(1):901.
10. Lorenzo-Gómez MF, Padilla-Fernández B, Flores-Fraile J, Valverde-Martínez S, González- Casado I, Hernández JMDD, et al. Impact of whole-cell bacterial immunoprophylaxis in the management of recurrent urinary tract infections in the frail elderly. Vaccine. 2021;39(42):6308- 14. 11. Nickel JC, Doiron RC. An Effective Sublingual Vaccine, MV140, Safely Reduces Risk of Recurrent Urinary Tract Infection in Women. Pathog Basel Switz. 2023;12(3):359. 12. Hopkins WJ, Elkahwaji J, Beierle LM, Leverson GE, Uehling DT. Vaginal mucosal vaccine for recurrent urinary tract infections in women: results of phase 2 clinical trial. J Urol. 2007;177(4):1349-53; quiz 1591. 13. Huttner A, Hatz C, van den Dobbelsteen G, Abbanat D, Hornacek A, Frölich R, et al. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial. Lancet Infect Dis. 2017;17(5):528-37.
UroVaxom ® (OM-89)
ExPEC4V
Uromune ® (MV 140)
Solco-Urovac ®
Intramuscular, 1 dose
Orally during 3 months
Sublingual during 3 months
Intramuscular or vaginal each week (3 weeks) and a booster dose Ten uropathogens dead (heat mediated): 6 serotypes E. coli, P. vulgaris, K. pneumoniae, M. Morganii, E. faecalis IgA and IgG production in the urogenital tract
Four bioconjugates containing O-antigens of E. coli: O1A, O2, O6A, O25B
E. coli lisade (18 serotypes)
Heat-inactivated whole bacteria: E. coli, K. pneumoniae, P. vulgaris, E. faecalis
Send your application to become member of one of the twelve YAU Working Groups now!
Production of specific antibodies
Stimulation of dendritic cells and cytokine- producing T-cells
Stimulation: dendritic cells, neutrophils and phagocytosis by macrophages
Submission deadlines: 1 March - 1 July - 1 November
References 1. Bonkat G, Bartoletti R, Bruyère F, Cai T, Geerlings SE, Kranz J, et al. EAU Guidelines on Urological Infections 2023. Available on: https://uroweb.org/guidelines/
3. Wagenlehner FME, Bjerklund Johansen TE, Cai T, Koves B, Kranz J, Pilatz A, et al. Epidemiology, definition and treatment of complicated urinary tract infections. Nat Rev Urol. octubre de 2020;17(10):586-600. 4. Prattley S, Geraghty R, Moore M, Somani BK. Role of Vaccines for Recurrent Urinary Tract Infections: A Systematic Review. Eur Urol Focus. 2020;6(3):593-604. 5. Naber KG, Cho YH, Matsumoto T, Schaeffer AJ. Immunoactive prophylaxis of recurrent urinary tract
Please check our website for details regarding the eligibility criteria and application procedure: www.uroweb.org/education/young-urologists-office-yuo/yau or contact the office via yau@uroweb.org
urological-infections/chapter/the-guideline 2. Malik RD, Wu YR, Zimmern PE. Definition of
Recurrent Urinary Tract Infections in Women: Which One to Adopt? Female Pelvic Med Reconstr Surg. 2018;24(6):424-429.
Table of Contents
European Urology Today June/July 2023
22
Powered by FlippingBook