Clinical efficiency of quadrivalent HPV (types 6/11/16/18) vaccine in patients with recurrent respiratory papillomatosis

Abstract

The aim of the study was to assess the clinical efficiency of quadrivalent HPV (types 6/11/16/18) vaccine in patients with recurrent respiratory papillomatosis (RRP). This was a prospective study of patients with RRP treated from January 2009 to July 2012 at the Ear, Nose and Throat Department of the Emergency County Hospital of Cluj-Napoca, Romania. Demographic characteristics, onset of RRP, HPV typing, use and number of cidofovir injections, number of surgeries for RRP per year, and use of human papillomavirus vaccine (types 6, 11, 16, 18) (recombinant, adsorbed)/Silgard® were considered from all the patients included in the study. Charts were reviewed for follow-up after diagnosis, after cidofovir, and after Silgard; all the statistical tests were applied at a significance level of 5%. The recurrences were observed within 27.53 ± 11.24 days after intralesional cidofovir injection. Thirteen patients with recurrence after cidofovir agreed and received Silgard® vaccine. 85% [54.44–99.41] of patients had no recurrences during 1-year follow-up. The recurrence of papillomas was observed in two patients (15%, 95% CI [0.59–45.56]), one with adult-onset RRP and one with juvenile-onset RRP. Both recurrences appeared after the first Silgard dose; one month after the third vaccine dose each patient underwent a new surgery for remaining papillomas with no recurrences at 1-year follow-up visit. Silgard® vaccination had a good effect and proved to be efficient in the treatment of our patients with RRR without appearance of recurrence in 85% of the patients during 1-year follow-up.

Juvenile recurrent respiratory papillomatosis: 10‐year audit and Australian prevalence estimates

“…However, the vaccine trials indicate that vaccination does not treat existing infection or disease. Despite case reports and retrospective reviews temporally associating vaccination with disease remission, there is currently no randomized trial evidence that vaccination is useful therapeutically in RRP patients . Rather, RRP may now be prevented via vaccination of females, therefore dramatically reducing the chance of infant exposure to HPV6/11.…”

“…Despite case reports and retrospective reviews temporally associating vaccination with disease remission, there is currently no randomized trial evidence that vaccination is useful therapeutically in RRP patients. [14][15][16][17] Rather, RRP may now be prevented via vaccination of females, therefore dramatically reducing the chance of infant exposure to HPV6/11. In Australia, a quadrivalent vaccine program (for females aged 12-26 years) commenced in 2007 and achieved high coverage.…”

Vacuna contra el virus papiloma humano como tratamiento para la papilomatosis respiratoria recurrente

“…Un estudio prospectivo no aleatorizado realizado en Rumania por Chirla y col 16 en 2014, de 31 pacientes con PRR en su presentación juvenil (diagnosticado en menores de 17 años) y adulta (diagnosticado en mayores de 17 años), utilizó Gardasil ® según esquema estándar de 3 dosis en 13 pacientes con papilomatosis severa (más de tres cirugías al año) que recurrió luego de tratamiento con resección quirúrgica y cidofovir, y se mantuvieron en seguimiento por 1 año. El estudio concluyó que el 85% (IC 95% [54,44-99,41]) de los pacientes intervenidos con la vacuna tetravalente no presentó evidencia de recurrencia a un 1 año de la intervención.…”

Multi‐Year Effect of Human Papillomavirus Vaccination on Recurrent Respiratory Papillomatosis

“…Several case reports and case series regarding the clinical effect of HPV vaccination for RRP and RRP have been published. One of these publications described only a single‐year effect of the quadrivalent HPV vaccination, demonstrating the suppression of tumor recurrence in approximately 80% of patients with RRP . Another article reported that recurrence was not observed in nearly half of the study subjects at 1 year after Gardasil (Merck & Co.) vaccination .…”