{"id":8793,"date":"2022-11-04T15:33:23","date_gmt":"2022-11-04T15:33:23","guid":{"rendered":"https:\/\/targetmalaria.org\/promising-results-for-a-new-malaria-vaccine-candidate\/"},"modified":"2023-08-14T15:31:35","modified_gmt":"2023-08-14T14:31:35","slug":"promising-results-for-a-new-malaria-vaccine-candidate","status":"publish","type":"post","link":"https:\/\/targetmalaria.org\/fr\/latest\/actus\/promising-results-for-a-new-malaria-vaccine-candidate\/","title":{"rendered":"De grands espoirs pour la pr\u00e9vention du paludisme : r\u00e9sultats r\u00e9cents des essais du vaccin R21"},"content":{"rendered":"

En septembre, nos espoirs ont \u00e9t\u00e9 lev\u00e9s par les r\u00e9sultats d’un essai contr\u00f4l\u00e9 randomis\u00e9 de phase 2b<\/a>  sur le vaccin antipalud\u00e9en R21\/Matrix-M. Le vaccin<\/a> a montr\u00e9 une grande efficacit\u00e9, un bon profil d’innocuit\u00e9 et un profil de tol\u00e9rance favorable 12 mois apr\u00e8s avoir re\u00e7u une dose de rappel, dans une population de 409 enfants \u00e2g\u00e9s de 5 \u00e0 17 mois au Burkina Faso. Qu’est-ce que cela nous apprend sur nos possibilit\u00e9s futures dans la lutte contre le paludisme ?<\/p>\n

Chaque minute, un enfant meurt du paludisme<\/b>, dans la plupart des cas en Afrique subsaharienne. Ces derni\u00e8res ann\u00e9es, les progr\u00e8s r\u00e9alis\u00e9s au cours de la premi\u00e8re d\u00e9cennie de ce mill\u00e9naire ont commenc\u00e9 \u00e0 marquer le pas, voire \u00e0 s’inverser, avec 14 millions de cas suppl\u00e9mentaires en 2020 par rapport \u00e0 2019, et 69 000 d\u00e9c\u00e8s de plus. Les outils existants sont confront\u00e9s \u00e0 de nouveaux d\u00e9fis, notamment la r\u00e9sistance des moustiques aux insecticides, la r\u00e9sistance des parasites aux m\u00e9dicaments antipaludiques, les mutations des parasites entra\u00eenant une sensibilit\u00e9 r\u00e9duite des tests de diagnostic et les facteurs socio-\u00e9conomiques emp\u00eachant les m\u00e8res et les b\u00e9b\u00e9s de recevoir un traitement pr\u00e9ventif.<\/p>\n

L’acc\u00e8s \u00e0 des vaccins s\u00fbrs et efficaces a un r\u00f4le important \u00e0 jouer dans la pr\u00e9vention des d\u00e9c\u00e8s \u00e9vitables dus au paludisme. Cependant, le d\u00e9veloppement d’un vaccin est un processus complexe une fois arriv\u00e9 au stade des essais sur l’homme. Les essais de phase 1 d\u00e9terminent la dose maximale s\u00fbre parmi un nombre limit\u00e9 de volontaires sains, g\u00e9n\u00e9ralement moins d’une centaine. Les essais de phase 2 recrutent plusieurs centaines de patients. Les essais de phase 2a explorent les doses optimales requises, tandis que les essais de phase 2b \u00e9tudient l’efficacit\u00e9 du vaccin. La tol\u00e9rance (apparition d’effets secondaires) et l’immunog\u00e9nicit\u00e9 (comme la production d’anticorps g\u00e9n\u00e9r\u00e9s par le vaccin) sont \u00e9galement explor\u00e9es \u00e0 la phase 2. Toutefois, ce sont les \u00e9tudes de phase 3 qui suivent, avec des donn\u00e9es g\u00e9n\u00e9r\u00e9es par de grands \u00e9chantillons (plus de plusieurs milliers de participants), qui peuvent fournir des r\u00e9sultats suffisamment significatifs sur le plan statistique pour \u00e9mettre des autorisations et des recommandations.<\/p>\n

En octobre 2021, l’OMS a \u00e9mis<\/a> la premi\u00e8re recommandation en faveur du vaccin RTS,S chez les enfants vivant dans des r\u00e9gions \u00e0 transmission mod\u00e9r\u00e9e \u00e0 \u00e9lev\u00e9e. Le RTS,S a \u00e9t\u00e9 d\u00e9velopp\u00e9 en 1987. Il a fait l’objet d’essais de phase 3<\/a> \u00e0 partir de 2009 et a montr\u00e9 une bonne tol\u00e9rance mais une efficacit\u00e9 de 56% sur la premi\u00e8re ann\u00e9e ; et \u00e0 plus long terme 36% sur une m\u00e9diane de 48 mois de suivi (apr\u00e8s quatre doses,) ce qui est appr\u00e9ciable mais reste mod\u00e9r\u00e9. En revanche, le R21\/Matrix-M a montr\u00e9 une efficacit\u00e9 de 77% \u00e0 1 an de la premi\u00e8re dose en 2021<\/a>, renforc\u00e9e par la publication la semaine derni\u00e8re d’une efficacit\u00e9 de 78% apr\u00e8s administration d’un booster \u00e0 12 mois (donc 2 ans apr\u00e8s la premi\u00e8re dose). Suite aux r\u00e9sultats de 2021, un essai de phase 3 pour R21\/Matrix-M a \u00e9t\u00e9 lanc\u00e9 en avril, avec une fin pr\u00e9vue pour d\u00e9cembre 2023<\/a>.<\/p>\n

Nous n’avons jamais \u00e9t\u00e9 aussi pr\u00e8s de disposer d’un vaccin atteignant l’objectif sp\u00e9cifi\u00e9 par l’OMS d’une efficacit\u00e9 de 75 % ou plus, avec un sch\u00e9ma de rappel potentiel permettant une efficacit\u00e9 \u00e0 long terme. Des donn\u00e9es suppl\u00e9mentaires sont n\u00e9anmoins n\u00e9cessaires pour conduire \u00e0 l’approbation et \u00e0 la mise en \u0153uvre. Plus que jamais, le d\u00e9fi de l’\u00e9radication du paludisme est \u00e0 la crois\u00e9e des chemins. Il n’existe pas de solution miracle, mais des innovations prometteuses telles que les nouveaux vaccins et l’impulsion g\u00e9n\u00e9tique, ainsi que les m\u00e9thodes de pr\u00e9vention, de d\u00e9pistage et de traitement actuellement utilis\u00e9es, peuvent nous fournir la bo\u00eete \u00e0 outils compl\u00e9mentaire pour r\u00e9ussir. <\/p>\n","protected":false},"excerpt":{"rendered":"

En septembre, nos espoirs ont \u00e9t\u00e9 lev\u00e9s par les r\u00e9sultats d’un essai contr\u00f4l\u00e9 randomis\u00e9 de phase 2b  sur le vaccin antipalud\u00e9en R21\/Matrix-M. Le vaccin a montr\u00e9 une grande efficacit\u00e9, un bon profil d’innocuit\u00e9 et un profil de tol\u00e9rance favorable 12 mois apr\u00e8s avoir re\u00e7u une dose de rappel, dans une population de 409 enfants \u00e2g\u00e9s de […]<\/p>\n","protected":false},"author":32,"featured_media":8328,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","featured_image_focal_point":[],"_image_focal_point":[],"footnotes":""},"categories":[113,88],"profile_tax":[],"class_list":["post-8793","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-actus","post_writers-alexandre-quach-fr","post_writers-alexandre-quach"],"acf":[],"yoast_head":"\nDe grands espoirs pour la pr\u00e9vention du paludisme : r\u00e9sultats r\u00e9cents des essais du vaccin R21 - Target Malaria<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/targetmalaria.org\/fr\/latest\/actus\/promising-results-for-a-new-malaria-vaccine-candidate\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"De grands espoirs pour la pr\u00e9vention du paludisme : r\u00e9sultats r\u00e9cents des essais du vaccin R21 - Target Malaria\" \/>\n<meta property=\"og:description\" content=\"En septembre, nos espoirs ont \u00e9t\u00e9 lev\u00e9s par les r\u00e9sultats d’un essai contr\u00f4l\u00e9 randomis\u00e9 de phase 2b  sur le vaccin antipalud\u00e9en R21\/Matrix-M. 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