Bye UTI

Updates on vaccines for UTI: Uromune™ sublingual spray

We were excited to tell you all about the new role of vaccines for prevention of recurrent UTI in our previous blog post: https://www.urologysingapore.com/uro-vaxom-a-vaccine-for-urinary-tract-infection-uti.
We are happy to share updated and interesting news on this front!
There is another new vaccine for prevention of recurrent UTI, with research published recently in the New England Journal of Medicine Medicine. Uromune™ (MV140), a sublingual preparation of whole-cell inactivated bacteria, has shown benefits in both observational studies and a multi-center, randomized, double-blind, placebo-controlled, parallel group, 1 year trial. The Uromune™ vaccine consists of a suspension of whole-cell heat-inactivated bacteria with selected strains of four bacterial species (Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Proteus vulgaris) at equal percentages. Treatment is self-administered daily sublingually by spraying two sprays just under the tongue.

Results

The median of UTI episodes was 3.0 (0.5 to 6.0) for placebo compared with 0.0 (0.0 to 1.0) in both groups receiving MV140 for both 3 months and 6 months (P<0.001). (Figure A)
Among women treated with placebo, 25% were free of UTIs compared with 56% and 58% of women who received 3 and 6 months of MV140 treatment, respectively. (Figure C)

Results

UROMUNE™ has a safety profile comparable to placebo. The most common adverse events (5% or more of participants) were chest infection, candidiasis, and vaginitis.

Local Singapore context

At this time, both vaccines (Uro-vaxom® and Uromune™) would need to be brought in via the Singapore’s Health Sciences Authority (HSA)’s Special Access Route on a Named-Patient basis. As such, all other therapeutic options should be tried for patients with recurrent UTI before resorting to the use of the vaccines. There is also a lead time needed to import the respective medicines from their country of manufacture. Storage instructions specific to Uromune™ includes the need for it to be kept in a refrigerator (2°C -8°C). All the vaccines are meant for adults and not suitable for children.
Last but certainly not least, these vaccines are used for patients with uncomplicated recurrent UTI. This implies that there is no other underlying anatomical or functional abnormality detected in the urinary tract. As such, all patients with recurrent UTI would need a full assessment of their urinary tract prior to starting the vaccine. Assessment typically includes physical examination, scans, urine flow tests and sometimes other specialized tests.
Dr Tricia Kuo

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