Butantan live tetravalent dengue vaccine for people with autoimmune rheumatic diseases

Safety and Immunogenicity of the Live Attenuated Tetravalent Butantan-Dengue Vaccine (Butantan-DV) in Patients With Autoimmune Rheumatic Diseases Living in Dengue-Endemic Areas

Phase 4 Interventional University of Sao Paulo General Hospital · NCT07087912

This study will test whether a single dose of the Butantan live tetravalent dengue vaccine is safe and produces immune responses in clinically stable people aged 12–59 with autoimmune rheumatic diseases compared with matched healthy volunteers.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment477 (estimated)
Ages12 Years to 59 Years
SexAll
SponsorUniversity of Sao Paulo General Hospital Academic / other
Drugs / interventionsMethotrexate, Prednisone
Locations2 sites (São Paulo, São Paulo and 1 other locations)
Trial IDNCT07087912 on ClinicalTrials.gov

What this trial studies

This open-label, Phase IIIb study enrolls 318 clinically stable patients aged 12–59 with autoimmune rheumatic diseases on low-grade or no immunosuppression and 159 age- and sex-matched healthy controls. All participants receive a single 0.5 mL subcutaneous dose of the live attenuated tetravalent Butantan-DV vaccine and are followed with scheduled visits (including early visits such as Days 7 and 14) to record adverse events and measure seroconversion. The trial directly compares rates of seroconversion and the frequency and intensity of common adverse events between ARD patients and controls and also explores whether physical activity levels and nutritional status affect vaccine-induced immune responses. Safety measures exclude those with higher immunosuppression and include routine clinical monitoring throughout follow-up.

Who should consider this trial

Good fit: Ideal candidates are people aged 12–59 with diagnosed autoimmune rheumatic diseases who have been clinically stable for at least three months and are receiving low-grade or no immunosuppressive therapy.

Not a fit: Patients with active or unstable disease, those on moderate-to-high immunosuppression, pregnant individuals, or people with other contraindications to live vaccines are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, the vaccine could allow clinically stable ARD patients on low or no immunosuppression to receive a single-dose dengue vaccine, lowering their risk of dengue and its complications.

How similar studies have performed: Phase II–III trials in the general population reported about 80% efficacy and an acceptable safety profile for Butantan-DV, but its safety and immunogenicity have not been prospectively studied in autoimmune rheumatic disease patients.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age between 12 and 59 years
* Male or female
* Clinical diagnosis of an autoimmune rheumatic disease (ARD) based on internationally accepted criteria (e.g., rheumatoid arthritis, systemic lupus erythematosus, juvenile idiopathic arthritis, Sjögren's syndrome, vasculitis)
* Healthy control matched by age and sex
* ARD patients with clinically stable disease for at least 3 months
* ARD patients under low-grade immunosuppression or no immunosuppression
* Acceptable immunosuppressive treatments include:

Hydroxychloroquine Sulfasalazine Prednisone ≤ 20 mg/day Methotrexate ≤ 0.4 mg/kg/week (maximum 20 mg/week) Leflunomide 20 mg/day Azathioprine \< 3 mg/kg/day Combination therapy with low-dose prednisone (≤ 7.5 mg/day), hydroxychloroquine, or sulfasalazine

* Healthy controls with no history of autoimmune or chronic infectious diseases
* Healthy controls not taking immunosuppressive medications Willing and able to comply with study procedures and follow-up
* Female participants of reproductive potential with negative pregnancy test at baseline
* Female participants of reproductive potential agreeing to use effective contraception for at least 90 days after vaccination

Exclusion Criteria:

* Prior receipt of any dengue vaccine
* Receipt of a live attenuated vaccine within 4 weeks prior to enrollment
* Receipt of an inactivated vaccine within 2 weeks prior to enrollment
* Known allergy to any component of the vaccine
* Febrile illness (≥ 37.8°C) within 72 hours prior to vaccination
* History of immunodeficiency syndromes
* History of asplenia
* History of cancer
* History of HIV infection
* History of primary immunodeficiencies
* Immunosuppression due to organ transplant
* Chronic uncontrolled comorbidities (e.g., heart failure, renal failure, hepatic insufficiency, diabetes mellitus)
* Hospitalization or acute illness at screening
* Receipt of blood transfusion within 3 months prior to enrollment
* Current pregnancy or breastfeeding
* Intention to become pregnant within 90 days post-vaccination
* Participation in another clinical trial within 30 days prior to enrollment

Where this trial is running

São Paulo, São Paulo and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Rheumatoid ArthritisJuvenile Idiopathic ArthritisSystemic Lupus ErythematosusJuvenile Systemic Lupus ErythematosusSystemic SclerosisIdiopathic Inflammatory MyopathiesAxial SpondyloarthritisPsoriatic Arthritis
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.