Breakthrough UTI vaccine could prevent infections for nine years

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Recurring urinary tract infections (UTIs) can be prevented for up to nine years with a simple oral spray vaccine, a ‘breakthrough’ British trial has shown.

The common bacterial infection, which causes burning pain and frequent urination, currently leads to 150,000 hospitalisations each year in the UK, costing the NHS £380 million annually.

Around half of women and 20% of men suffer UTIs. The elderly population is particularly at risk, with UTIs causing irregular heartbeat, high blood pressure, delirium and potentially fatal falls.

In a clinical study conducted at the UK’s Royal Berkshire Hospital, 89 patients were given the treatment, called MV140, with 2 sprays of a pineapple-flavored suspension under the tongue.

When reassessing the same patients after nine years, 54% of participants remained UTI-free for nine years after the vaccine regime, with no significant side effects.

The average infection-free period across the cohort was 54.7 months (four and a half years) – 56.7 months for women and 44.3 months, one year less, for men.

In addition, 40% of the trial participants reported having second doses of the vaccine after one or two years.

Jennifer Rohn, professor and head of the center for urological biology at UCL, described the new vaccine as ‘very promising’ with ‘a remarkable effect on many of the recurrent UTI sufferers who took part’.

However, Rohn also told Bio Pharma Reporter that she would like to see these studies expanded to include more people, including patients with complex UTIs that might prove more challenging to address.

Looking at the wider landscape, ‘it is better for the individual as well as for healthcare systems to invest in prevention strategies, especially with UTIs, where antibiotics are often ineffective, leading to repeated cycles of fruitless treatment that only serve to fuel the global antibiotic resistance crisis,’ Rohn added.

Jacqui Prieto, associate clinical professor and specialist in inflection prevention at the University of Southampton, also believes that the new vaccine could potentially be an important advance for older people, particularly those living in care homes, who are at greater risk of developing UTI.

"Care home residents who receive repeated antibiotic treatment for UTI are at increased risk of antibiotic-resistant infections, which are more likely to lead to life-threatening illness and admission to hospital," she told Bio Pharma Reporter. 

"Pharmacological therapies recommended to reduce the risk of recurrent UTI are under-used in care home residents with recurrent UTI and so it will be important to understand whether the vaccine may benefit this group."

While investigators had previously studied MV140’s short-term safety and effectiveness, this marked the first long-term follow-up study.

“Before having the vaccine, all our participants suffered with recurrent UTIs, and for many women, these can be difficult to treat. Nine years after first receiving this new UTI vaccine, around half of participants remained infection free,” said Bob Yang, consultant urologist at the Royal Berkshire NHS Foundation Trust, who co-led the research.

“Overall, this vaccine is safe in the long term and our participants reported having fewer UTIs that were less severe. Many of those who did get a UTI told us that simply drinking plenty of water was enough to treat it.”

Recurrent infections which need short-term antibiotic treatment develop in between 20% to 30% of UTI cases.

With multidrug resistant UTIs now on the rise, new modalities to prevent and treat these infections are sorely needed.

As Rohn points out, there has been no new first-line cure for UTI since Fleming discovered antibiotics nearly a century ago.

“Considering that UTI affects upwards of 400 million people per year, this is astonishing. Sadly, research repeatedly shows that women’s healthcare issues have been historically neglected, with less research funding and healthcare emphasis than diseases that affect more men,” she added.

“There has also been a perception that UTI is not ‘serious’, but with a quarter of a million people per year already dying from UTIs associated with drug resistance, the problem is only going to get worse if nothing is done.”

MV140 was developed by Spanish pharmaceutical company Immunotek and contains 4 bacterial species in a suspension with water. It is currently available off-license in 26 countries.

These latest results were presented at the at the ongoing European Association of Urology (EAU) Congress in Paris.