Safety and immunogenicity of an investigational maternal trivalent group B streptococcus vaccine in pregnant women and their infants: Results from a randomized placebo-controlled phase II trial.


Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
14 10 2020
Historique:
received: 04 06 2020
revised: 18 08 2020
accepted: 20 08 2020
pubmed: 5 9 2020
medline: 28 4 2021
entrez: 5 9 2020
Statut: ppublish

Résumé

This study evaluated the safety and immunogenicity of an investigational trivalent group B streptococcus (GBS) vaccine in US pregnant women, transplacental serotype-specific antibody transfer and persistence in infants, and serotype-specific antibodies in breast milk. This randomized, observer-blind, placebo-controlled trial administered one dose of trivalent GBS vaccine (n = 49) or placebo (n = 26) to healthy pregnant 18-40-year-old women at 24 Baseline characteristics were similar between groups. Serious adverse events were reported for 16% of GBS-vaccinated women and 15% of their infants, and 15% of placebo recipients and 12% of their infants; none were fatal or deemed vaccine-related. Serotype-specific IgG geometric mean concentrations (GMCs) were 13-23-fold higher in vaccine vs placebo recipients on day 31 and persisted until postpartum day 90. Median antibody concentrations were substantially higher in women with detectable pre-vaccination antibody concentrations. Antibody transfer ratios in the vaccine group were 0.62-0.82. Infant IgG GMCs and breast milk sIgA GMCs were higher in the vaccine vs the placebo group at all timepoints. Maternal immunization with the trivalent GBS vaccine in US women had a favorable safety profile, elicited antibodies that were transplacentally transferred and persisted in infants for a minimum of 3 months. Clinicaltrials.gov, NCT02046148.

Sections du résumé

BACKGROUND
This study evaluated the safety and immunogenicity of an investigational trivalent group B streptococcus (GBS) vaccine in US pregnant women, transplacental serotype-specific antibody transfer and persistence in infants, and serotype-specific antibodies in breast milk.
METHODS
This randomized, observer-blind, placebo-controlled trial administered one dose of trivalent GBS vaccine (n = 49) or placebo (n = 26) to healthy pregnant 18-40-year-old women at 24
RESULTS
Baseline characteristics were similar between groups. Serious adverse events were reported for 16% of GBS-vaccinated women and 15% of their infants, and 15% of placebo recipients and 12% of their infants; none were fatal or deemed vaccine-related. Serotype-specific IgG geometric mean concentrations (GMCs) were 13-23-fold higher in vaccine vs placebo recipients on day 31 and persisted until postpartum day 90. Median antibody concentrations were substantially higher in women with detectable pre-vaccination antibody concentrations. Antibody transfer ratios in the vaccine group were 0.62-0.82. Infant IgG GMCs and breast milk sIgA GMCs were higher in the vaccine vs the placebo group at all timepoints.
CONCLUSIONS
Maternal immunization with the trivalent GBS vaccine in US women had a favorable safety profile, elicited antibodies that were transplacentally transferred and persisted in infants for a minimum of 3 months.
CLINICAL TRIAL REGISTRATION
Clinicaltrials.gov, NCT02046148.

Identifiants

pubmed: 32883555
pii: S0264-410X(20)31108-7
doi: 10.1016/j.vaccine.2020.08.056
pii:
doi:

Substances chimiques

Streptococcal Vaccines 0

Banques de données

ClinicalTrials.gov
['NCT02046148']

Types de publication

Clinical Trial, Phase II Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

6930-6940

Informations de copyright

Copyright © 2020 GlaxoSmithKline Biologicals S.A. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Z Bebia, M Lattanzi, O Henry, A Karsten, I Margarit, G Buffi and L Grassano are employees of the GSK group of companies. M Lattanzi, O Henry, A Karsten and I Margarit hold shares in the GSK group of companies. A Dreisbach was an employee of the GSK group of companies. GK Swamy, KM Edwards and JD Campbell report funding from the GSK group of companies for the work under consideration. TD Metz reports that her institution received funding from the GSK group of companies for the work under consideration. Outside the submitted work, GK Swamy is an advisor and chair of IDMCs for the GSK group of companies for RSV vaccine trials in pregnant women and chair of IDMCs for Pfizer for GBS vaccine trials in pregnant and nonpregnant women. Outside the submitted work, KM Edwards is an advisor to Bionet, X4 Pharmaceuticals, Merck, and IBM, and is on DSMBs for Moderna, Roche, Sanofi Pasteur and Sequiras. KM Edwards also reports grants from the CDC and the NIH. RH Beigi and DE Soper report no potential conflicts.

Auteurs

Geeta K Swamy (GK)

Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA. Electronic address: Geeta.Swamy@duke.edu.

Torri D Metz (TD)

Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, CO, USA. Electronic address: torri.metz@hsc.utah.edu.

Kathryn M Edwards (KM)

Vanderbilt Vaccine Research Program, Vanderbilt University, Nashville, TN, USA. Electronic address: kathryn.edwards@vumc.org.

David E Soper (DE)

Medical University of South Carolina, Charleston, SC, USA. Electronic address: soperde@musc.edu.

Richard H Beigi (RH)

UPMC Magee-Women's Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: beigrh@mail.magee.edu.

James D Campbell (JD)

Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jcampbel@som.umaryland.edu.

Luca Grassano (L)

GSK, Siena, Italy. Electronic address: luca.x.grassano@gsk.com.

Giada Buffi (G)

GSK, Siena, Italy. Electronic address: giada.x.buffi@gsk.com.

Annette Dreisbach (A)

GSK, Marburg, Germany. Electronic address: annettedreisbach@gmx.de.

Immaculada Margarit (I)

GSK, Siena, Italy. Electronic address: immaculada.x.margarit-y-ros@gsk.com.

Annette Karsten (A)

GSK, Marburg, Germany. Electronic address: annette.x.karsten@gsk.com.

Ouzama Henry (O)

GSK, Rockville, MD, USA. Electronic address: ouzama.n.henry@gsk.com.

Maria Lattanzi (M)

GSK, Siena, Italy. Electronic address: maria.x.lattanzi@gsk.com.

Zourab Bebia (Z)

GSK, Rockville, MD, USA. Electronic address: zourab.x.bebia@gsk.com.

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Classifications MeSH