A new fully liquid presentation of MenACWY-CRM conjugate vaccine: Results from a multicentre, randomised, controlled, observer-blind study.

Conjugate vaccine Immune response MenA free saccharide MenACWY Neisseria meningitidis O-acetylation

Journal

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

Informations de publication

Date de publication:
29 10 2021
Historique:
received: 07 06 2021
revised: 17 09 2021
accepted: 28 09 2021
pubmed: 13 10 2021
medline: 26 10 2021
entrez: 12 10 2021
Statut: ppublish

Résumé

The currently licensed quadrivalent MenACWY-CRM conjugate vaccine presentation consists of two vials (lyophilised MenA and liquid MenCWY) to be reconstituted before injection. A new fully liquid formulation in a single vial has been developed to further improve the vaccine presentation. Since the MenA structure is subject to hydrolytic degradation, this study was conducted to compare the immunogenicity and safety of the investigational MenACWY-CRM liquid vaccine with the licensed vaccine. In this multicentre, randomised, controlled, observer-blind, phase 2b study, 979 healthy adults were administered a single dose of MenACWY-CRM liquid presentation or the currently licensed MenACWY-CRM vaccine. MenA free saccharide generation was accelerated to approximately 30% in the liquid presentation and MenA polysaccharide O-acetylation was reduced to approximately 40%, according to a controlled procedure. Immunological non-inferiority of the MenACWY-CRM liquid to the licensed vaccine, as measured by human serum bactericidal assay (hSBA) geometric mean titres (GMTs) against MenA 1 month post-vaccination, was the primary study objective. Safety assessment was among the secondary objectives. Immune responses against each serogroup were similar between the two vaccine groups and was non-inferior for MenA. Adjusted hSBA GMTs for MenA were 185.16 and 211.33 for the MenACWY-CRM liquid presentation and currently licensed vaccine presentation, respectively. The between-group ratio of hSBA GMTs for MenA was 0.88, with a two-sided 95% confidence interval lower limit of 0.64, greater than the prespecified non-inferiority margin of 0.5, thus meeting the primary study objective. Both vaccines were well tolerated. No serious adverse events were considered related to vaccination. The levels of MenA free saccharide and polysaccharide O-acetylation did not affect the immunogenicity of the fully liquid presentation, which was demonstrated to be non-inferior to the immunogenicity of the currently licensed MenACWY-CRM vaccine against MenA. The immunogenicity, reactogenicity and safety profiles of the two vaccine presentations were similar.

Sections du résumé

BACKGROUND
The currently licensed quadrivalent MenACWY-CRM conjugate vaccine presentation consists of two vials (lyophilised MenA and liquid MenCWY) to be reconstituted before injection. A new fully liquid formulation in a single vial has been developed to further improve the vaccine presentation. Since the MenA structure is subject to hydrolytic degradation, this study was conducted to compare the immunogenicity and safety of the investigational MenACWY-CRM liquid vaccine with the licensed vaccine.
METHODS
In this multicentre, randomised, controlled, observer-blind, phase 2b study, 979 healthy adults were administered a single dose of MenACWY-CRM liquid presentation or the currently licensed MenACWY-CRM vaccine. MenA free saccharide generation was accelerated to approximately 30% in the liquid presentation and MenA polysaccharide O-acetylation was reduced to approximately 40%, according to a controlled procedure. Immunological non-inferiority of the MenACWY-CRM liquid to the licensed vaccine, as measured by human serum bactericidal assay (hSBA) geometric mean titres (GMTs) against MenA 1 month post-vaccination, was the primary study objective. Safety assessment was among the secondary objectives.
RESULTS
Immune responses against each serogroup were similar between the two vaccine groups and was non-inferior for MenA. Adjusted hSBA GMTs for MenA were 185.16 and 211.33 for the MenACWY-CRM liquid presentation and currently licensed vaccine presentation, respectively. The between-group ratio of hSBA GMTs for MenA was 0.88, with a two-sided 95% confidence interval lower limit of 0.64, greater than the prespecified non-inferiority margin of 0.5, thus meeting the primary study objective. Both vaccines were well tolerated. No serious adverse events were considered related to vaccination.
CONCLUSIONS
The levels of MenA free saccharide and polysaccharide O-acetylation did not affect the immunogenicity of the fully liquid presentation, which was demonstrated to be non-inferior to the immunogenicity of the currently licensed MenACWY-CRM vaccine against MenA. The immunogenicity, reactogenicity and safety profiles of the two vaccine presentations were similar.

Identifiants

pubmed: 34635373
pii: S0264-410X(21)01283-4
doi: 10.1016/j.vaccine.2021.09.068
pii:
doi:

Substances chimiques

Antibodies, Bacterial 0
MenACWY 0
MenACWY-CRM vaccine 0
Meningococcal Vaccines 0
Vaccines, Conjugate 0

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

6628-6636

Informations de copyright

Copyright © 2021 GlaxoSmithKline Biologicals S.A. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest TA, SVH, MA, BK, BdW, GFDD, MC, PVS, EF, ML and MP are employed by the GSK group of companies. TA, MA, BdW, PVS, EF, ML and MP hold shares in the GSK group of companies. CV reports her institution received payments from the GSK group of companies, MSD and Pfizer, outside the submitted work. ILR reports her institution received payments from the GSK group of companies for the conduct of the study. TN reports payments from the GSK group of companies, Merck, Sanofi Pasteur and Seqirus, outside the submitted work. TA, SVH, MA, BK, BdW, GFDD, MC, PVS, EF, ML, MP, CV, ILR and TN declare no other financial and non-financial relationships and activities. JV, TS, GG, MF, GI, TFS, AMN and SC declare no financial and non-financial relationships and activities and no conflicts of interest.

Auteurs

Corinne Vandermeulen (C)

Leuven University Vaccinology Centre, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, PO 7001, 3000 Leuven, Belgium. Electronic address: corinne.vandermeulen@kuleuven.be.

Isabel Leroux-Roels (I)

Center for Vaccinology, Ghent University and Ghent University Hospital, Ghent, Belgium. Electronic address: isabel.lerouxroels@uzgent.be.

James Vandeleur (J)

Paratus Clinical Blacktown Clinic, Main Street, Blacktown, NSW 2148, Australia.

Tommaso Staniscia (T)

Department of Medicine and Aging Sciences, 'G. d'Annunzio' University Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy. Electronic address: tommaso.staniscia@unich.it.

Ginette Girard (G)

Diex Research, 15 J.-A. Bombardier, Sherbrooke, Québec J1L 0H8, Canada. Electronic address: ggirard@diex.ca.

Murdo Ferguson (M)

Colchester Research Group, 68 Robie Street, Truro, Nova Scotia, Canada. Electronic address: mftruroclinics@eastlink.ca.

Giancarlo Icardi (G)

Department of Health Sciences (Dissal), University of Genoa, and Hygiene Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy. Electronic address: icardi@unige.it.

Tino F Schwarz (TF)

Klinikum Würzburg Mitte, Standort Juliusspital, Salvatorstr. 7, 97074 Würzburg, Germany. Electronic address: tino.schwarz@kwm-klinikum.de.

A Munro Neville (AM)

AusTrials, Level 3, Westside Private Hospital, 32 Morrow St, Taringa, QLD 4068, Australia. Electronic address: munro.neville@austrials.com.au.

Terry Nolan (T)

Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3010, Australia; Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia. Electronic address: t.nolan@unimelb.edu.au.

Sandro Cinquetti (S)

Public Health Department, Local Health Unit N. 2 'Marca Trevigiana', Treviso, Veneto Region, Italy. Electronic address: sandro.cinquetti@aulss2.veneto.it.

Tauseefullah Akhund (T)

GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy. Electronic address: tauseefullah.x.akhund@gsk.com.

Sofie Van Huyneghem (S)

GSK, Regional Evidence Generation, Avenue Pascal 2, 4, 6, 1300 Wavre, Belgium. Electronic address: sofie.x.van-huyneghem@gsk.com.

Marianna Aggravi (M)

GSK, Technical Development, Via Fiorentina 1, Siena 53100, Italy. Electronic address: marianna.x.aggravi@gsk.com.

Barry Kunnel (B)

GSK, Data Strategy & Management, Global Clinical Operations Development - R&D, Hullenbergweg 83-85, 1101CL Amsterdam, the Netherlands. Electronic address: barry.x.kunnel@gsk.com.

Bertrand de Wergifosse (B)

GSK, Clinical Laboratory Sciences, Rue de l'Institut, 89, 1330 Rixensart, Belgium. Electronic address: bertrand.d.de-wergifosse@gsk.com.

Gabriele Filippo Di Domenico (GFD)

GSK, Biostatistics and Statistical Programming, Via Fiorentina 1, Siena 53100, Italy. Electronic address: gabriele-filippo.x.di-domenico@gsk.com.

Marco Costantini (M)

GSK, Biostatistics and Statistical Programming, Via Fiorentina 1, Siena 53100, Italy. Electronic address: marco.x.costantini@gsk.com.

Puneet Vir Singh (P)

GSK, Safety Evaluation and Risk Management, Via Fiorentina 1, Siena 53100, Italy. Electronic address: puneetvirsingh.x.puneetvirsingh@gsk.com.

Elena Fragapane (E)

GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy. Electronic address: elena.x.fragapane@gsk.com.

Maria Lattanzi (M)

GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy. Electronic address: maria.x.lattanzi@gsk.com.

Michele Pellegrini (M)

GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy. Electronic address: michele.x.pellegrini@gsk.com.

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