A phase 2/3, participant-blind, observer-blind, randomised, controlled study to assess the safety and immunogenicity of SII-ChAdOx1 nCoV-19 (COVID-19 vaccine) in adults in India.

AZD1222 COVID-19 Immunogenicity SII-ChAdOx1 nCoV-19 Safety

Journal

EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 19 08 2021
revised: 29 10 2021
accepted: 11 11 2021
pubmed: 7 12 2021
medline: 7 12 2021
entrez: 6 12 2021
Statut: ppublish

Résumé

This phase 2/3 immunobridging study evaluated the safety and immunogenicity of the ChAdOx1 nCoV-19 Coronavirus Vaccine (Recombinant) (SII-ChAdOx1 nCoV-19), manufactured in India at the Serum Institute of India Pvt Ltd (SIIPL), following technology transfer from the AstraZeneca. This participant-blind, observer-blind study randomised participants 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (ChAdOx1 nCoV-19) (immunogenicity/reactogenicity cohort) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort). The study participants were enrolled from 14 hospitals across India between August 25 and October 31, 2020. Two doses of study products were given 4 weeks apart. The primary objectives were to demonstrate non-inferiority of SII-ChAdOx1 nCoV-19 to AZD1222 in terms of geometric mean titre (GMT) ratio of anti-SARS-CoV-2 spike IgG antibodies 28 days after the second dose (defined as lower limit of 95% CI >0·67) and to determine the incidence of serious adverse events (SAEs) causally related to SII-ChAdOx1 nCoV-19. The anti-spike IgG response was assessed using a multiplexed electrochemiluminescence-based immunoassay. Safety follow-up continued until 6 months after first dose. Trial registration: CTRI/2020/08/027170. 1601 participants were enrolled: 401 to the immunogenicity/reactogenicity cohort and 1200 to the safety cohort. After two doses, seroconversion rates for anti-spike IgG antibodies were more than 98·0% in both the groups. SII-ChAdOx1 nCoV-19 was non-inferior to AZD1222 (GMT ratio 0·98; 95% CI 0·78-1·23). SAEs were reported in ≤ 2·0% participants across the three groups; none were causally related. A total of 34 SARS-CoV-2 infections were reported; of which 6 occurred more than 2 weeks after the second dose; none were severe. SII-ChAdOx1 nCoV-19 has a non-inferior immune response compared to AZD1222 and an acceptable safety/reactogenicity profile. Pharmacovigilance should be maintained to detect any safety signals. SIIPL funded the contract research organisation and laboratory costs, while the site costs were funded by the Indian Council of Medical Research. The study vaccines were supplied by SIIPL and AstraZeneca.

Sections du résumé

BACKGROUND BACKGROUND
This phase 2/3 immunobridging study evaluated the safety and immunogenicity of the ChAdOx1 nCoV-19 Coronavirus Vaccine (Recombinant) (SII-ChAdOx1 nCoV-19), manufactured in India at the Serum Institute of India Pvt Ltd (SIIPL), following technology transfer from the AstraZeneca.
METHODS METHODS
This participant-blind, observer-blind study randomised participants 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (ChAdOx1 nCoV-19) (immunogenicity/reactogenicity cohort) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort). The study participants were enrolled from 14 hospitals across India between August 25 and October 31, 2020. Two doses of study products were given 4 weeks apart. The primary objectives were to demonstrate non-inferiority of SII-ChAdOx1 nCoV-19 to AZD1222 in terms of geometric mean titre (GMT) ratio of anti-SARS-CoV-2 spike IgG antibodies 28 days after the second dose (defined as lower limit of 95% CI >0·67) and to determine the incidence of serious adverse events (SAEs) causally related to SII-ChAdOx1 nCoV-19. The anti-spike IgG response was assessed using a multiplexed electrochemiluminescence-based immunoassay. Safety follow-up continued until 6 months after first dose. Trial registration: CTRI/2020/08/027170.
FINDINGS RESULTS
1601 participants were enrolled: 401 to the immunogenicity/reactogenicity cohort and 1200 to the safety cohort. After two doses, seroconversion rates for anti-spike IgG antibodies were more than 98·0% in both the groups. SII-ChAdOx1 nCoV-19 was non-inferior to AZD1222 (GMT ratio 0·98; 95% CI 0·78-1·23). SAEs were reported in ≤ 2·0% participants across the three groups; none were causally related. A total of 34 SARS-CoV-2 infections were reported; of which 6 occurred more than 2 weeks after the second dose; none were severe.
INTERPRETATION CONCLUSIONS
SII-ChAdOx1 nCoV-19 has a non-inferior immune response compared to AZD1222 and an acceptable safety/reactogenicity profile. Pharmacovigilance should be maintained to detect any safety signals.
FUNDING BACKGROUND
SIIPL funded the contract research organisation and laboratory costs, while the site costs were funded by the Indian Council of Medical Research. The study vaccines were supplied by SIIPL and AstraZeneca.

Identifiants

pubmed: 34870133
doi: 10.1016/j.eclinm.2021.101218
pii: S2589-5370(21)00499-5
pmc: PMC8629682
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101218

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

PSK, CB, AD, MG, US, DK, and BG are employees of SIIPL. JV and EJK are employees of AstraZeneca. All other authors declare no competing interests.

Références

Nat Med. 2021 Feb;27(2):270-278
pubmed: 33335323
Lancet. 2021 Jan 9;397(10269):99-111
pubmed: 33306989
Nat Commun. 2021 May 11;12(1):2670
pubmed: 33976165
NPJ Vaccines. 2021 Feb 22;6(1):28
pubmed: 33619260
Nat Med. 2021 Feb;27(2):279-288
pubmed: 33335322
Mayo Clin Proc. 2021 Sep;96(9):2493-2494
pubmed: 34366135
Eur J Intern Med. 2021 Nov;93:112-113
pubmed: 34419309
Lancet. 2021 Dec 19;396(10267):1979-1993
pubmed: 33220855
Lancet. 2021 Mar 6;397(10277):881-891
pubmed: 33617777
EClinicalMedicine. 2021 Jul 23;38:101038
pubmed: 34505032
N Engl J Med. 2021 May 20;384(20):1885-1898
pubmed: 33725432
Lancet. 2020 Aug 15;396(10249):467-478
pubmed: 32702298
J Med Virol. 2022 Jan;94(1):407-412
pubmed: 34491572
Lancet Infect Dis. 2020 Aug;20(8):e192-e197
pubmed: 32539990
Lancet. 2021 Aug 14;398(10300):577-578
pubmed: 34329583

Auteurs

Prasad S Kulkarni (PS)

Serum Institute of India Pvt Ltd, Pune, India.

Chandrasekaran Padmapriyadarsini (C)

Indian Council of Medical Research, Delhi, India.

Johan Vekemans (J)

Clinical Development, Infection, Late-stage Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.

Ashish Bavdekar (A)

KEM Hospital Research Centre, Vadu Budruk, Pune, India.

Madhu Gupta (M)

Post Graduate Institute of Medical Education & Research, Chandigarh, India.

Praveen Kulkarni (P)

JSS Academy of Higher Education and Research, Mysore, India.

B S Garg (BS)

Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India.

Nithya J Gogtay (NJ)

Seth G S Medical College & KEM Hospital, Mumbai, India.

Muralidhar Tambe (M)

B J Government Medical College and Sassoon General Hospitals, Pune, India.

Sanjay Lalwani (S)

Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India.

Kiranjit Singh (K)

Jehangir Clinical Development Centre Pvt Ltd, Pune, India.

Renuka Munshi (R)

TN Medical College & BYL Nair Hospital, Mumbai, India.

Sushant Meshram (S)

Government Medical College, Nagpur, India.

T S Selvavinayagam (TS)

Directorate of Public Health and Preventive Medicine, Chennai, India.

Krishna Pandey (K)

Rajendra Memorial Research Institute of Medical Sciences, Patna, India.

Devi Madhavi Bhimarasetty (DM)

Andhra Medical College, Visakhapatnam, India.

S R Ramakrishnan (SR)

Sri Ramchandra Institute of Higher Education and Research, Chennai, India.

Chetanraj Bhamare (C)

Serum Institute of India Pvt Ltd, Pune, India.

Abhijeet Dharmadhikari (A)

Serum Institute of India Pvt Ltd, Pune, India.

Rajeev Vadakkedath (R)

PPD India Pvt Ltd, Mumbai, India.

Cyrille J Bonhomme (CJ)

Vaccine Sciences Department, PPD® Laboratories Inc., Richmond, VA, USA.

Madhuri Thakar (M)

Indian Council of Medical Research, Delhi, India.

Swarali N Kurle (SN)

Indian Council of Medical Research, Delhi, India.

Elizabeth J Kelly (EJ)

Translational Medicine, Microbial Sciences, AstraZeneca, Gaithersburg, MD, USA.

Manish Gautam (M)

Serum Institute of India Pvt Ltd, Pune, India.

Nivedita Gupta (N)

Indian Council of Medical Research, Delhi, India.

Samiran Panda (S)

Indian Council of Medical Research, Delhi, India.

Balram Bhargava (B)

Indian Council of Medical Research, Delhi, India.

Umesh Shaligram (U)

Serum Institute of India Pvt Ltd, Pune, India.

Dhananjay Kapse (D)

Serum Institute of India Pvt Ltd, Pune, India.

Bhagwat Gunale (B)

Serum Institute of India Pvt Ltd, Pune, India.

Classifications MeSH