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Vandermeulen C, Leroux-Roels I, Vandeleur J, Staniscia T, Girard G, Ferguson M, Icardi G, Schwarz TF, Neville AM, Nolan T, Cinquetti S, Akhund T, Van Huyneghem S, Aggravi M, Kunnel B, de Wergifosse B, Domenico GFD, Costantini M, Vir Singh P, Fragapane E, Lattanzi M, Pellegrini M. A new fully liquid presentation of MenACWY-CRM conjugate vaccine: Results from a multicentre, randomised, controlled, observer-blind study. Vaccine 2021; 39:6628-6636. [PMID: 34635373 DOI: 10.1016/j.vaccine.2021.09.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/17/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Corinne Vandermeulen
- Leuven University Vaccinology Centre, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, PO 7001, 3000 Leuven, Belgium.
| | - Isabel Leroux-Roels
- Center for Vaccinology, Ghent University and Ghent University Hospital, Ghent, Belgium.
| | - James Vandeleur
- Paratus Clinical Blacktown Clinic, Main Street, Blacktown, NSW 2148, Australia
| | - Tommaso Staniscia
- Department of Medicine and Aging Sciences, 'G. d'Annunzio' University Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| | - Ginette Girard
- Diex Research, 15 J.-A. Bombardier, Sherbrooke, Québec J1L 0H8, Canada.
| | - Murdo Ferguson
- Colchester Research Group, 68 Robie Street, Truro, Nova Scotia, Canada.
| | - Giancarlo Icardi
- Department of Health Sciences (Dissal), University of Genoa, and Hygiene Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy.
| | - Tino F Schwarz
- Klinikum Würzburg Mitte, Standort Juliusspital, Salvatorstr. 7, 97074 Würzburg, Germany.
| | - A Munro Neville
- AusTrials, Level 3, Westside Private Hospital, 32 Morrow St, Taringa, QLD 4068, Australia.
| | - Terry Nolan
- Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3010, Australia; Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.
| | - Sandro Cinquetti
- Public Health Department, Local Health Unit N. 2 'Marca Trevigiana', Treviso, Veneto Region, Italy.
| | - Tauseefullah Akhund
- GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy.
| | - Sofie Van Huyneghem
- GSK, Regional Evidence Generation, Avenue Pascal 2, 4, 6, 1300 Wavre, Belgium.
| | - Marianna Aggravi
- GSK, Technical Development, Via Fiorentina 1, Siena 53100, Italy.
| | - Barry Kunnel
- GSK, Data Strategy & Management, Global Clinical Operations Development - R&D, Hullenbergweg 83-85, 1101CL Amsterdam, the Netherlands.
| | | | | | - Marco Costantini
- GSK, Biostatistics and Statistical Programming, Via Fiorentina 1, Siena 53100, Italy.
| | - Puneet Vir Singh
- GSK, Safety Evaluation and Risk Management, Via Fiorentina 1, Siena 53100, Italy.
| | - Elena Fragapane
- GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy.
| | - Maria Lattanzi
- GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy.
| | - Michele Pellegrini
- GSK, Clinical Research and Development Centre, Via Fiorentina 1, Siena 53100, Italy.
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