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Carlos JC, Tadesse BT, Borja-Tabora C, Alberto E, Ylade MC, Sil A, Kim DR, Ahn HS, Yang JS, Lee JY, Kim MS, Park J, Kwon SY, Kim H, Yang SY, Ryu JH, Park H, Shin JH, Lee Y, Kim JH, Mojares ZR, Wartel TA, Sahastrabuddhe S. A Phase 3, Multicenter, Randomized, Controlled Trial to Evaluate Immune Equivalence and Safety of Multidose and Single-dose Formulations of Vi-DT Typhoid Conjugate Vaccine in Healthy Filipino Individuals 6 Months to 45 Years of Age. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 24:100484. [PMID: 35664443 PMCID: PMC9160840 DOI: 10.1016/j.lanwpc.2022.100484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Trial Design Phase 3, randomized, controlled, multicenter, equivalence trial. Methods Recruitment of participants occurred between 04Februray2020 and 15July2020 at four centers in the Philippines: University of the East - Ramon Magsaysay Memorial Medical Center Inc., Quezon City; University of Philippines Manila - National Institute of Health, Ermita Manila; Asian Hospital and Medical Center, Metro Manila, Philippines Study; and Medical Research Unit, Tropical Disease Foundation, Makati City, Metro Manila, Philippines. Participants 1800 adults and children 6-months to 45-years of age. Interventions Participants received a single injection of multidose (MD) or single dose (SD) Vi-DT as test vaccines or meningococcal conjugate vaccine as a comparator. Objective To evaluate immune equivalence of SD and MD formulations of Vi-DT, and to assess the safety of both formulations compared with comparator vaccine. Outcome Measurement Blood draw for immunogenicity was performed at baseline prior to vaccine receipt and at four weeks after vaccination for a subset of participants to determine anti-Vi IgG geometric mean titers (GMT) and seroconversion rates. The primary outcome was comparison of anti Vi-IgG seroconversion and GMT between the two formulations of Vi-DT at 4 weeks following vaccine administration. Immune equivalence of MD and SD formulations was confirmed when the two-tailed 95% confidence interval (CI) of the GMT ratio is within [0.67, 1.5] at a two-sided significance level of 0.05. All participants were followed for safety events for six months after vaccine administration. Randomization Participants were randomized to receive SD Vi-DT, MD Vi-DT, or meningococcal conjugate vaccines in 2.5:2.5:1 allocation ratio. Blinding Study participants and observers were blinded to treatment assignment. Findings Immune equivalence of SD (n=252) and MD (n=247) formulations was confirmed by anti-Vi IgG GMT ratio of 1.14 (95%CI: 0.91, 1.43) with respective GMTs in the MD and SD groups of 640.62 IU/mL (95%CI: 546.39, 751.11) and 562.57 IU/mL (95%CI: 478.80, 661.00) (p=0.259). Similarly, anti-Vi IgG seroconversion rate difference between the two formulations of ‒0.43% (95%CI: -4.42, 3.56) confirmed immune equivalence with corresponding seroconversion rates of 98.38% (95%CI: 95.91, 99.37) and 98.81% (95%CI: 96.56, 99.59) in MD and SD Vi-DT formulations, respectively (p=0.722). Both formulations of Vi-DT had a satisfactory safety profile - all five serious adverse events reported during the study were unrelated to the investigational product. Interpretation The MD and SD formulations of Vi-DT elicited robust and equivalent immune responses following one dose vaccination, and both formulations demonstrated a favorable safety profile. Trial Registration ClinicalTrials.gov: NCT04204096. Funding This study was funded by the Bill & Melinda Gates Foundation (OPP 1115556).
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Affiliation(s)
- Josefina Cadorna Carlos
- University of the East-Ramon Magsaysay Memorial Medical Center Inc., Quezon City, Philippines
| | | | | | - Edison Alberto
- Medical Research Unit, Tropical Disease Foundation, Inc., Makati City, Metro Manila, Philippines
| | - Michelle C. Ylade
- University of the Philippines Manila-National Institutes of Health, Ermita, Manila, Philippines
| | - Arijit Sil
- International Vaccine Institute, Seoul, Republic of Korea
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hyeon Seon Ahn
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jae Seung Yang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Ji Yeon Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | - Min Soo Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jiwook Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Soo-Young Kwon
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hun Kim
- SK bioscience, Seongmam-si, Seoul, Republic of Korea
| | | | - Ji-hwa Ryu
- SK bioscience, Seongmam-si, Seoul, Republic of Korea
| | - Hokeun Park
- SK bioscience, Seongmam-si, Seoul, Republic of Korea
| | | | - Yoonyeong Lee
- SK bioscience, Seongmam-si, Seoul, Republic of Korea
| | - Jerome H. Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - T. Anh Wartel
- International Vaccine Institute, Seoul, Republic of Korea
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