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

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.

Coelenterazine: a two-stage antioxidant in lipid micelles

Coelenterazine is a luciferin found in many marine bioluminescent organisms. This luciferin also possesses high antioxidant properties and an exceptional ability to protect cells exposed to oxidative stress. It has been suggested that coelenterazine's antioxidative mechanisms include the formation of an oxidation product, coelenteramine, also endowed with chain-breaking properties. In this work, coelenterazine analogs were shown to delay the onset of lipid peroxidation in a linoleate micellar solution exposed to free radical initiators. Their consumption was accompanied by the concomitant formation of coelenteramine. This was followed by a reduction in the peroxidation rate coinciding with the consumption of coelenterazine's oxidation product coelenteramine. The addition of coelenteramine to micelles reduced the propagation rate of the oxidative process. When coelenterazine analogs oxidizing into an inactive analog of coelenteramine were applied, the delaying effect but not the reduced peroxidation rate nor the consumption of the aminopyrazine was observed. These results demonstrate the role of the oxidation product coelenteramine in the chain-breaking properties of coelenterazine and analogs.