Immune Response Induced by a Vaccine Against Group B Streptococcus and Safety in Pregnant Women and Their Offsprings

A Phase II Randomized, Observer-Blind, Multi-Center, Controlled Study of a Trivalent Group B Streptococcus Vaccine in Healthy Pregnant Women

The study investigated the immune response induced by the Group B streptococcus vaccine in healthy pregnant women. In addition, the study investigated the amount of vaccine induced antibodies which were transferred to the newborn.

Study Overview

• Status: Completed
• Conditions: Bacterial Infection; Streptococcal Infection; Gram-positive Bacterial Infection
• Intervention / Treatment: Biological: Group B Streptococcus Trivalent Vaccine; Biological: Placebo

• Study Type: Interventional
• Enrollment (Actual): 86
• Phase: Phase 2

Contacts and Locations

Study Locations

• Belgium
  • Leuven
    • Herestraat, Leuven, Belgium, 49-B-3000
      • UZ Leuven
  • Tienen
    • Gasthuismolenstraat 31, Tienen, Belgium, 3300
      • Regionaal Ziekenhuis Heilig Hart,
• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6H3N1
      • University of British Columbia, Rm B3 25 B, 4500 Oak Street,
  • Nova Scotia
    • Halifax, Nova Scotia, Canada, B3K 6R8
      • Dalhousie University, IWK Health Centre, 5850/5980 University Avenue,
  • Quebec
    • Boulevard laurier, S-745, Quebec, Canada, G1V 4G2
      • Centre hospitalier universitaire de Quebec (CHUQ)- hospital CHUL, Centre de recherche en infectiologie, 2705,

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 40 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

1. Healthy pregnant women 18-40 years of age at 24-35 weeks of gestation at screening.
2. Individuals who have given a written consent after the nature of the study has been explained according to local regulatory requirements.
3. Individuals in good health as determined by the outcome of medical history, physical examination and clinical judgment of the investigator.
4. Individuals who will be available for all scheduled visits (ie, not planning to leave the area before the end of the study period).

Exclusion Criteria:

1. Individuals who were unwilling and/or unable to give written informed consent to participate in the study.
2. Individuals with a history of severe allergic reactions after previous vaccinations such as anaphylactic shock, asthma, urticaria, or other allergic reaction or hypersensitivity to any vaccine component.

3. Individuals with any known or suspected impairment/alteration of immune function, either congenital or acquired or resulting from:

   • receipt of immunosuppressive therapy within 30 days prior to enrollment (any systemic corticosteroid administered for more than 5 days, or in a daily dose > 15 mg/kg/day prednisone or equivalent during any of 30 days prior to enrollment, or cancer chemotherapy).
   • receipt of immunostimulants.
   • receipt of parenteral immunoglobulin preparation, blood products, and /or plasma derivatives within 12 weeks prior to enrollment and for the full length of the study.

   Note: Anti-D (Rho) Immunoglobulins (anti-RhD) given for Anti-D prophylaxis were to be allowed.

4. Individuals characterized as "high risk" pregnancies at investigator discretion, such as those who have:

   • gestational diabetes
   • preeclampsia/eclampsia
   • women at risk of preterm labor (except positivity for vaginal GBS)
   • History of previous pregnancy complications including delivery of preterm infant.
   • History of still-birth, late abortions and children with congenital anomalies.
5. Individuals who had received any other investigational agent or investigational intervention during the course of the study.
6. Individuals with acute infection including oral temperature ≥ 38°C were to be temporarily excluded. They could be enrolled once the infection had resolved (as judged by investigator).
7. HIV positive by history.

8. Individuals reporting any known or suspected serious acute, chronic or progressive disease (eg, any history of neoplasm, malignancy, including lymphoproliferative disorder, diabetes, cardiac disease, malnutrition, renal failure, autoimmune disease, HBV or HCV, blood disorders).

   Note: Malignancies, highly likely to having been cured at the investigators discretion are allowed. (eg, no relapse since 5 years post last malignancy specific treatment).

9. Individuals with bleeding diathesis, or any condition that might have been associated with a prolonged bleeding time.
10. Individuals with behavioral or cognitive impairment or psychiatric disease that, in the opinion of the investigator, might have interfered with the subject's ability to participate in the study (eg, who were not able to comprehend or to follow all required study procedures for the whole period of the study).
11. Individuals with any progressive or severe neurologic disorder, seizure disorder, epilepsy or Guillain-Barré syndrome.
12. Individuals with history or any illness that, in the opinion of the investigator, might have posed additional risk to subjects due to participation in the study.
13. Individuals who were part of study personnel or close family members conducting this study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group B Streptococcus Trivalent Vaccine; Pregnant women who received one injection of Group B Streptococcus Trivalent Vaccine.	Biological: Group B Streptococcus Trivalent Vaccine; Pregnant women who received one injection of Group B Streptococcus Trivalent Vaccine administered intramuscularly.
Placebo Comparator: Placebo; Pregnant women who received one injection of saline solution.	Biological: Placebo; Pregnant women who received one injection of saline solution administered intramuscularly.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Geometric Mean Concentrations (GMCs) of Antibodies in Mothers and Infants at Delivery/Birth	GMCs of anti-Group B Streptococcus (GBS) capsular polysaccharide (CPS) antibodies against serotypes Ia, Ib and III in mothers and in infants at delivery/birth are presented.	Day of delivery/birth
Geometric Mean of the Ratios Between Infant Antibody Level (μg/mL) and Maternal Antibody Level (μg/mL) at Time of Delivery	The Geometric mean transfer ratio of anti-GBS CPS antibodies against serotypes Ia, Ib and III at delivery is calculated as the geometric mean of the pairwise ratios between the antibody concentrations from infant at birth and to maternal serum concentration at delivery.	Day of delivery/birth

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
GMCs (Enzyme-linked Immunosorbent Assay, ELISA) Antibodies Against Serotypes Ia, Ib and III in Maternal Subjects	GMCs (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III in maternal subjects at study day 1, study day 31 and at day 91 post-partum after one administration of GBS vaccine or placebo are reported.	Day 1, day 31 and day 91 post-delivery
Geometric Mean Ratios (GMRs) of Antibody GMCs (ELISA) in Maternal Subjects	GMRs of GMCs (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III, in maternal subjects at study day 31, at delivery and at day 91 post-partum versus day 1 (baseline) after one administration of GBS vaccine or placebo are reported.	Day 31, day of delivery, day 91 post-delivery
GMC (ELISA) of Anti-GBS CPS Antibodies in Infants	GMC (ELISA) of anti-GBS CPS antibodies against serotypes Ia, Ib and III in infants at birth and at 3 months of age are reported.	Day of birth and day 91 after birth
GMRs of Anti-GBS CPS Antibody GMCs (ELISA) in Infants at 3 Months of Age Versus GMCs at Birth	GMRs of anti-GBS CPS antibody GMCs (ELISA) against serotypes Ia, Ib and III in infants at 3 months of age (day 91 after birth) versus GMCs at birth are reported.	Day 91 after birth
Percentages of Infant Subjects Showing Anti-diphtheria Antibodies GMCs (ELISA) Over 0.1 IU/mL at 1 Month After the Last Routine Infant Immunization	Percentages of infant subjects showing anti-diphtheria antibodies GMCs (ELISA) over 0.1 IU/mL in sera collected at 1 month after the last routine infant immunization (ie, either 5 months or 7 months after birth, depending on the vaccination schedule) are reported.	1 month after the last routine infant immunization
Percentage of Maternal Subjects Reporting Solicited Local and Systemic Adverse Events (AEs)	Percentage of maternal subjects reporting solicited local and systemic AEs and other indicators of reactogenicity from day 1 to 7 after vaccination are reported.	From day 1 to 7 after vaccination
Percentage of Maternal Subjects Reporting Unsolicited AEs and Serious Adverse Events (SAEs)	Percentage of maternal subjects reporting unsolicited AEs, SAEs, AEs requiring a non-routine physician's visit, AEs leading to withdrawal are reported.	All AEs were recorded until delivery, after delivery all AEs requiring a non-routine physician's visit and AEs leading to withdrawal from the study. SAEs were collected for the duration of the trial.
Percentages of Infants Reporting SAEs	Percentages of infants born from women who received either one injection of the study vaccine or placebo, reporting SAEs from birth until study termination are reported.	From birth until study termination

Collaborators and Investigators

• Sponsor: Novartis
• Collaborators: Novartis Vaccines
• Investigators: Principal Investigator: Gilbert Donders, Prof., Regional Hospital Heilig Hart, Tienen, Belgium

Publications and helpful links

General Publications

• Fabbrini M, Rigat F, Tuscano G, Chiarot E, Donders G, Devlieger R, Filippini S, Frigimelica E, Forte P, Wittke F, Halperin SA, Slobod K, Grandi G, Margarit I. Functional activity of maternal and cord antibodies elicited by an investigational group B Streptococcus trivalent glycoconjugate vaccine in pregnant women. J Infect. 2018 May;76(5):449-456. doi: 10.1016/j.jinf.2018.01.006. Epub 2018 Jan 31.
• Donders GG, Halperin SA, Devlieger R, Baker S, Forte P, Wittke F, Slobod KS, Dull PM. Maternal Immunization With an Investigational Trivalent Group B Streptococcal Vaccine: A Randomized Controlled Trial. Obstet Gynecol. 2016 Feb;127(2):213-21. doi: 10.1097/AOG.0000000000001190.

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Actual): April 1, 2013
• Study Completion (Actual): October 1, 2013

Study Registration Dates

• First Submitted: September 27, 2011
• First Submitted That Met QC Criteria: October 3, 2011
• First Posted (Estimate): October 5, 2011

Study Record Updates

• Last Update Posted (Estimate): September 8, 2014
• Last Update Submitted That Met QC Criteria: September 5, 2014
• Last Verified: September 1, 2014

More Information

Terms related to this study

• Keywords: Vaccine; Group B streptococcus; GBS; Prevention of group B streptococcus infection
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Bacterial Infections and Mycoses; Infections; Communicable Diseases; Bacterial Infections; Streptococcal Infections; Gram-Positive Bacterial Infections
• Other Study ID Numbers: V98_04; 2010-020840-36