The immunogenicity and safety of an investigational meningococcal serogroups A, C, W-135, Y tetanus toxoid conjugate vaccine (ACWY-TT) compared with a licensed meningococcal tetravalent polysaccharide vaccine: a randomized, controlled non-inferiority study

Ghassan Dbaibo, Noel Macalalad, Mari Rose Aplasca-De Los Reyes, Efren Dimaano, Veronique Bianco, Yaela Baine, Jacqueline Miller, Ghassan Dbaibo, Noel Macalalad, Mari Rose Aplasca-De Los Reyes, Efren Dimaano, Veronique Bianco, Yaela Baine, Jacqueline Miller

Abstract

Immunogenicity and safety of ACWY-TT compared with licensed ACWY polysaccharide vaccine (MenPS) in healthy adults, and lot-to-lot consistency of three ACWY-TT lots were evaluated in a phase 3, open, controlled study. Adults aged 18-55 y were randomized to receive ACWY-TT (one of three lots) or MenPS. Serum bactericidal antibodies (rSBA) were measured pre- and 1 mo post-vaccination. Adverse events (AEs) were assessed 4 d (solicited symptoms) and 31 d (unsolicited symptoms) post-vaccination. Serious AEs were reported up to 6 mo after vaccination. The number of vaccinated subjects was 1247 (ACWY-TT, n = 935; MenPS, n = 312). ACWY-TT lot-to-lot consistency and non-inferiority of ACWY-TT as compared with MenPS groups were demonstrated according to pre-specified criteria. The percentages of subjects with a vaccine response (VR = rSBA titer ≥ 1:32 in initially seronegative; ≥ 4-fold increase in initially seropositive) to ACWY-TT vs. MenPS were 80.1%/69.8% (serogroup A), 91.5%/ 92.0% (C), 90.2%/85.5% (W-135), 87.0%/78.8% (Y). Exploratory analyses showed that for serogroups A, W-135 and Y, VR rates and GMTs were significantly higher for ACWY-TT compared with MenPS. For each serogroup, ≥ 98.0% of subjects had rSBA titers ≥ 1:128. Grade 3 solicited AEs were reported in ≤ 1.6% of subjects in any group. The immunogenicity of ACWY-TT vaccine was non-inferior to MenPS for all four serogroups in adults, with significantly higher VR rates to serogroups A, W-135 and Y and an acceptable safety profile. Consistency of 3 ACWY-TT production lots was demonstrated. These data suggest that, if licensed, ACWY-TT conjugate vaccine may be used for protection against invasive meningococcal disease in healthy adults. This study is registered at clinicaltrials.gov NCT00453986.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3495723/bin/hvi-8-873-g1.jpg
Figure 1. Subject flow through the study. *An additional 105 subjects were enrolled in the cohort evaluated for the co-administration of influenza vaccine (the analysis of co-administration with seasonal influenza vaccine will be presented in a separate publication).
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3495723/bin/hvi-8-873-g2.jpg
Figure 2. rSBA GMTs (with 95% CIs) before and one month after vaccination (ATP immunogenicity cohort). Pre, pre-vaccination (plain columns); P1, 1 mo post vaccination (hatched columns). Blue bars, ACWY-TT group; Orange bars, MenPS group.

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Source: PubMed

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