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Pediatric Safety and Immunogenicity Study of Cell-Culture Derived and Egg-based Subunit Influenza Vaccines in Healthy Children and Adolescents

20 oktober 2015 uppdaterad av: Novartis

A Combined Phase II/III, Observer-Blind, Randomized, Multi-center Study to Evaluate Safety, Tolerability and Immunogenicity of Trivalent Subunit Influenza Vaccines, Produced Either in Mammalian Cell Culture or in Embryonated Hen Eggs, in Healthy Children and Adolescents

The present study is the first study designed to evaluate safety, tolerability and immunogenicity of the cell culture-derived influenza vaccine in healthy children and adolescents aged 3 to 17 years. A step-down approach is utilized in which reactogenicity and safety will be assessed in children and adolescents 9 to 17 years of age (Cohort 1) prior to enrolling additional children and adolescents 9 to 17 years of age (Cohort 2) and children 3 to 8 years of age (Cohort 3).

Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

3604

Fas

  • Fas 2
  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Helsinki, Finland, 00100
        • Site 71: Etelä-Helsingin rokotetutkimusklinikka
      • Helsinki, Finland, 00930
        • Site 72: Itä-Helsingin rokotetutkimusklinikka
      • Järvenpää, Finland, 04400
        • Site 76: Järvenpään rokotetutkimusklinikka
      • Kotka, Finland, 48600
        • Site 77: Kotkan rokotetutkimusklinikka
      • Lahti, Finland, 15140
        • Site 67: Lahden rokotetutkimusklinikka
      • Oulu, Finland, 90100
        • Site 75: Oulun rokotetutkimusklinikka
      • Pori, Finland, 28120
        • Site 68: Porin rokotetutkimusklinikka
      • Tampere, Finland, 33100
        • Site 66: Tampereen rokotetutkimusklinikka
      • Turku, Finland, 20520
        • Site 69: Turun rokotetutkimusklinikka
      • Vantaa, Finland, 01300
        • Site 73: Itä-Vantaan rokotetutkimusklinikka
      • Vantaa, Finland, 01600
        • Site 74: Länsi-Vantaan rokotetutkimusklinikka
    • Espoo
      • Heikintori, Espoo, Finland, 02100
        • Site 70: Espoon rokotetutkimusklinikka
    • Kokkola
      • Rantakatu 7, Kokkola, Finland, 67100
        • Site 79: Kokkola Vaccine Research Clinic
    • Kuopio
      • Microkatu 1,Osa/Section A, 3rd floor PL1188, Kuopio, Finland, 70211
        • Site 78: Kuopio Vaccine Research Clinic
    • Arkansas
      • Fayetteville, Arkansas, Förenta staterna, 72703
        • Site 09
    • California
      • Downey, California, Förenta staterna, 90241
        • Site 10
    • Kentucky
      • Bardstown, Kentucky, Förenta staterna, 40004
        • Site 02
    • Louisiana
      • Metairie, Louisiana, Förenta staterna, 70006
        • Site 14
    • Missouri
      • St. Louis, Missouri, Förenta staterna, 63104
        • Site 01
    • Nebraska
      • Omaha, Nebraska, Förenta staterna, 68134
        • Site 11
    • New Jersey
      • Edison, New Jersey, Förenta staterna, 08817
        • Site 04
    • New York
      • Endwell, New York, Förenta staterna, 13760
        • Site 05
    • Texas
      • Fort Worth, Texas, Förenta staterna, 76135
        • Site 16
      • San Angelo, Texas, Förenta staterna, 76904
        • Site 13
      • San Antonio, Texas, Förenta staterna, 78205
        • Site 12
    • Utah
      • Bountiful, Utah, Förenta staterna, 84010
        • Site 08
      • Salt Lake City, Utah, Förenta staterna, 84109
        • Site 07
      • Salt Lake City, Utah, Förenta staterna, 84121
        • Site 03
    • Virginia
      • Burke, Virginia, Förenta staterna, 22105
        • Site 06
    • Washington
      • Spokane, Washington, Förenta staterna, 99202
        • Site 15
      • Ferrara, Italien, 44100
        • Site 42: Dipartimento di Medicina Clinica e Sperimentale - Sezione di Igiene e Medicina Preventiva
      • Genova, Italien, 16132
        • Site 47: Dipartimento Scienze della Salute, Sezione di Igiene e Medicina Preventiva, Univesità di Genova
      • Novara, Italien, 28100
        • Site 41: Ospedale Maggiore della Carità-Clinica Pediatrica
      • Perugia, Italien, 06070
        • Site 46: USL 2 Perugia, Distretto del perugino, Centro di Salute n. 4 (Madonna Alta) e n. 6 (Ellera di Corciano del distretto del perugino)
      • Ragusa, Italien, 97100
        • Site 45: AUSL 7
      • Dakovo, Kroatien
        • Site 44:Spec. Pediatric Dispensary
      • Ljudevita Gaja 2, Djakovo, Kroatien
        • Site 83
      • Sisak, Kroatien
        • Site 43: Spec. Pediatric Dispensary
      • Zagreb, Kroatien
        • Site 27:Institute of Public Health
      • Zagreb, Kroatien
        • Site 29: Institute of Public Health
      • Zagreb, Kroatien
        • Site 40:Spec. Pediatric Dispensary
      • Zagreb, Kroatien
        • Site 49: Spec. Pediatric Dispensary
      • Zagreb, Kroatien
        • Site 50: Spec. Pediatric Dispensary
      • Zagreb, Kroatien
        • Site 86: Spec. Pediatric Dispensary
      • Kaunas, Litauen, 48259
        • Site 35
      • Vilnius, Litauen, 01117
        • Site 36
      • Vilnius, Litauen, 02169
        • Site 32
      • Vilnius, Litauen, 04318
        • Site 34
      • Vilnius, Litauen, 10207
        • Site 31
      • Vilnius, Litauen, 11200
        • Site 33
    • Arges
      • Campulung Muscel, Arges, Rumänien, 115100
        • Site 25
    • Dolj
      • Craiova, Dolj, Rumänien, 200642
        • Site 21
      • Budapest, Ungern, 1042
        • Site 57: Házi Gyermekorvosi Rendelő
      • Budapest, Ungern, 1089
        • Site 53: Heim Pál Gyermekkórház
      • Budapest, Ungern, 1097
        • Site 52: Ferencvárosi Gyermekorvos Kft.
      • Budapest, Ungern, 1136
        • Site 56: Házi Gyermekorvosi Rendelő
      • Budapest, Ungern, 1173
        • Site 54: Házi Gyermekorvosi Rendelő
      • Miskolc, Ungern, 3534
        • Site 51: 5053. számú Gyermekorvosi Rendelő
      • Nyíregyháza, Ungern, 4481
        • Site 55: Revamed kft.
      • Szombathely, Ungern, 9700
        • Site 59: Vas Megyei Markusovszky Lajos, Általános, Rehabilitációs és Gyógyfürdő Kórház, Egyetemi Oktató Kórház

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

3 år till 17 år (Barn)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. Subjects aged 9 to 17 years (Cohorts 1 and 2) and 3 to 8 years (Cohort 3), whose parents/legal guardians have given written informed consent prior to study entry. Assent will be obtained from subjects according to age requirements of the ECs/IRBs;
  2. In good health as determined by:

    1. medical history,
    2. physical examination,
    3. clinical judgment of the Investigator;
  3. Able to comply with all study procedures and available for all clinic visits and telephone calls scheduled in the study.

Exclusion Criteria:

  1. Any serious disease, such as:

    1. cancer,
    2. autoimmune disease (including rheumatoid arthritis),
    3. diabetes mellitus,
    4. chronic pulmonary disease,
    5. acute or progressive hepatic disease,
    6. acute or progressive renal disease;
  2. History of any anaphylaxis or serious reaction following administration of vaccine, or hypersensitivity to eggs, egg protein, chicken feathers, influenza viral protein, neomycin, polymyxin, or any other vaccine component, chemically related substance, or component of the potential packaging materials;
  3. Known or suspected impairment/alteration of immune function, including:

    1. use of immunosuppressive therapy such as systemic corticosteroids known to be associated with the suppression of hypothalamic-pituitary-adrenal (HPA) axis or chronic use of inhaled high-potency corticosteroids within 60 days prior to Visit 1,
    2. cancer chemotherapy,
    3. receipt of immunostimulants within 60 days prior to Visit 1,
    4. receipt of parenteral immunoglobulin preparation, blood products, and/or plasma derivatives within 3 months prior to Visit 1 or planned during the full length of the study,
    5. known HIV infection or HIV-related disease;
  4. History of Guillain-Barré syndrome;
  5. Bleeding diathesis;
  6. Surgery planned during the study period;
  7. Receipt of another investigational agent within 90 days, or before completion of the safety follow-up period in another study, whichever is longer, prior to enrollment and unwilling to refuse participation in another clinical study through the end of the study;
  8. Receipt of another vaccine within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to Visit 1;
  9. Laboratory-confirmed influenza disease within 6 months prior to Visit 1;
  10. For subjects aged 3 to 8 years old, ever received two doses of an influenza vaccine in one influenza season;
  11. Receipt of an influenza vaccine within 6 months prior to Visit 1;
  12. Experienced a temperature 38.0°C [100.4°F]) and/or any acute illness within 3 days prior to Visit 1;
  13. Pregnant or nursing mother;
  14. Female of childbearing potential who is sexually active and has not used acceptable birth control measures for at least 2 months prior to study entry and who does not plan to use acceptable birth control measures during the 3 weeks following vaccination or refuses to have a urine pregnancy test prior to enrollment. Oral, injected, inserted or implanted hormonal contraceptive, diaphragm or condom with spermicidal agent or intrauterine device are considered acceptable forms of birth control;
  15. Children of research staff or those living with research staff directly involved with the clinical study. Research staff are individuals with direct study subject contact, indirect contact with study subjects, or study site personnel who have access to any study documents containing subject information. This would include receptionists, persons scheduling appointments or making screening calls, regulatory specialists, laboratory technicians, etc.;
  16. Any condition, which in the opinion of the Investigator, might interfere with the evaluation of the study objectives.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Cohorts 1 + Cohort 2 (9-17 Yrs) cTIV
All subjects received one 0.5 mL IM injection, of cell culture-derived trivalent influenza vaccine containing 15μg of HA for each strain (A/Solomon Islands/3/2006 [H1N1]-like, A/Wisconsin/67/2005 [H3N2]-like, and B/Malaysia/ 2506/2004-like), recommended for the 2007-2008 influenza season in the Northern Hemisphere
One 0.5 ml injection of the cell culture-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm.
Two 0.5 mL injections,of the cell culture-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm, administered four weeks apart.
Aktiv komparator: Cohorts 1 + Cohort 2 (9-17 Yrs) eTIV
All subjects received one 0.5 mL injection, of egg -derived trivalent influenza vaccine containing 15μg of HA for each strain (A/Solomon Islands/3/2006 [H1N1]-like, A/Wisconsin/67/2005 [H3N2]-like and B/Malaysia/ 2506/2004-like), recommended for the 2007-2008 influenza season in the Northern Hemisphere.
One 0.5 ml injection of the conventional egg-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm.
Two 0.5 mL injections of the conventional egg-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm,administered four weeks apart.
Experimentell: Cohort 3 (3-8 Yrs) cTIV
All subjects received two 0.5 mL injections, administered four weeks apart, of cell culture-derived trivalent influenza vaccine containing 15μg of HA for each strain (A/Solomon Islands/3/2006 [H1N1]-like, A/Wisconsin/67/2005 [H3N2]-like and B/Malaysia/ 2506/2004-like), recommended for the 2007-2008 influenza season in the Northern Hemisphere
One 0.5 ml injection of the cell culture-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm.
Two 0.5 mL injections,of the cell culture-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm, administered four weeks apart.
Aktiv komparator: Cohort 3 (3-8 Yrs) eTIV
All subjects received two 0.5 mL injections, administered four weeks apart of egg -derived trivalent influenza vaccine containing 15μg of HA for each strain (A/Solomon Islands/3/2006 [H1N1]-like, A/Wisconsin/67/2005 [H3N2]-like and B/Malaysia/ 2506/2004-like), recommended for the 2007-2008 influenza season in the Northern Hemisphere
One 0.5 ml injection of the conventional egg-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm.
Two 0.5 mL injections of the conventional egg-derived influenza vaccine in the deltoid muscle, preferably of the nondominant arm,administered four weeks apart.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Geometric Mean Titers of the Cell Culture-derived Vaccine Compared With the Egg-derived Vaccine in 3 to 8 Year-old Children
Tidsram: Day 50 post vaccination

To demonstrate non-inferiority of the post vaccination hemagglutination inhibition (HI) geometric mean titer (GMT) of the cell culture-derived influenza (cTIV) vaccine to the corresponding GMT of the egg-derived (eTIV) influenza vaccine, for all three strains, after two injections administered four weeks apart to a subset of children 3 to 8 years of age.

GMTs were evaluated using two assays, HI egg derived antigen assay and HI cell derived antigen assay.

Day 50 post vaccination
Percentages of Subjects Who Attained Seroconversion or Significant Increase in Antibody Titers in the Cell Culture-derived Vaccine Compared With the Egg-derived Vaccine in 3 to 8 Year-old Children
Tidsram: Day 50 post vaccination

To demonstrate non-inferiority of the cell culture-derived influenza (cTIV) vaccine to the egg-derived (eTIV) influenza vaccine in the percentage of subjects achieving seroconversion or significant increase in antibody titer post vaccination, for all three strains, after two injections administered four weeks apart in children 3 to 8 years of age.

Seroconversion rate was evaluated using two assays- HI egg derived antigen assay and HI cell derived antigen assay.

Day 50 post vaccination

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Geometric Mean Titers After 1 Dose of the Cell Culture-derived or the Egg-derived Influenza Vaccine in 9 to 17 Year-old Children and Adolescents
Tidsram: Day 29 post vaccination

To evaluate immunogenicity in terms of Geometric Mean Titers (GMTs) in children 9 to 17 years of age after one injection of either cTIV vaccine or eTIV.

GMTs were evaluated using two assays, HI egg derived antigen assay and HI cell derived antigen assay.

Day 29 post vaccination
Geometric Mean Ratio After 1 Dose of the Cell Culture-derived or the Egg-derived Influenza Vaccine in 9 to 17 Year-old Children and Adolescents.
Tidsram: Day 29 post vaccination

Immunogenicity was evaluated in terms of Geometric Mean Ratio (GMRs) in 9 to 17 year-old children and adolescents after one injection of either cTIV vaccine or eTIV.

The criterion is met according to European (CHMP) guideline if the mean geometric increase GMR (day29/day1) in HI antibody titer is >2.5.

Day 29 post vaccination
Percentages of Subjects Who Achieved HI Titers ≥40 After 1 Dose of the Cell Culture-derived Vaccine or the Egg-derived Influenza Vaccine in 9 to 17 Year-old Children and Adolescents
Tidsram: Day 29 post vaccination

To evaluate immunogenicity in terms of percentage of 9 to 17 year-old children and adolescents achieving HI titers ≥40, after one injection of either the cTIV vaccine or the eTIV vaccine.

This criterion is met according to European (CHMP) guideline if the percentage of subjects achieving HI titers ≥40 is >70% and according to the US (CBER) guideline is met if the lower bound of the two sided 95%CI for percentage of subjects achieving HI titers ≥40 is ≥70%.

Day 29 post vaccination
Percentages of Subjects Who Attained Seroconversion or Significant Increase After 1 Dose of the Cell Culture-derived Vaccine or the Egg-derived Influenza Vaccine in 9 to 17 Year-old Children and Adolescents
Tidsram: Day 29 post vaccination

Seroconversion or significant increase as per CHMP criteria is defined as percentage of subjects with a pre vaccination HI titer <10 to a post vaccination titer ≥40 or a pre vaccination HI titer ≥10 and a ≥4-fold increase in post vaccination HI antibody titer. According to the CHMP criteria, the percentage of subjects achieving seroconversion or significant increase should be >40%.

According to the CBER criteria, the lower bound of the two-sided 95% CI for the percentage of subjects achieving seroconversion/significant increase should be ≥40%.

Day 29 post vaccination
Geometric Mean Titers After Two Doses of the Cell Derived or the Egg Derived Vaccine in 3 to 8 Year-old Children
Tidsram: Day 29 and Day 50 post vaccination
To evaluate immunogenicity in terms of Geometric Mean Titers (GMTs) in children 3 to 8 years of age after two doses of either cTIV vaccine or eTIV,administered 4 weeks apart.
Day 29 and Day 50 post vaccination
Geometric Mean Ratio After Two Doses of the Cell-derived or the Egg-derived Vaccine in 3 to 8 Year-old Children
Tidsram: Day 29 and Day 50 post vaccination

To evaluate immunogenicity in terms of Geometric Mean Ratio (GMR) in children 3 to 8 years of age after two doses of either the cTIV vaccine or the eTIV vaccine, administered 4 weeks apart according to the CHMP criteria.

The criterion is met according to the European (CHMP) guideline if the mean geometric increase (GMR day 29/day 1 and GMR day 50/day 1) in HI antibody titer is >2.5

Day 29 and Day 50 post vaccination
Percentages of Subjects Who Achieved HI Titers ≥40 After Two Doses of the Cell Culture Derived or the Egg Derived Influenza Vaccine in 3 to 8 Year-old Children
Tidsram: Day 29 and Day 50 post vaccination

To evaluate immunogenicity in terms of HI titers ≥40, in children 3-8 years of age after two doses of either cTIV vaccine or eTIV vaccine, administered 4 weeks apart.

The criterion is met according to European (CHMP) guideline if the percentage of subjects achieving HI titers ≥40 is >70% and according to the US (CBER) guideline if the lower bound of the two sided 95%CI for percentage of subjects achieving HI titers ≥40 is ≥70%.

Day 29 and Day 50 post vaccination
Percentages of Subjects Who Achieved Seroconversion or Significant Increase in HI Titers After Two Doses of the Cell Culture-derived Vaccine or the Egg-derived Influenza Vaccine in 3 to 8 Year-old Children
Tidsram: Day 29 and Day 50 post vaccination

Seroconversion or significant increase as per CHMP criteria is defined as percentage of subjects with a pre vaccination HI titer <10 to a post vaccination titer ≥40 or a pre vaccination HI titer ≥10 and a ≥4-fold increase in post vaccination HI antibody titer. According to the CHMP criteria, the percentage of subjects achieving seroconversion or significant increase should be >40%.

According to the CBER criteria, the lower bound of the two-sided 95% CI for the percentage of subjects achieving seroconversion/significant increase should be ≥40%.

Day 29 and Day 50 post vaccination
Number of Subjects Reporting Local and Systemic Reactions After 1 Dose of the Cell Culture-derived or the Egg-derived Influenza Vaccine in 9 to 17 Year-old Children and Adolescents.
Tidsram: up to 7 days after vaccination
To evaluate safety and tolerability in terms of number of 9 to 17 year-old children and adolescents (cohorts 1 and 2) reporting local and systemic reactions following of one injection of the cTIV or the eTIV vaccine .
up to 7 days after vaccination
Number of Subjects Reporting Local and Systemic Reactions After One and Two Doses of the Cell Culture-derived Vaccine or Egg-derived Influenza Vaccine in 3 to 8 Year-old Children.
Tidsram: up to 7 days after each vaccination
To evaluate the safety and tolerability of the cTIV and the eTIV influenza vaccines in 3 to 8 year-old children terms of number of participants reporting local and systemic reactions after each vaccination.
up to 7 days after each vaccination

Samarbetspartners och utredare

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Sponsor

Samarbetspartners

Publikationer och användbara länkar

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 oktober 2007

Primärt slutförande (Faktisk)

1 februari 2008

Avslutad studie (Faktisk)

1 juli 2008

Studieregistreringsdatum

Först inskickad

21 mars 2008

Först inskickad som uppfyllde QC-kriterierna

21 mars 2008

Första postat (Uppskatta)

27 mars 2008

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

23 november 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

20 oktober 2015

Senast verifierad

1 oktober 2015

Mer information

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