Meningitis Clinical Trial
Official title:
A Phase 3 Trial to Evaluate the Safety, Immunogenicity, and Non-Interference With Concomitant Routine Vaccines, of a Meningococcal Serogroup ACYWX Conjugate Vaccine (NmCV-5) in Comparison With MenACWY-TT Conjugate Vaccine in Healthy Malian Infants
Verified date | April 2024 |
Source | Emory University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Infants aged 9 months will be randomized to receive a meningococcal vaccine at 9 months or 15 months. Infants randomized to the 9-month age group will be further randomized in a 2:1 ratio to receive a single dose of the experimental meningococcal vaccine (NmCV-5) or a single dose of the comparator meningococcal vaccine (MenACWY-TT). Prospectively identified and consented infants randomized to the 15-month age group will return when aged 15 months and will be randomized in a 2:1 ratio to receive a single dose of NmCV-5 or a single dose of MenACWY-TT.
Status | Active, not recruiting |
Enrollment | 1325 |
Est. completion date | July 2025 |
Est. primary completion date | March 10, 2023 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 9 Months to 11 Months |
Eligibility | Inclusion Criteria: 1. Male and female children between 9 months and 11 months old inclusive. 2. Parent(s)/legal guardian(s) have provided written informed consent, after the nature of the study has been explained according to local regulatory requirements. 3. The investigator believes that their parent(s)/guardian(s) will be available for all the subjects visits and will comply with the requirements of the protocol (e.g., timely reporting of adverse events). 4. Individual is in good health as determined by medical history, physical examination, and clinical judgement of the investigator. 5. Individual has completed their local infant EPI vaccines, not including 9-month EPI vaccines (at the 9-month visit) or 15- month EPI vaccines (at the 15-month visit). A birth dose of oral polio vaccine is not required. Exclusion Criteria: 1. History of receipt of any meningococcal vaccine. 2. Has received a measles-containing vaccine. 3. Current or previous, confirm or suspected disease caused by N. meningitidis. 4. Household contact with and/or intimate exposure to an individual with any laboratory confirmed N. meningitidis infection within 60 days of enrolment or study vaccination (for the 15-month age group). 5. History of severe allergic reactions after previous vaccinations or hypersensitivity to any study vaccine component including tetanus, diphtheria and mutant diphtheria toxoid (CRM197). 6. Acute or chronic, clinically significant pulmonary, cardiovascular, metabolic, neurological, hepatic, or renal functional abnormality, as determined by medical history or physical examination. 7. Any confirmed or suspected condition with impaired or altered function of the immune system (e.g., immunodeficiency, autoimmune conditions, malnutrition). 8. Have any bleeding disorder which is considered a contraindication to intramuscular injection or blood draw. 9. Severe acute malnutrition. Note: a weight-for-length Z-score of less than -3 satisfies this exclusion criteria. 10. History of either hepatitis B or hepatitis C virus infection, human immunodeficiency virus infection, or hereditary immunodeficiency. 11. Presence of major and clinically significant congenital defects. 12. Chronic administration (defined as more than 14 days) of immunosuppressants or other immune-modifying drugs within three months prior to the study vaccination or planned use throughout the study period (for corticosteroids, this means prednisone, or equivalent, = 0.5 mg/kg per day. Inhaled, intranasal, and topical steroids are allowed). 13. Administration of blood, blood products and/or plasma derivatives or any parenteral immunoglobulin preparation in the past 3 months or planned use throughout the study period. 14. Administration of any vaccine within 14 days prior to enrolment in the study or planned administration of any vaccine within 14 days before or after study vaccination. 15. Use of any investigational or non-registered drug or vaccine within 28 days prior to the administration of study vaccine or planned during the study. 16. Malaria infection as confirmed by a Rapid Diagnostic Test. Note: subjects positive at screening may be treated for malaria as per national guidelines outside of the study, and if the subject remains eligible, vaccinated no earlier than 5 days after completing treatment. 17. Individuals who are close family member* of individuals conducting this study. *defined as a child with direct genetic relationship to a member of the study team. 18. Have experienced a moderate or severe acute infection and/or fever (defined as temperature = 37.5°C) within 3 days prior to enrolment or study vaccination. 19. Have received systemic antibiotic treatment within 3 days prior to enrolment or study vaccination. 20. Non-residence in the study area or intent to move out within six months. 21. Any condition which, in the opinion of the investigator, might post additional risk to the subject due to participation in the study. |
Country | Name | City | State |
---|---|---|---|
Mali | Centre pour le Developpement des Vaccins du Mali | Bamako |
Lead Sponsor | Collaborator |
---|---|
Emory University | National Institute of Allergy and Infectious Diseases (NIAID) |
Mali,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Number of Participants With Serious Adverse Events (SAE) Through 2 Years of Follow-Up | To assess the safety and tolerability of a single dose of NmCV-5 or MenACWY-TT, when given concomitantly with routine vaccines, all Serious Adverse Events (SAE) occurring during 2 years of follow-up after meningococcal vaccination are reported.
Endpoints are the number of participants with unsolicited adverse events that are reported as Serious Adverse Events (SAEs) according to ICH/GCP guidelines or the study protocol collected from the time of Step 2 randomization and vaccination and with date of event onset up to and including Study Day 730. |
Measured from time of meningococcal vaccination to Study Day 730 or early study termination, whichever is earlier. Follow-up time to Study Day 730 visit was a mean (s.d.) of xxx.x (x.x) days. | |
Other | Geometric Mean of rSBA Titers at Study Day 181 for Meningitis Serogroups A, C, W, Y and X | For each study age group (9 months and 15 months) and for each of the five serogroups (A, C, W, Y, and X), geometric means and 95% CIs of rSBA titers at Day 181 are calculated by study vaccination arm within each study age group.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 4 (Study Day 181). |
Measured from time of meningococcal vaccination to blood sample collection at Day 181 visit. Follow-up time to Day 181 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Number of Participants With rSBA Titers = 8 at Study Day 181 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the number and proportion of participants with rSBA titers = 8 at Day 181 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and proportion of participants with rSBA titers = 8 for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 4 (Study Day 181). This is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 181 visit. Follow-up time to Day 181 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Number of Participants With rSBA Titers = 128 at Study Day 181 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the number and proportion of participants with rSBA titers = 128 at Day 181 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and proportion of participants with rSBA titers = 128 for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 4 (Study Day 181). This is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 181 visit. Follow-up time to Day 181 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Geometric Mean Fold Rise (GMFR) at Study Day 181 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the Geometric Mean Fold Rise (GMFR) from baseline to Day 181 of rSBA titers to meningococcal serogroups A, C, W, Y and X is estimated, with 95% CI.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X from samples collected at Visit 1 (Day 1) and Visit 4 (Day 181). The point and interval estimates will be obtained from a back transformation of the estimated mean difference of the log-transformed rSBA titers. |
Measured from time of blood sample collection just prior to meningococcal vaccination at Day 1 visit to blood sample collection at Day 181 visit. Follow-up time to Day 181 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Geometric Mean of rSBA Titers at Study Day 730 for Meningitis Serogroups A, C, W, Y and X | For each study age group (9 months and 15 months) and for each of the five serogroups (A, C, W, Y, and X), geometric means and 95% CIs of rSBA titers at Day 730 are calculated by study vaccination arm within each study age group.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 5 (Study Day 730). |
Measured from time of meningococcal vaccination to blood sample collection at Day 730 visit. Follow-up time to Day 730 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Number of Participants With rSBA Titers = 8 at Study Day 730 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the number and proportion of participants with rSBA titers = 8 at Day 730 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and proportion of participants with rSBA titers = 8 for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 5 (Study Day 730). This is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 730 visit. Follow-up time to Day 730 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Number of Participants With rSBA Titers = 128 at Study Day 730 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the number and proportion of participants with rSBA titers = 128 at Day 730 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and proportion of participants with rSBA titers = 128 for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 5 (Study Day 730). This is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 730 visit. Follow-up time to Day 730 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Other | Geometric Mean Fold Rise (GMFR) at Study Day 730 for Meningitis Serogroups A, C, W, Y and X | To assess the persistence of immune response elicited by a single dose of meningococcal vaccine, the Geometric Mean Fold Rise (GMFR) from baseline to Day 730 of rSBA titers to meningococcal serogroups A, C, W, Y and X is estimated, with 95% CI.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X from samples collected at Visit 1 (Day 1) and Visit 5 (Day 730). The point and interval estimates will be obtained from a back transformation of the estimated mean difference of the log-transformed rSBA titers. |
Measured from time of blood sample collection just prior to meningococcal vaccination at Day 1 visit to blood sample collection at Day 730 visit. Follow-up time to Day 730 visit blood specimen collection was a mean (s.d.) of xx.x (x.x) days. | |
Primary | Number of Participants With Seroprotection for Meningitis Serogroups A, C, W and Y | Null hypothesis: The immune response to meningitis serogroup "S" at Day 29 elicited by one dose of NmCV-5 is inferior to the immune response elicited by one dose of MenACWY-TT.
Alternative hypothesis: The immune response to meningitis serogroup "S" at Day 29 elicited by one dose of NmCV-5 is non-inferior, by a pre-specified margin, to the immune response elicited by one dose of MenACWY-TT, where "S" denotes one of the meningitis serogroups: A, C, W or Y. Endpoints are the seroprotective response at Day 29 to serogroups A, C, W and Y in the NmCV-5 arm and seroprotective response at Day 29 to serogroups A, C, W and Y in the MenACWY-TT arm with seroprotective response defined as serogroup specific rSBA antibody titers = 8. Non-inferiority comparisons are made between study vaccination arms within each study age group (9 months or 15 months of age). Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Primary | Number of Participants With Seroprotection for Meningitis Serogroup X (NmCV-5) vs Lowest Comparator (MenACWY-TT) | Null hypothesis: At Day 29, the immune response to meningitis serogroup X elicited by one dose of NmCV-5 is inferior to the lowest immune response (among meningitis serogroups A, C, W or Y) elicited by one dose of MenACWY-TT.
Alternative hypothesis: At Day 29, the immune response to meningitis serogroup X elicited by one dose of NmCV-5 is non-inferior, by a pre-specified margin, to the lowest immune response (among meningitis serogroups A, C, W or Y) elicited by one dose of MenACWY-TT. Endpoints are the seroprotective response to serogroup X in the NmCV-5 arm and the minimum seroprotective response among serogroups A, C, W and Y in the MenACWY-TT arm at Day 29 with seroprotective response defined as serogroup specific rSBA antibody titers = 8. Non-inferiority comparisons are made between study vaccination arms within each study age group (9 months or 15 months). Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Number of Participants With Serious Adverse Events (SAE) | To assess the safety and tolerability of a single dose of NmCV-5 or MenACWY-TT, when given concomitantly with routine vaccines, all Serious Adverse Events (SAE) occurring during the first 6 months of the follow-up period after meningococcal vaccination are reported.
Endpoints are the number of participants with unsolicited adverse events that are reported as Serious Adverse Events (SAEs) according to ICH/GCP guidelines or the study protocol collected from the time of Step 2 randomization and vaccination and with date of event onset up to and including Study Day 181. |
Measured from time of meningococcal vaccination to Study Day 181 or early study termination, whichever is earlier. Follow-up time to Study Day 181 visit was a mean (s.d.) of 180.8 (3.0) days. | |
Secondary | Number of Participants With Solicited Adverse Events (Reactogenicity) | To assess the safety and tolerability of a single dose of NmCV-5 or MenACWY-TT, when given concomitantly with routine vaccines, all solicited AEs occurring during a 7-day follow-up period after meningococcal vaccination are reported. Solicited AEs include injection site (local) events (erythema/redness, induration/swelling, pain and/or tenderness) and systemic events (irritability, drowsiness/lethargy, decrease eating/anorexia, vomiting, fever (axillary), and feverish).
Endpoints are the number of participants with solicited adverse events collected from about 30 minutes after meningococcal vaccination to Study Day 8 (7 days after vaccination). NOTE: Capture of data for symptom Feverish began on June 15, 2022, so some participants were not assessed for this symptom. Also, Fever (Axillary) is objectively measured by oral temperature and Feverish is a subjective observation from a parent who feels their infant has a raised temperature but not verified by thermometer. |
Measured from about 30 minutes after meningococcal vaccination to Study Day 8 (7 days) for all participants. | |
Secondary | Number of Participants With Unsolicited Adverse Events | To assess the safety and tolerability of a single dose of NmCV-5 or MenACWY-TT, when given concomitantly with routine vaccines, all unsolicited AEs occurring through 28 days after meningococcal vaccination are reported. Unsolicited AEs include AEs reported in scheduled or interim (unscheduled) visits after receipt of meningitis vaccination and with date of onset up to and including Study Day 29.
Endpoints are the number of participants reporting at least one unsolicited adverse event (overall and by MedDRA preferred term). |
Measured from time of meningococcal vaccination to Study Day 29 (28 days) for all participants. | |
Secondary | Number of Participants With Seroprotection for Meningitis Serogroup X | Null hypothesis: The immune response to meningitis serogroup X at Day 29 elicited by one dose of NmCV-5 is not superior to the immune response elicited by one dose of MenACWY-TT, Alternative hypothesis: The immune response to meningitis serogroup X at Day 29 elicited by one dose of NmCV-5 is superior, by a pre-specified margin, to the immune response elicited by one dose of MenACWY-TT.
Endpoints are the seroprotective response to serogroup X in the NmCV-5 arm at Day 29 and the seroprotective response defined to serogroup X in the MenACWY-TT arm at Day 29 with seroprotective response defined as serogroup specific rSBA antibody titers = 8. Superiority comparisons are made between study vaccination arms within each study age group (9 months or 15 months of age). Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Number of Participants With Seropositive Response to Measles Vaccine | Null hypothesis: The immune response to measles at Day 29 elicited by the MR vaccine when co-administered with one dose of NmCV-5 is inferior to the immune response elicited by the MR vaccine when co-administered with one dose of MenACWY-TT.
Alternative hypothesis: The immune response to measles at Day 29 elicited by the MR vaccine when co-administered with one dose of NmCV-5 is non inferior, by a pre-specified margin, to the immune response elicited by the MR vaccine when co-administered with one dose of MenACWY-TT. Endpoints are the seropositive responses to measles vaccine at Day 29 post vaccination, defined as anti-measles IgG concentration >200 mIU/mL. Non-inferiority comparisons are made between study vaccination arms within each study age group (9 months or 15 months of age). Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Number of Participants With Seropositive Response to Rubella Vaccine | Null hypothesis: The immune response to rubella at Day 29 elicited by the MR vaccine when co-administered with one dose of NmCV-5 is inferior to the immune response elicited by the MR vaccine when co-administered with one dose of MenACWY-TT.
Alternative hypothesis: The immune response to rubella at Day 29 elicited by the MR vaccine when co-administered with one dose of NmCV-5 is non inferior, by a pre-specified margin, to the immune response elicited by the MR vaccine when co-administered with one dose of MenACWY-TT. Endpoints are the seropositive responses to rubella vaccine at Day 29 post vaccination, defined as anti-rubella IgG concentration >20 IU/mL. Non-inferiority comparisons are made between study vaccination arms within each study age group (9 months or 15 months of age). Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Number of Participants With Seroprotective Response to Yellow Fever Vaccine | Null hypothesis: The immune response to yellow fever at Day 29 elicited by the yellow fever vaccine when co-administered with one dose of NmCV-5 is inferior to the immune response elicited by the yellow fever vaccine when co-administered with one dose of MenACWY-TT.
Alternative hypothesis: The immune response to yellow fever at Day 29 elicited by the yellow fever vaccine when co-administered with one dose of NmCV-5 is non inferior, by a pre-specified margin, to the immune response elicited by the yellow fever vaccine when co-administered with one dose of MenACWY-TT. Endpoints are the seroprotective responses to yellow fever vaccine at Day 29 post vaccination, defined as yellow fever neutralizing antibody titers =10. Non-inferiority comparisons are made between study vaccination arms within the 9 months study age group only. Proportions and difference in proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Geometric Mean of rSBA Titers for Meningitis Serogroups A, C, W, Y and X | For each study age group (9 months and 15 months) and for each of the five serogroups (A, C, W, Y, and X), geometric means and 95% CIs of rSBA titers at Day 29 are calculated by study vaccination arm within each study age group, and the Geometric Mean Titer (GMT) Ratio of rSBA titers at Day 29 for NmCV-5 relative to MenACWY-TT will be estimated, along with 95% CIs. The point and interval estimates will be obtained from a back transformation of the estimated difference in means of the log-transformed rSBA titers.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 3 (Study Day 29). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Seroresponse for Meningitis Serogroups A, C, W, Y and X | To assess clinically significant immune response indicators elicited by a single dose of meningococcal vaccine, the number and proportion of participants with seroresponse in rSBA titers at Day 29 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and percentage of participants with seroresponse in rSBA titers to meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 3 (Study Day 29), where seroresponse is defined as a post-immunization (Day 29) rSBA titer of 32 or greater if the participant's pre-immunization (Baseline) rSBA titer was < 8; or a = four-fold increase over baseline at Day 29 post-immunization if the participant's pre-immunization rSBA titer was = 8. Seroresponse is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of blood sample collection just prior to meningococcal vaccination at Day 1 visit to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Geometric Mean Fold Rise (GMFR) for Meningitis Serogroups A, C, W, Y and X | To assess clinically significant immune response indicators elicited by a single dose of meningococcal vaccine, the Geometric Mean Fold Rise (GMFR) from baseline to Day 29 of rSBA titers to meningococcal serogroups A, C, W, Y and X is estimated, with 95% CI.
Endpoints are the rSBA titer values for meningococcal serogroups A, C, W, Y and X from samples collected at Visit 1 (Day 1) and Visit 3 (Day 29). The point and interval estimates will be obtained from a back transformation of the estimated mean difference of the log-transformed rSBA titers. |
Measured from time of blood sample collection just prior to meningococcal vaccination at Day 1 visit to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. | |
Secondary | Number of Participants With rSBA Titers = 128 for Meningitis Serogroups A, C, W, Y and X | To assess clinically significant immune response indicators elicited by a single dose of meningococcal vaccine, the number and proportion of participants with rSBA titers = 128 at Day 29 is calculated for meningococcal serogroups A, C, W, Y and X.
Endpoints are the number and proportion of participants with rSBA titers = 128 for meningococcal serogroups A, C, W, Y and X, from samples collected at Visit 3 (Study Day 29). This is calculated for each study vaccination arm within each study age group (9 months or 15 months of age). Proportions are reported as percentages (number of infants per 100). |
Measured from time of meningococcal vaccination to blood sample collection at Day 29 visit. Follow-up time to Day 29 visit blood specimen collection was a mean (s.d.) of 30.9 (2.8) days. |
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