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    Clinical Trial Results:
    A Randomized, Double-Blinded, Controlled with GARDASIL® (Human Papillomavirus Vaccine [Types 6, 11, 16, 18] (Recombinant, adsorbed)), Phase III Clinical Trial to Study the Immunogenicity and Tolerability of V503 (9-Valent Human Papillomavirus [HPV] L1 Virus-Like Particle [VLP] Vaccine) in Preadolescent and Adolescent Girls (9- to 15-year-olds)

    Summary
    EudraCT number
    2010-023393-39
    Trial protocol
    FI   BE   SE   ES   DK   IT  
    Global end of trial date
    20 Dec 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Apr 2016
    First version publication date
    02 Aug 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GDS01C
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01304498
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Sanofi Pasteur MSD S.N.C.
    Sponsor organisation address
    162 avenue Jean Jaurès - CS 50712, Lyon Cedex 07, France, 69367
    Public contact
    Clinical Trials Disclosure, Sanofi Pasteur MSD S.N.C., ClinicalTrialsDisclosure@spmsd.com
    Scientific contact
    Clinical Trials Disclosure, Sanofi Pasteur MSD S.N.C., ClinicalTrialsDisclosure@spmsd.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000654-PIP01-09
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    20 Dec 2011
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    20 Dec 2011
    Global end of trial reached?
    Yes
    Global end of trial date
    20 Dec 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To demonstrate that administration of the 9-valent HPV L1 VLP (9vHPV) vaccine induces non-inferior Geometric Mean Titres (GMTs) for serum anti-HPV 16 and anti-HPV 18 compared to GARDASIL® (qHPV) in preadolescent and adolescent girls 9 to 15 years of age.
    Protection of trial subjects
    Healthy girls with known allergy to any vaccine component were excluded. Vaccines were administered by qualified study personnel. After each vaccination, subjects were kept under observation for at least 30 minutes to ensure their safety.
    Background therapy
    -
    Evidence for comparator
    # 9vHPV vaccine (= V503) is a prophylactic 9-valent HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) L1 virus-like particle (VLP) vaccine that is composed of VLPs of the 4 HPV types (Type 6, 11, 16, and 18) contained in qHPV vaccine (= GARDASIL®, a quadrivalent prophylactic HPV vaccine), plus the VLPs of 5 additional oncogenic HPV types (Types 31, 33, 45, 52, and 58). # qHPV vaccine has been approved by the European Medicines Agency (EMA) in September 2006 and is currently approved and marketed in over 100 countries. # This study was designed to provide a direct comparison of immunogenicity and safety/tolerability of the 9vHPV vaccine versus qHPV vaccine in preadolescent and adolescent girls, 9 to 15 years of age.
    Actual start date of recruitment
    23 Feb 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 89
    Country: Number of subjects enrolled
    Sweden: 122
    Country: Number of subjects enrolled
    Belgium: 96
    Country: Number of subjects enrolled
    Denmark: 69
    Country: Number of subjects enrolled
    Finland: 150
    Country: Number of subjects enrolled
    Italy: 74
    Worldwide total number of subjects
    600
    EEA total number of subjects
    600
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    246
    Adolescents (12-17 years)
    354
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Study subjects were enrolled in 24 active centres in 6 European countries (Belgium, Denmark, Finland, Italy, Spain, and Sweden) between 23 February 2011 and 11 May 2011.

    Pre-assignment
    Screening details
    603 subjects were screened. 600 subjects were randomised. 592 subjects received all 3 doses of 9vHPV or qHPV vaccine. 589 subjects completed the study.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Blinded vaccines had visually identical presentations and were presented in an indistinguishable packaging. The subjects, investigators (and his/her staff), laboratory staff, and sponsor remained blinded to subject vaccine allocation.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    9vHPV vaccine
    Arm description
    # Subjects received 3 doses of 9vHPV vaccine* by intramuscular (IM) route: dose 1 at Visit 1 (V1, Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *9vHPV vaccine = V503 = 9-valent HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) L1 virus-like particle (VLP) vaccine (recombinant, absorbed)
    Arm type
    Experimental

    Investigational medicinal product name
    9-valent HPV VLP
    Investigational medicinal product code
    9vHPV
    Other name
    V503
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL, IM route (deltoid muscle of the nondominant arm), 3 doses: dose 1 at V1 (Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks).

    Arm title
    qHPV vaccine
    Arm description
    # Subjects received 3 doses of qHPV vaccine* by intramuscular (IM) route: dose 1 at V1 (Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *qHPV vaccine = GARDASIL® = 4-valent HPV (Types 6, 11, 16 and 18) L1 virus-like particle (VLP) vaccine (Recombinant, absorbed)
    Arm type
    Active comparator

    Investigational medicinal product name
    GARDASIL®
    Investigational medicinal product code
    qHPV
    Other name
    SILGARD®
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    0.5 mL, IM route (deltoid muscle of the nondominant arm), 3 doses: dose 1 at V1 (Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks).

    Number of subjects in period 1
    9vHPV vaccine qHPV vaccine
    Started
    300
    300
    Completed
    294
    295
    Not completed
    6
    5
         Consent withdrawn by subject
    2
    3
         Adverse event, non-fatal
    1
    1
         Lost to follow-up
    2
    1
         Protocol deviation
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    9vHPV vaccine
    Reporting group description
    # Subjects received 3 doses of 9vHPV vaccine* by intramuscular (IM) route: dose 1 at Visit 1 (V1, Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *9vHPV vaccine = V503 = 9-valent HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) L1 virus-like particle (VLP) vaccine (recombinant, absorbed)

    Reporting group title
    qHPV vaccine
    Reporting group description
    # Subjects received 3 doses of qHPV vaccine* by intramuscular (IM) route: dose 1 at V1 (Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *qHPV vaccine = GARDASIL® = 4-valent HPV (Types 6, 11, 16 and 18) L1 virus-like particle (VLP) vaccine (Recombinant, absorbed)

    Reporting group values
    9vHPV vaccine qHPV vaccine Total
    Number of subjects
    300 300 600
    Age categorical
    Units: Subjects
        9-12 years old
    150 150 300
        13-15 years old
    150 150 300
    Age continuous
    Age at 1st dose
    Units: years
        arithmetic mean (standard deviation)
    12.6 ( 1.9 ) 12.6 ( 1.9 ) -
    Gender categorical
    Units: Subjects
        Female
    300 300 600

    End points

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    End points reporting groups
    Reporting group title
    9vHPV vaccine
    Reporting group description
    # Subjects received 3 doses of 9vHPV vaccine* by intramuscular (IM) route: dose 1 at Visit 1 (V1, Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *9vHPV vaccine = V503 = 9-valent HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) L1 virus-like particle (VLP) vaccine (recombinant, absorbed)

    Reporting group title
    qHPV vaccine
    Reporting group description
    # Subjects received 3 doses of qHPV vaccine* by intramuscular (IM) route: dose 1 at V1 (Day 1), dose 2 at V2 (2 months after Day 1, ±3 weeks), and dose 3 at V3 (6 months after Day 1, ±4 weeks). # Subjects were blood sampled (i) before vaccination (V1), and (ii) at V4, i.e., 3 to 7 weeks after V3 = Post-Dose 3. *qHPV vaccine = GARDASIL® = 4-valent HPV (Types 6, 11, 16 and 18) L1 virus-like particle (VLP) vaccine (Recombinant, absorbed)

    Primary: Non-inferiority of Geometric Mean Titres (GMTs) of anti-HPV types 16 and 18 antibodies (Abs) Post-Dose 3 (V4) of 9vHPV versus qHPV vaccine

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    End point title
    Non-inferiority of Geometric Mean Titres (GMTs) of anti-HPV types 16 and 18 antibodies (Abs) Post-Dose 3 (V4) of 9vHPV versus qHPV vaccine
    End point description
    Anti-HPV types 16 and 18 Ab titres were measured by competitive Luminex ImmunoAssay (cLIA) 3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4). Ab titres are expressed in milli Merck units (mMU)/mL. Analysis was done on the HPV specific Per Protocol Sets (PPS), i.e., subjects who received all 3 vaccinations, and seronegative to the relevant HPV type at Day 1, excluding those with protocol deviation which could interfere with the immunogenicity evaluation. Note: (N=***, ***) represents the number of assessed subjects in the "9vHPV vaccine" and "qHPV vaccine" groups, respectively.
    End point type
    Primary
    End point timeframe
    3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    276
    270
    Units: Titres
    geometric mean (confidence interval 95%)
        Anti-HPV 16 GMT (N=276, 270)
    6739.5 (6134.5 to 7404.1)
    6887.4 (6220.8 to 7625.5)
        Anti-HPV 18 GMT (N=276, 269)
    1956.6 (1737.3 to 2203.7)
    1795.6 (1567.2 to 2057.3)
    Statistical analysis title
    Non-inferiority for HPV 16
    Statistical analysis description
    The estimate of the 9vHPV vaccine/qHPV vaccine GMT ratio for HPV 16 was calculated with its P-value and its 2-sided 95% confidence interval (CI) using an ANOVA model including group and age stratum as independent variables. If the lower bound of the 95% CI was greater than 0.67 (i.e., the non-inferiority margin), it was concluded that 9vHPV GMT was non-inferior to qHPV GMT. Analysis was done on the HPV 16 specific PPS. N= 546 (9vHPV vaccine: 276, qHPV vaccine: 270).
    Comparison groups
    9vHPV vaccine v qHPV vaccine
    Number of subjects included in analysis
    546
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    P-value
    < 0.001
    Method
    ANOVA
    Parameter type
    GMT ratio
    Point estimate
    0.97
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.85
         upper limit
    1.11
    Statistical analysis title
    Non-inferiority for HPV 18
    Statistical analysis description
    The estimate of the 9vHPV vaccine/qHPV vaccine GMT ratio for HPV 18 was calculated with its P-value and its 2-sided 95% confidence interval (CI) using an ANOVA model including group and age stratum as independent variables. If the lower bound of the 95% CI was greater than 0.67 (i.e., the non-inferiority margin), it was concluded that 9vHPV GMT was non-inferior to qHPV GMT. Analysis was done on the HPV 18 specific PPS. N= 545 (9vHPV vaccine: 276, qHPV vaccine: 269).
    Comparison groups
    9vHPV vaccine v qHPV vaccine
    Number of subjects included in analysis
    546
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    P-value
    < 0.001
    Method
    ANOVA
    Parameter type
    GMT ratio
    Point estimate
    1.08
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.91
         upper limit
    1.29

    Secondary: Comparison of GMTs of anti-HPV types 6 and 11 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine

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    End point title
    Comparison of GMTs of anti-HPV types 6 and 11 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine
    End point description
    Anti-HPV types 6 and 11 Ab titres were measured by cLIA 3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4). Ab titres are expressed in mMU/mL. Analysis was done on the HPV specific Per Protocol Sets (PPS), i.e., subjects who received all 3 vaccinations, and seronegative to the relevant HPV type at Day 1, excluding those with protocol deviation which could interfere with the immunogenicity evaluation. Note: (N=***, ***) represents the number of assessed subjects in the "9vHPV vaccine" and "qHPV vaccine" groups, respectively.
    End point type
    Secondary
    End point timeframe
    3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    273
    261
    Units: Titres
    geometric mean (confidence interval 95%)
        Anti-HPV 6 GMT (N=273, 261)
    1679.4 (1518.9 to 1856.9)
    1565.9 (1412.2 to 1736.3)
        Anti-HPV 11 GMT (N=273, 261)
    1315.6 (1183.8 to 1462)
    1417.3 (1274.2 to 1576.5)
    Statistical analysis title
    9vHPV/qHPV GMT ratio for HPV 6
    Statistical analysis description
    The estimate of the 9vHPV vaccine/qHPV vaccine GMT ratio for HPV 6 was calculated with its 2-sided 95% confidence interval (CI) using an ANOVA model including group and age stratum as independent variables. Analysis was done on the HPV 6 specific PPS. N= 534 (9vHPV vaccine: 273, qHPV vaccine: 261).
    Comparison groups
    9vHPV vaccine v qHPV vaccine
    Number of subjects included in analysis
    534
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    GMT ratio
    Point estimate
    1.07
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.93
         upper limit
    1.23
    Statistical analysis title
    9vHPV/qHPV GMT ratio for HPV 11
    Statistical analysis description
    The estimate of the 9vHPV vaccine/qHPV vaccine GMT ratio for HPV 11 was calculated with its 2-sided 95% confidence interval (CI) using an ANOVA model including group and age stratum as independent variables. Analysis was done on the HPV 11 specific PPS. N= 534 (9vHPV vaccine: 273, qHPV vaccine: 261).
    Comparison groups
    9vHPV vaccine v qHPV vaccine
    Number of subjects included in analysis
    534
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    GMT ratio
    Point estimate
    0.93
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.8
         upper limit
    1.08

    Secondary: Seroconversion rates for anti-HPV types 6, 11, 16, and 18 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine

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    End point title
    Seroconversion rates for anti-HPV types 6, 11, 16, and 18 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine
    End point description
    The seroconversion rates to HPV types 6, 11, 16, and 18 defined as Ab titres ≥30 mMU/mL for anti-HPV 6, ≥16 mMU/mL for anti-HPV 11, ≥20 mMU/mL for anti-HPV 16, and ≥24 mMU/mL for anti-HPV 18 were determined 3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4). Ab titres were measured by cLIA. Analysis was done on the HPV specific Per Protocol Sets (PPS), i.e., subjects who received all 3 vaccinations, and seronegative to the relevant HPV type at Day 1, excluding those with protocol deviation which could interfere with the immunogenicity evaluation. Note: (N=***, ***) represents the number of assessed subjects in the "9vHPV vaccine" and "qHPV vaccine" groups, respectively.
    End point type
    Secondary
    End point timeframe
    3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    276
    270
    Units: Percentage of subjects
    number (confidence interval 95%)
        Anti-HPV 6 ≥30 mMU/mL (N=273, 261)
    100 (98.7 to 100)
    100 (98.6 to 100)
        Anti-HPV 11 ≥16 mMU/mL (N=273, 261)
    100 (98.7 to 100)
    100 (98.6 to 100)
        Anti-HPV 16 ≥20 mMU/mL (N=276, 270)
    100 (98.7 to 100)
    100 (98.6 to 100)
        Anti-HPV 18 ≥24 mMU/mL (N=276, 269)
    100 (98.7 to 100)
    100 (98.6 to 100)
    No statistical analyses for this end point

    Secondary: Global summary of safety from D1 to D15 after any vaccination (3 doses of 9vHPV or qHPV)

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    End point title
    Global summary of safety from D1 to D15 after any vaccination (3 doses of 9vHPV or qHPV)
    End point description
    Adverse events (AEs) were recorded as follows. 1/ From D1 to D5 after each vaccination: # oral temperature ≥37.8°C, # solicited (erythema, pain, and swelling at injection-site) and # other injection-site adverse reactions (ISRs). 2/ From D1 to D15 after each vaccination: systemic AEs. AEs at injection sites were always considered as related to vaccine (ISRs). The investigator had to assess whether systemic AEs were vaccine-related systemic AEs or not. The percentage of subjects presenting at least once the considered events after any vaccination is reported hereafter. Analyses following any doses were based on the vaccines corresponding to the highest number of doses received by the subject. Analysis was done on the Safety Set, i.e., all subjects who received at least 1 dose of the study vaccines and who had safety follow-up data.
    End point type
    Secondary
    End point timeframe
    From Day 1 (D1) to D15 after any vaccination (3 doses of 9vHPV or qHPV).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    299
    300
    Units: Percentage of subjects
    number (not applicable)
        At least 1 AE (D1-D15)
    96
    93.7
        At least 1 vaccine-related AE (D1-D15)
    93.3
    90.3
        At least 1 ISR (D1-D5)
    91.6
    88.3
        At least 1 solicited ISR (D1-D5)
    91.6
    88.3
        At least 1 other ISR (D1-D5)
    11.7
    14
        At least 1 systemic AE (D1-D15)
    47.5
    52
        At least 1 vaccine-related systemic AE (D1-D15)
    20.7
    24.3
    No statistical analyses for this end point

    Secondary: Percentage of subjects reporting ISRs from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV)

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    End point title
    Percentage of subjects reporting ISRs from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV)
    End point description
    The percentage of subjects presenting at least once solicited (erythema, pain, and swelling) or other ISRs from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV) is reported hereafter. AEs at injection-site were always considered as related to vaccine (ISRs). Analyses following any doses were based on the vaccines corresponding to the highest number of doses received by the subject. Analysis was done on the Safety Set, i.e., all subjects who received at least 1 dose of the study vaccines and who had safety follow-up data.
    End point type
    Secondary
    End point timeframe
    From Day 1 (D1) to D5 after any vaccination (3 doses of 9vHPV or qHPV).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    299
    300
    Units: Percentage of subjects
    number (not applicable)
        Solicited injection-site erythema
    34.1
    29.3
        Solicited injection-site pain
    89.3
    88.3
        Solicited injection-site swelling
    47.8
    36
        Unsolicited injection-site haematoma
    3.7
    4.7
        Unsolicited injection-site pruritus
    4
    2.7
        Unsolicited injection-site haemorrhage
    1
    2
        Unsolicited injection-site induration
    2
    1
        Unsolicited injection-site warmth
    0.7
    1.7
        Unsolicited injection-site reaction
    0.3
    1
        Unsolicited injection-site discomfort
    0.7
    0.3
        Unsolicited injection-site paraesthesia
    0.3
    0.7
        Unsolicited injection-site discolouration
    0.3
    0.3
        Unsolicited injection-site lymphadenopathy
    0.3
    0.3
        Unsolicited injection-site nodule
    0.3
    0.3
        Unsolicited injection-site papule
    0
    0.7
        Unsolicited injection-site rash
    0
    0.7
        Unsolicited injection-site movement impairment
    0
    0.3
        Unsolicited injection-site scar
    0
    0.3
    No statistical analyses for this end point

    Secondary: Percentage of subjects reporting oral temperature [37.8°C-38.9°C[ or [38.9°C-39.9°C[ from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV)

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    End point title
    Percentage of subjects reporting oral temperature [37.8°C-38.9°C[ or [38.9°C-39.9°C[ from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV)
    End point description
    Maximum oral temperatures recorded daily were reported from D1 to D5 after any vaccination (3 doses of 9vHPV or qHPV). The percentage of subjects presenting at least once oral temperature [37.8°C-38.9°C[ or [38.9°C-39.9°C[ is presented hereafter. Analyses following any doses were based on the vaccines corresponding to the highest number of doses received by the subject. Analysis was done on the Safety Set, i.e., all subjects who received at least 1 dose of the study vaccines and who had safety follow-up data.
    End point type
    Secondary
    End point timeframe
    From Day 1 (D1) to D5 after any vaccination (3 doses of 9vHPV or qHPV).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    299
    300
    Units: Percentage of subjects
    number (not applicable)
        Oral temperature [37.8°C-38.9°C[
    5.4
    2.7
        Oral temperature [38.9°C-39.9°C[
    1.3
    0.7
    No statistical analyses for this end point

    Other pre-specified: GMTs of anti-HPV types 31, 33, 45, 52, and 58 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine

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    End point title
    GMTs of anti-HPV types 31, 33, 45, 52, and 58 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine
    End point description
    Anti-HPV types 31, 33, 45, 52, and 58 Ab titres were measured by cLIA 3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4). Ab titres are expressed in mMU/mL. Analysis was done on the HPV specific Per Protocol Sets (PPS), i.e., subjects who received all 3 vaccinations, and seronegative to the relevant HPV type at Day 1, excluding those with protocol deviation which could interfere with the immunogenicity evaluation. Note: (N=***, ***) represents the number of assessed subjects in the "9vHPV vaccine" and "qHPV vaccine" groups, respectively.
    End point type
    Other pre-specified
    End point timeframe
    3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    276
    271
    Units: Titres
    geometric mean (confidence interval 95%)
        Anti-HPV 31 GMT (N=276, 268)
    1770.4 (1585.7 to 1976.6)
    22.2 (18.9 to 26.1)
        Anti-HPV 33 GMT (N=275, 269)
    937.1 (845.3 to 1038.9)
    4 (3.6 to 4.5)
        Anti-HPV 45 GMT (N=275, 271)
    622.4 (545.4 to 710.2)
    3.2 (2.8 to 3.6)
        Anti-HPV 52 GMT (N=276, 269)
    927.3 (837.5 to 1026.9)
    1.9 (1.8 to 2.1)
        Anti-HPV 58 GMT (N=267, 261)
    1348.8 (1218.3 to 1493.2)
    9.4 (8.1 to 10.9)
    No statistical analyses for this end point

    Other pre-specified: Seroconversion rates for anti-HPV types 31, 33, 45, 52, and 58 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine

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    End point title
    Seroconversion rates for anti-HPV types 31, 33, 45, 52, and 58 Abs Post-Dose 3 (V4) of 9vHPV or qHPV vaccine
    End point description
    The seroconversion rates to HPV types 31, 33, 45, 52, and 58 defined as Ab titres ≥10 mMU/mL for anti-HPV 31, and ≥8 mMU/mL for anti-HPV 33, 45, 52, and 58 were determined 3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4). Ab titres were measured by cLIA. Analysis was done on the HPV specific Per Protocol Sets (PPS), i.e., subjects who received all 3 vaccinations, and seronegative to the relevant HPV type at Day 1, excluding those with protocol deviation which could interfere with the immunogenicity evaluation. Note: (N=***, ***) represents the number of assessed subjects in the "9vHPV vaccine" and "qHPV vaccine" groups, respectively.
    End point type
    Other pre-specified
    End point timeframe
    3 to 7 weeks Post-Dose 3 of 9vHPV or qHPV vaccine (V4).
    End point values
    9vHPV vaccine qHPV vaccine
    Number of subjects analysed
    276
    271
    Units: Percentage of subjects
    number (confidence interval 95%)
        Anti-HPV 31 ≥10 mMU/mL (N=276, 268)
    100 (98.7 to 100)
    73.5 (67.8 to 78.7)
        Anti-HPV 33 ≥8 mMU/mL (N=275, 269)
    100 (98.7 to 100)
    20.4 (15.8 to 25.8)
        Anti-HPV 45 ≥8 mMU/mL (N=275, 271)
    99.6 (98 to 100)
    21 (16.3 to 26.4)
        Anti-HPV 52 ≥8 mMU/mL (N=276, 269)
    100 (98.7 to 100)
    3.3 (1.5 to 6.3)
        Anti-HPV 58 ≥8 mMU/mL (N=267, 261)
    100 (98.6 to 100)
    54.8 (48.5 to 60.9)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Systemic adverse events (AEs) were collected from D1 to D15 after each dose of 9vHPV or qHPV vaccine. Serious AEs and deaths were collected throughout the study.
    Adverse event reporting additional description
    Analysis of AEs was done on the Safety Set, i.e., all subjects who received at least 1 dose of the study vaccines and who had safety follow-up data. Unsolicited non-serious systemic AEs (vaccine-related or not) with incidence ≥1% are presented hereafter. None of the serious AEs were vaccine-related.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    14.1
    Reporting groups
    Reporting group title
    9vHPV vaccine
    Reporting group description
    # Subjects received 3 doses of 9vHPV vaccine (V503) by IM route: dose 1 at Visit 1 (Day 1), dose 2 at Visit 2 (2 months after Day 1, ±3 weeks), and dose 3 at Visit 3 (6 months after Day 1, ±4 weeks). # Respectively, 142 (47.5%) subjects reported at least 1 unsolicited systemic AE, and 62 (20.7%) subjects reported at least 1 vaccine-related unsolicited systemic AE within 15 days after any vaccination (3 doses of 9vHPV vaccine).

    Reporting group title
    qHPV vaccine
    Reporting group description
    # Subjects received 3 doses of qHPV vaccine (GARDASIL®) by IM route: dose 1 at Visit 1 (Day 1), dose 2 at Visit 2 (2 months after Day 1, ±3 weeks), and dose 3 at Visit 3 (6 months after Day 1, ±4 weeks). # Respectively, 156 (52.0%) subjects reported at least 1 unsolicited systemic AE, and 73 (24.3%) subjects reported at least 1 vaccine-related unsolicited systemic AE within 15 days after any vaccination (3 doses of qHPV vaccine).

    Serious adverse events
    9vHPV vaccine qHPV vaccine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 299 (0.33%)
    2 / 300 (0.67%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Nervous system disorders
    Partial complex epilepsy
    Additional description: Event of severe intensity that occurred 36 days after qHPV vaccine dose 1. This subject received the 2 other doses of qHPV vaccine without experiencing further adverse event.
         subjects affected / exposed
    0 / 299 (0.00%)
    1 / 300 (0.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
    Additional description: Event of moderate intensity diagnosed approximately 2 months after 9vHPV vaccine dose 2, experienced by the same subject who experienced pulmonary vasculitis.
         subjects affected / exposed
    1 / 299 (0.33%)
    0 / 300 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary vasculitis
    Additional description: Event of moderate intensity diagnosed approximately 2 months after 9vHPV vaccine dose 2, experienced by the same subject who experienced anaemia.
         subjects affected / exposed
    1 / 299 (0.33%)
    0 / 300 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Henoch-Schonlein purpura
    Additional description: Event of moderate intensity that occurred 46 days after qHPV vaccine dose 2.
         subjects affected / exposed
    0 / 299 (0.00%)
    1 / 300 (0.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    9vHPV vaccine qHPV vaccine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    142 / 299 (47.49%)
    156 / 300 (52.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    57 / 299 (19.06%)
    57 / 300 (19.00%)
         occurrences all number
    84
    93
    Dizziness
         subjects affected / exposed
    4 / 299 (1.34%)
    7 / 300 (2.33%)
         occurrences all number
    4
    7
    Syncope
         subjects affected / exposed
    2 / 299 (0.67%)
    3 / 300 (1.00%)
         occurrences all number
    2
    3
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    22 / 299 (7.36%)
    17 / 300 (5.67%)
         occurrences all number
    23
    17
    Fatigue
         subjects affected / exposed
    1 / 299 (0.33%)
    10 / 300 (3.33%)
         occurrences all number
    1
    12
    Malaise
         subjects affected / exposed
    4 / 299 (1.34%)
    2 / 300 (0.67%)
         occurrences all number
    4
    2
    Feeling cold
         subjects affected / exposed
    2 / 299 (0.67%)
    3 / 300 (1.00%)
         occurrences all number
    2
    3
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    16 / 299 (5.35%)
    16 / 300 (5.33%)
         occurrences all number
    17
    17
    Abdominal pain upper
         subjects affected / exposed
    11 / 299 (3.68%)
    12 / 300 (4.00%)
         occurrences all number
    12
    17
    Abdominal pain
         subjects affected / exposed
    4 / 299 (1.34%)
    4 / 300 (1.33%)
         occurrences all number
    5
    4
    Diarrhoea
         subjects affected / exposed
    4 / 299 (1.34%)
    3 / 300 (1.00%)
         occurrences all number
    4
    3
    Vomiting
         subjects affected / exposed
    3 / 299 (1.00%)
    3 / 300 (1.00%)
         occurrences all number
    3
    3
    Reproductive system and breast disorders
    Dysmenorrhoea
         subjects affected / exposed
    9 / 299 (3.01%)
    12 / 300 (4.00%)
         occurrences all number
    11
    15
    Respiratory, thoracic and mediastinal disorders
    Oropharyngeal pain
         subjects affected / exposed
    16 / 299 (5.35%)
    17 / 300 (5.67%)
         occurrences all number
    17
    18
    Cough
         subjects affected / exposed
    9 / 299 (3.01%)
    4 / 300 (1.33%)
         occurrences all number
    9
    4
    Skin and subcutaneous tissue disorders
    Urticaria
         subjects affected / exposed
    2 / 299 (0.67%)
    3 / 300 (1.00%)
         occurrences all number
    2
    3
    Eczema
         subjects affected / exposed
    1 / 299 (0.33%)
    3 / 300 (1.00%)
         occurrences all number
    1
    6
    Musculoskeletal and connective tissue disorders
    Neck pain
         subjects affected / exposed
    4 / 299 (1.34%)
    2 / 300 (0.67%)
         occurrences all number
    4
    2
    Myalgia
         subjects affected / exposed
    3 / 299 (1.00%)
    2 / 300 (0.67%)
         occurrences all number
    4
    2
    Pain in extremity
         subjects affected / exposed
    3 / 299 (1.00%)
    1 / 300 (0.33%)
         occurrences all number
    3
    1
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    5 / 299 (1.67%)
    16 / 300 (5.33%)
         occurrences all number
    7
    18
    Upper respiratory tract infection
         subjects affected / exposed
    9 / 299 (3.01%)
    11 / 300 (3.67%)
         occurrences all number
    10
    13
    Rhinitis
         subjects affected / exposed
    3 / 299 (1.00%)
    5 / 300 (1.67%)
         occurrences all number
    3
    5
    Gastroenteritis
         subjects affected / exposed
    1 / 299 (0.33%)
    5 / 300 (1.67%)
         occurrences all number
    1
    5
    Pharyngitis
         subjects affected / exposed
    2 / 299 (0.67%)
    3 / 300 (1.00%)
         occurrences all number
    2
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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