Clinical Trial Results:
Immunogenicity and safety study of GSK Biologicals’ combined measles-mumps-rubella vaccine in subjects seven years and older (209762).
Summary
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EudraCT number |
2011-003672-36 |
Trial protocol |
SK EE |
Global end of trial date |
17 Sep 2015
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Results information
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Results version number |
v1 |
This version publication date |
15 Jan 2017
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First version publication date |
15 Jan 2017
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Other versions |
v2 |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
115231
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02058563 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
GlaxoSmithKline Biologicals
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Sponsor organisation address |
Rue de l’Institut 89, Rixensart, Belgium, B-1330
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Public contact |
Clinical Trials Call Center, GlaxoSmithKline Biologicals, 44 2089904466, GSKClinicalSupportHD@gsk.com
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Scientific contact |
Clinical Trials Call Center, GlaxoSmithKline Biologicals, 44 2089904466, GSKClinicalSupportHD@gsk.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
08 Jul 2016
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
24 May 2015
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Global end of trial reached? |
Yes
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Global end of trial date |
17 Sep 2015
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To demonstrate the non-inferiority of INV_MMR vaccine to COM_MMR vaccine in terms of Geometric Mean Concentration (GMCs) for anti measles, anti mumps and anti rubella antibodies at Day 42. Criteria for the determination of non-inferiority for measles, mumps, and rubella viruses: Lower limit (LL) of the 2-sided 95% Confidence Interval (CI) on GMC ratio (INV_MMR over COM_MMR) is equal to or above 0.67 for anti-measles, anti-mumps, and anti rubella antibodies.
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Protection of trial subjects |
All subjects were observed closely for at least 30 minutes following the administration of vaccines with appropriate medical treatment readily available in case of a rare anaphylactic reaction.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
17 Jul 2014
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Estonia: 109
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Country: Number of subjects enrolled |
Slovakia: 216
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Country: Number of subjects enrolled |
United States: 671
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Worldwide total number of subjects |
996
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EEA total number of subjects |
325
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
250
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Adolescents (12-17 years) |
84
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Adults (18-64 years) |
661
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From 65 to 84 years |
1
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85 years and over |
0
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Recruitment
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Recruitment details |
A total of 996 subjects were enrolled and 994 were vaccinated. Of the 994 vaccinated subjects, 83 subjects from 2 US site s were excluded due to significant GCP concerns, resulting in 911 subjects in the Total vaccinated cohort considered for the analysis. | ||||||||||||||||||||||||
Pre-assignment
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Screening details |
The subjects were observed closely for at least 30 minutes following the administration of vaccine(s), with appropriate medical treatment readily available in case of a rare anaphylactic reaction. | ||||||||||||||||||||||||
Pre-assignment period milestones
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Number of subjects started |
996 | ||||||||||||||||||||||||
Number of subjects completed |
911 | ||||||||||||||||||||||||
Pre-assignment subject non-completion reasons
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Reason: Number of subjects |
excluded due to GCP concerns: 83 | ||||||||||||||||||||||||
Reason: Number of subjects |
subjects non vaccinated: 2 | ||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall study period (Day 0 to Day 180) (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||
Roles blinded |
Investigator, Monitor, Subject | ||||||||||||||||||||||||
Blinding implementation details |
Data will be collected in an observer-blind manner. By observer-blind, it is meant that during the course of the study, the vaccine recipient and those responsible for the evaluation of any study endpoint (e.g. safety, reactogenicity, and efficacy) will all be unaware of which vaccine was administered. To do so, vaccine preparation and administration will be done by authorized medical personnel who will not participate in any of the study clinical evaluations.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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INV_MMR Group | ||||||||||||||||||||||||
Arm description |
Subjects received one dose of INV_MMR (Priorix®) vaccine at Visit 1 (Day 0). | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Priorix
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Investigational medicinal product code |
209762
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Other name |
MEASLES VIRUS SCHWARZ STRAIN (LIVE, ATTENUATED); INV_MMR
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Pharmaceutical forms |
Powder and solvent for solution for injection
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
A single vaccination was given on study Day 0 in the “triceps” region of the upper arm.
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Arm title
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COM_MMR Group | ||||||||||||||||||||||||
Arm description |
Subjects received one dose of COM_MMR (M-M-R®II ) vaccine from Lot 1 or Lot 2 at Visit 1 (Day 0). | ||||||||||||||||||||||||
Arm type |
Active comparator | ||||||||||||||||||||||||
Investigational medicinal product name |
M-M-R VAXPRO
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Investigational medicinal product code |
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Other name |
COM_MMR
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Pharmaceutical forms |
Powder and solvent for solution for injection
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
A single vaccination was given on study Day 0 in the “triceps” region of the upper arm.
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Notes [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same. Justification: A total of 996 subjects were enrolled and 994 were vaccinated. Of the 994 vaccinated subjects, 83 subjects from 2 US sites were excluded due to significant GCP concerns, resulting in 911 subjects in the Total vaccinated cohort considered for the analysis. |
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Baseline characteristics reporting groups
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Reporting group title |
INV_MMR Group
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Reporting group description |
Subjects received one dose of INV_MMR (Priorix®) vaccine at Visit 1 (Day 0). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
COM_MMR Group
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Reporting group description |
Subjects received one dose of COM_MMR (M-M-R®II ) vaccine from Lot 1 or Lot 2 at Visit 1 (Day 0). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
INV_MMR Group
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Reporting group description |
Subjects received one dose of INV_MMR (Priorix®) vaccine at Visit 1 (Day 0). | ||
Reporting group title |
COM_MMR Group
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Reporting group description |
Subjects received one dose of COM_MMR (M-M-R®II ) vaccine from Lot 1 or Lot 2 at Visit 1 (Day 0). |
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End point title |
Anti-measles virus antibody Concentrations | ||||||||||||
End point description |
Antibody concentrations are expressed as Geometric Mean Concentrations (GMCs) in milli International Units per milliliter (mIU/mL). Seropositivity was defined as subjects with anti-measles virus antibody concentration equal or greater than 150 mIU/mL.
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End point type |
Primary
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End point timeframe |
At Day 42
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Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Statistical analysis description |
Non-inferiority of INV_MMR vaccine to COM_MMR vaccine in terms of Geometric Mean Concentration (GMCs) for anti measles, anti mumps and anti rubella antibodies at Day 42.The 95% CI for adjusted geometric mean concentrations (GMCs) and the adjusted GMC ratio were obtained using an ANCOVA model on the logarithm-transformed concentrations including the vaccine group (for adjusted GMC ratio) as fixed effect, gender, age and country groups as continuous effects and the pre-vaccination log-transformed
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Comparison groups |
COM_MMR Group v INV_MMR Group
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Number of subjects included in analysis |
869
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority [1] | ||||||||||||
Method |
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Parameter type |
Adjusted GMC ratio | ||||||||||||
Point estimate |
1
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
0.91 | ||||||||||||
upper limit |
1.11 | ||||||||||||
Notes [1] - Criteria for the determination of non-inferiority for measles, mumps, and rubella viruses: Lower limit (LL) of the 2-sided 95% Confidence Interval (CI) on GMC ratio ((INV_MMR over COM_MMR) was to be equal to or above 0.67 for anti-measles, anti-mumps, and anti rubella antibodies. Number of subjects in INV-MMR Group and in COM-MMR Group considered for calculating the adjusted GMC ratio, are 432 and 435 and adjusted GMCs = 1790.2 (LL=1669.6;UL=1919.5) and 1781.5 (LL=1661.8;UL=1909.7) respectively |
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End point title |
Anti-mumps virus antibody Concentrations | ||||||||||||
End point description |
Antibody concentrations are expressed as Geometric Mean Concentrations (GMCs) in EU/mL. Seropositivity was defined as subjects with anti-mumps virus antibody concentration equal or greater than 5 EU/mL.
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End point type |
Primary
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End point timeframe |
At Day 42
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Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Statistical analysis description |
Non-inferiority of INV_MMR vaccine to COM_MMR vaccine in terms of Geometric Mean Concentration (GMCs) for anti measles, anti mumps and anti rubella antibodies at Day 42.The 95% CI for adjusted geometric mean concentrations (GMCs) and the adjusted GMC ratio were obtained using an ANCOVA model on the logarithm-transformed concentrations including the vaccine group (for adjusted GMC ratio) as fixed effect, gender, age and country groups as continuous effects and the pre-vaccination log-transformed.
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Comparison groups |
COM_MMR Group v INV_MMR Group
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Number of subjects included in analysis |
869
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority [2] | ||||||||||||
Method |
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Parameter type |
Adjusted GMC ratio | ||||||||||||
Point estimate |
1.05
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
0.96 | ||||||||||||
upper limit |
1.16 | ||||||||||||
Notes [2] - Criteria for the determination of non-inferiority for measles, mumps, and rubella viruses: Lower limit (LL) of the 2-sided 95% Confidence Interval (CI) on GMC ratio (INV_MMR over COM_MMR) was to be equal to or above 0.67 for anti-measles, anti-mumps, and anti rubella antibodies. Number of subjects in INV-MMR Group and in COM-MMR Group considered for calculating the adjusted GMC ratio, are 432 and 435 and adjusted GMCs = 113.5 (LL=106.0;UL=121.6) and 107.8 (LL=100.7;UL=115.4) respectively. |
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End point title |
Anti-rubella virus antibody Concentrations | |||||||||||||||
End point description |
Antibody concentrations are expressed as Geometric Mean Concentrations (GMCs) in IU/mL. Seropositivity was defined as subjects with anti-rubella virus antibody concentration equal or greater than 4 IU/mL.
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End point type |
Primary
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End point timeframe |
At Day 42
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Statistical analysis title |
Statistical analysis 1 | |||||||||||||||
Statistical analysis description |
Non-inferiority of INV_MMR vaccine to COM_MMR vaccine in terms of Geometric Mean Concentration (GMCs) for anti measles, anti mumps and anti rubella antibodies at Day 42.The 95% CI for adjusted geometric mean concentrations (GMCs) and the adjusted GMC ratio were obtained using an ANCOVA model on the logarithm-transformed concentrations including the vaccine group (for adjusted GMC ratio) as fixed effect, gender, age and country groups as continuous effects and the pre-vaccination log-transformed
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Comparison groups |
COM_MMR Group v INV_MMR Group
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Number of subjects included in analysis |
869
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority [3] | |||||||||||||||
Method |
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Parameter type |
Adjusted GMC ratio | |||||||||||||||
Point estimate |
1.02
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Confidence interval |
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level |
95% | |||||||||||||||
sides |
2-sided
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lower limit |
0.93 | |||||||||||||||
upper limit |
1.11 | |||||||||||||||
Notes [3] - Criteria for the determination of non-inferiority for measles, mumps, and rubella viruses: Lower limit (LL) of the 2-sided 95% Confidence Interval (CI) on GMC ratio (INV_MMR over COM_MMR) was to be equal to or above 0.67 for anti-measles, anti-mumps, and anti rubella antibodies. Number of subjects in the INV-MMR Group and in the COM-MMR Group considered for calculating the adjusted GMC ratio, are 432 and 435 and adjusted GMCs = 76.1 (LL=71.5;UL=81.0) and 74.6 (LL=70.2;UL=79.4) respectively. |
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End point title |
Number of subjects with anti-measles virus antibody concentration equal to or above the threshold of 200 mIU/mL (seroresponse rate) | |||||||||
End point description |
Seroresponse was defined as: Anti-measles virus antibody concentration equal to or above the threshold of 200 mIU/mL after administration of INV_MMR vaccine vs. COM_MMR at Day 42
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End point type |
Secondary
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End point timeframe |
At Day 42
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No statistical analyses for this end point |
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End point title |
Number of subjects with anti-mumps virus antibody concentration equal to or above the threshold of 10 EU/mL (seroresponse rate). | |||||||||
End point description |
Seroresponse was defined as: Anti-mumps virus antibody concentration equal to or above the threshold of 10 EU/mL after administration of INV_MMR vaccine vs. COM_MMR at Day 42.
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End point type |
Secondary
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End point timeframe |
At Day 42
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No statistical analyses for this end point |
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End point title |
Number of subjects with anti-rubella virus antibody concentration equal to or above the threshold of 10 IU/mL (seroresponse rate). | |||||||||
End point description |
Seroresponse was defined as: Anti-rubella virus antibody concentration equal to or above the threshold of 10 IU/mL after administration of INV_MMR vaccine vs. COM_MMR at Day 42.
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End point type |
Secondary
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End point timeframe |
At Day 42
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No statistical analyses for this end point |
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End point title |
Number of subjects who achieved a 4-fold or greater rise in anti-measles, anti-mumps and anti-rubella virus antibody concentrations. | ||||||||||||||||||
End point description |
For subjects with seronegative status at pre-vaccination, a 4-fold rise in antibody concentration is defined as 4 times the cut-off level of the assay. Cut-off levels for anti-measles, anti-mumps and anti-rubella virus antibody concentrations are 150 m IU/mL, 5 EU/mL and 4 IU/mL.
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End point type |
Secondary
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End point timeframe |
At Day 42
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No statistical analyses for this end point |
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End point title |
Number of subjects with solicited local symptoms | |||||||||||||||||||||||||||
End point description |
Assessed solicited local symptoms were pain, redness and swelling. Any = Occurrence of any local symptom regardless of its intensity grade. Grade 3 Pain = Significant pain at rest. Prevented normal every day activities. Grade 3 redness = redness with surface diameter >50mm. Grade 3 swelling = swelling with surface diameter >50mm.
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End point type |
Secondary
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End point timeframe |
During the 4-day (Days 0-3) post-vaccination period
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting fever | ||||||||||||||||||
End point description |
Fever was assessed:Any fever (≥38°C) = occurrence of any fever regardless of its intensity grade or relationship to vaccination. Grade3 fever = fever >39.5°C. . Related = symptom assessed by the investigator as causally related to study vaccination.The preferred route for recording temperature in this study was oral.
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End point type |
Secondary
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End point timeframe |
During the 43 days (Days 0-42) post-vaccination period.
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting solicited general symptoms as parotid/salivary gland swelling and any sign of meningism /seizure. | |||||||||||||||||||||||||||
End point description |
Assessed MMR specific symptoms were parotid/salivary gland swelling and any sign of meningism /seizure.
Parotid/salivary gland swelling: Any = occurrence of any general symptom regardless of its intensity grade or relationship to vaccination; Grade 3 Parotid/salivary gland swelling = Swelling accompanied with general symptoms. Meningism /seizure: Any= occurrence of any general symptom regardless of its intensity grade or relationship to vaccination; Grade-3 meningism /seizure= Prevented normal, everyday activities (In adults/adolescents, such an AE could, for example, prevented attendance at work/school and could necessitated the administration of corrective therapy). Related symptom = symptom assessed by the investigator as causally related to study vaccination.
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End point type |
Secondary
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End point timeframe |
During the 43 days (Days 0-42) post-vaccination period.
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting unsolicited AEs | |||||||||
End point description |
Any untoward medical occurrence in a patient or clinical investigation child, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product
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End point type |
Secondary
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End point timeframe |
During the 43 days (Days 0-42) post-vaccination period.
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting solicited rash symptom. | ||||||||||||||||||||||||||||||
End point description |
Assessed any rash, Grade 3, Related, Localized rash, Generalized rash,measles/rubella-rash. Any= occurrence of any general symptom regardless of its intensity grade or relationship to vaccination. Grade3 rash/exanthema= Rash which prevented normal, everyday activities (In adults/adolescents, such an AE could, for example, prevented attendance at work/school and could necessitated the administration of corrective therapy). Grade 3 measles/rubella/varicella-like rash = Rash with more than150 lesions. Related = symptom assessed by the investigator as causally related to study vaccination.
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End point type |
Secondary
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End point timeframe |
During the 43 days (Days 0-42) post-vaccination period.
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting solicited joint pain (arthralgia/arthritis) | ||||||||||||||||||
End point description |
Assessed any, Grade-3, Related. Any= occurrence of any general symptom regardless of its intensity grade or relationship to vaccination Grade3 joint pain (arthralgia/arthritis)= Pain which prevented normal, everyday activities (In adults/adolescents, such an AE could, for example, prevented attendance at work/school and could necessitated the administration of corrective therapy). Related = symptom assessed by the investigator as causally related to study vaccination.
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End point type |
Secondary
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End point timeframe |
During the 43 days (Days 0-42) post-vaccination period.
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting NOCDs | |||||||||
End point description |
Occurrence of new onset chronic diseases (NOCDs)
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End point type |
Secondary
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End point timeframe |
Day 0 through the end of the study (Day 180)
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting adverse events prompting ER visits | |||||||||
End point description |
Occurrence of AEs prompting emergency room (ER) visits.
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End point type |
Secondary
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End point timeframe |
Day 0 through the end of the study (Day 180)
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No statistical analyses for this end point |
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End point title |
Number of subjects reporting serious adverse events (SAEs) | |||||||||
End point description |
A serious adverse event (SAE) is any untoward medical occurrence that results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization or results in disability/incapacity.
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End point type |
Secondary
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End point timeframe |
Day 0 through the end of the study (Day 180)
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No statistical analyses for this end point |
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Adverse events information [1]
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Timeframe for reporting adverse events |
Serious Adverse Events: From Day 0 to Day 180
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Adverse event reporting additional description |
The frequent adverse event data is currently being re-analyzed and the record will be updated once it becomes available.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
COM_MMR Group
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Reporting group description |
Subjects received one dose of COM_MMR (M-M-R®II) vaccine from Lot 1 or Lot 2 at Visit 1 (Day 0). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
INV_MMR Group
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Reporting group description |
Subjects received one dose of INV_MMR (Priorix®) vaccine at Visit 1 (Day 0). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: The frequent adverse event data is currently being re-analyzed and the record will be updated once it becomes available. |
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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12 Nov 2013 |
The study has been changed in design based on the United States (US) Food and Drug Administration (FDA) Center for Biologics Evaluation and Research (CBER) feedback, highlighting the heterogeneous nature of the study population in terms of prior vaccination with a measles-containing vaccine and the possibility of providing 1 or 2 doses of measles, mumps and rubella vaccine (MMR) as part of this study. The study has therefore been simplified to evaluate the administration of 1 dose of MMR vaccine only. Prior receipt of at least 1 dose of MMR has been added as a study inclusion criterion. Whereas children 7 17 years of age will be excluded if they have received more than 1 dose of MMR vaccine, adults 18 years of age and older will be able to enroll with a verbal or written history of 1 or more doses of MMR vaccine. Prior MMR vaccination status will be recorded at baseline.
Due to CBER’s request to add a confirmatory objective for geometric mean concentration (GMC) ratio, the sample size has been increased in order to maintain statistical power.
Since the change in study design includes only a one-dose cohort, all assessments and schedules in the study now refer to a single vaccination at Day 0, a safety follow up visit (Visit 2) at Day 42, and a phone contact at Day 180.
In the interest of safety, definitions and categories of solicited local and general adverse events have been refined. The protocol has also been revised to include the offer of a rescue plan for subjects that fail to meet the seroresponse threshold for antibodies to measles, mumps or rubella virus components.
Descriptive secondary statistical analyses have been added. |
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29 Sep 2014 |
The Dominican Republic will not be participating in the study as originally planned; therefore, all references to that country are deleted. Based on PAREXEL’s site assessment and feasibility, the ex-United States (US) sites are willing and able to adjust their enrollment goals to include the pediatric subjects originally allocated to the Dominican Republic. Consequently, changes are made to pediatric enrollment figures for ex-US sites.
Exclusion criterion 7 was amended to include more specific instructions regarding the administration of live influenza vaccine during the study.
Minor administrative changes have been made to align this protocol with other protocols in the MMR program. These include changes to clarify the recording of adverse events and concomitant medication/vaccination, amending Table 14 for the recording of AEs, SAEs, and pregnancy; and clarification of the recording of rash events. |
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08 Mar 2015 |
Due to a delay in the availability of serologic data, the study team has decided to conduct one final analysis at study end, therefore eliminating the two-step analysis. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |