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    Clinical Trial Results:
    A Phase IIIb, Open Label, Controlled, Multi-Center Study to Evaluate the Safety, Tolerability and Immunogenicity of Two Doses of Novartis Meningococcal Group B Vaccine when administered to Immunocompromised Patients from 2 to 17 years of age who are at Increased Risk of Meningococcal Disease because of Complement Deficiency or Asplenia compared to matched Healthy Controls.

    Summary
    EudraCT number
    2013-002454-78
    Trial protocol
    IT   ES   PL  
    Global end of trial date
    22 Oct 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    19 Mar 2016
    First version publication date
    19 Mar 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    V72_62
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02141516
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Not applicable: Not applicable
    Sponsors
    Sponsor organisation name
    Novartis Vaccines and Diagnostics S.r.l.
    Sponsor organisation address
    Via Fiorentina, 1, Siena, Italy, 53100
    Public contact
    Posting Director, Novartis Vaccines and Diagnostics S.r.l., RegistryContactVaccinesUS@novartis.com
    Scientific contact
    Posting Director, Novartis Vaccines and Diagnostics S.r.l., RegistryContactVaccinesUS@novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000139-PIP01-07
    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
    15 Feb 2016
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    16 Mar 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Oct 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Immunogenicity Objective - To evaluate the immunogenicity of two doses of rMenB+OMV NZ in subjects with increased risk of meningococcal disease because of complement deficiency or asplenia and in healthy age-matched subjects, at 1 month after the second vaccination. Safety Objective - To assess the safety and tolerability of two doses of rMenB+OMV NZ in subjects with increased risk of meningococcal disease because of complement deficiency or asplenia and in healthy age-matched subjects.
    Protection of trial subjects
    This clinical study was designed and shall be implemented and reported in accordance with the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) Harmonized Tripartite Guidelines for Good Clinical Practice (GCP), with applicable local regulations: including European Directive 2001/20/EC, Novartis codes on protection of human rights, and with the ethical principles laid down in the Declaration of Helsinki (European Council 2001, US Code of Federal Regulations, ICH 1997).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    27 May 2014
    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
    Russian Federation: 45
    Country: Number of subjects enrolled
    Poland: 57
    Country: Number of subjects enrolled
    Spain: 66
    Country: Number of subjects enrolled
    United Kingdom: 38
    Country: Number of subjects enrolled
    Italy: 33
    Worldwide total number of subjects
    239
    EEA total number of subjects
    194
    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)
    132
    Adolescents (12-17 years)
    107
    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
    Subjects were enrolled at 4 centers in Italy, 3 centers in Poland, 3 centers in the Russian Federation, 4 centers in Spain and 4 centers in the United Kingdom.

    Pre-assignment
    Screening details
    All the enrolled subjects were included in the trial.

    Period 1
    Period 1 title
    Overall (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    The trial is designed as an open-label study and all subjects will receive the same treatment.

    Arms
    Are arms mutually exclusive
    No

    Arm title
    CompDef
    Arm description
    Subjects aged ≥ 2 to ≤ 17 years with complement deficiencies received 2 doses of rMenB+OMV NZ administered 2 months apart.
    Arm type
    Experimental

    Investigational medicinal product name
    Meningococcal (group B)
    Investigational medicinal product code
    Other name
    rMenB+OMV NZ
    Pharmaceutical forms
    Suspension for injection in pre-filled pen
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Two doses of 0.5 mL each administered 2 months apart.

    Arm title
    Asplenia
    Arm description
    Subjects aged ≥ 2 to ≤ 17 years with Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.
    Arm type
    Experimental

    Investigational medicinal product name
    Meningococcal (group B)
    Investigational medicinal product code
    Other name
    rMenB+OMV NZ
    Pharmaceutical forms
    Suspension for injection in pre-filled pen
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Two doses of 0.5 mL each administered 2 months apart.

    Arm title
    CompDef+Asplenia
    Arm description
    Subjects aged ≥ 2 to ≤ 17 years with either complement deficiencies or Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.
    Arm type
    Experimental

    Investigational medicinal product name
    Meningococcal (group B)
    Investigational medicinal product code
    Other name
    rMenB+OMV NZ
    Pharmaceutical forms
    Suspension for injection in pre-filled pen
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Two doses of 0.5 mL each administered 2 months apart.

    Arm title
    Healthy Subjects
    Arm description
    Healthy subjects aged ≥ 2 to ≤ 17 years received 2 doses of rMenB+OMV NZ administered 2 months apart.
    Arm type
    Experimental

    Investigational medicinal product name
    Meningococcal (group B)
    Investigational medicinal product code
    Other name
    rMenB+OMV NZ
    Pharmaceutical forms
    Suspension for injection in pre-filled pen
    Routes of administration
    Intramuscular use
    Dosage and administration details
    Two doses of 0.5 mL each administered 2 months apart.

    Number of subjects in period 1
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Started
    40
    112
    152
    87
    Completed
    40
    107
    147
    87
    Not completed
    0
    5
    5
    0
         Adverse event, non-fatal
    -
    1
    1
    -
         Other
    -
    3
    3
    -
         Lost to follow-up
    -
    1
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    CompDef
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with complement deficiencies received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Asplenia
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    CompDef+Asplenia
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with either complement deficiencies or Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Healthy Subjects
    Reporting group description
    Healthy subjects aged ≥ 2 to ≤ 17 years received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects Total
    Number of subjects
    40 112 152 87
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
        From 65-84 years
        85 years and over
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    8.5 ± 4.35 11.1 ± 3.7 10.4 ± 4.03 10.2 ± 4.14 -
    Gender categorical
    Units: Subjects
        Female
    17 46 63 44 107
        Male
    23 66 89 43 132

    End points

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    End points reporting groups
    Reporting group title
    CompDef
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with complement deficiencies received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Asplenia
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    CompDef+Asplenia
    Reporting group description
    Subjects aged ≥ 2 to ≤ 17 years with either complement deficiencies or Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Healthy Subjects
    Reporting group description
    Healthy subjects aged ≥ 2 to ≤ 17 years received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Subject analysis set title
    All Enrolled Set
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All screened subjects who provide informed consent and provide demographic and/or baseline screening assessments, regardless of the subject’s treatment status in the trial and received a subject ID.

    Subject analysis set title
    Full Analysis Set (FAS), Immunogenicity Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All subjects in the Enrolled Population who received a study vaccination and provided an evaluable serum sample at one month after the second dose of rMenB+OMV NZ whose assay result is available for at least one of the serogroup B indicator strains or M10713 strain or Enzyme-linked Immunosorbent Assay (ELISA).

    Subject analysis set title
    Solicited Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects in the Exposed Set with any solicited adverse event data.

    Subject analysis set title
    Unsolicited Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects in the Exposed Set with post-vaccination unsolicited adverse event records.

    Subject analysis set title
    Overall Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects in the Exposed Set with any adverse event data.

    Primary: 1. Percentages of subjects with serum bactericidal activity using human complement (hSBA) titers ≥ 5 against N. meningitidis serogroup.

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    End point title
    1. Percentages of subjects with serum bactericidal activity using human complement (hSBA) titers ≥ 5 against N. meningitidis serogroup. [1]
    End point description
    Immunogenicity was assessed in terms of percentage of subjects with hSBA titers ≥ 5 against N. meningitidis serogroup B indicator strains (H44/76, 5/99, and NZ98/254) and M10713 strain following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    106
    144
    85
    Units: Percentages of Subjects
    number (confidence interval 95%)
        H44/76; Day 1 (N=39,104,143,84)
    0 (0 to 9)
    7 (2.7 to 13.4)
    5 (2 to 9.8)
    6 (2 to 13.3)
        H44/76; Day 91 (N=39,104,143,85)
    87 (72.6 to 95.7)
    97 (91.8 to 99.4)
    94 (89.3 to 97.6)
    98 (91.8 to 99.71)
        5/99; Day 1 (N=37,103,140,82)
    0 (0 to 9.5)
    12 (6.2 to 19.5)
    9 (4.5 to 14.5)
    6 (2 to 13.7)
        5/99; Day 91 (N=38,106,144,83)
    95 (82.3 to 99.4)
    100 (96.6 to 100)
    99 (95.1 to 99.83)
    99 (93.5 to 99.97)
        NZ98/254; Day 1 (N=36,105,141,83)
    0 (0 to 9.7)
    4 (1 to 9.5)
    3 (0.8 to 7.1)
    2 (0.29 to 8.4)
        NZ98/254; Day 91 (N=38,106,144,84)
    68 (51.3 to 82.5)
    86 (77.7 to 91.9)
    81 (73.9 to 87.3)
    83 (73.6 to 90.6)
        M10713; Day 1 (N=36,102,138,82)
    56 (38.1 to 72.1)
    79 (70.3 to 86.8)
    73 (65 to 80.4)
    78 (67.5 to 86.4)
        M10713; Day 91 (N=37,103,140,83)
    73 (55.9 to 86.2)
    94 (87.8 to 97.8)
    89 (82.1 to 93.3)
    99 (93.5 to 99.97)
    No statistical analyses for this end point

    Primary: 2. Percentages of subjects with serum bactericidal activity hSBA titers ≥ 8 against N. meningitidis serogroup.

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    End point title
    2. Percentages of subjects with serum bactericidal activity hSBA titers ≥ 8 against N. meningitidis serogroup. [2]
    End point description
    Immunogenicity was assessed in terms of percentage of subjects with hSBA titers ≥ 8 against N. meningitidis serogroup B indicator strains (H44/76, 5/99, and NZ98/254) and M10713 strain following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    106
    144
    85
    Units: Percentages of Subjects
    number (confidence interval 95%)
        H44/76; Day 1 (N=39,104,143,84)
    0 (0 to 9)
    2 (0.23 to 6.8)
    1 (0.17 to 5)
    2 (0.29 to 8.3)
        H44/76; Day 91 (N=39,104,143,85)
    87 (72.6 to 95.7)
    95 (89.1 to 98.4)
    93 (87.5 to 96.6)
    98 (91.8 to 99.71)
        5/99; Day 1 (N=37,103,140,82)
    0 (0 to 9.5)
    11 (5.5 to 18.3)
    8 (4 to 13.6)
    5 (1.3 to 12)
        5/99; Day 91 (N=38,106,144,83)
    92 (78.6 to 98.3)
    100 (96.6 to 100)
    98 (94 to 99.57)
    99 (93.5 to 99.97)
        NZ98/254; Day 1 (N=36,105,141,83)
    0 (0 to 9.7)
    4 (1 to 9.5)
    3 (0.8 to 7.1)
    0 (0 to 4.3)
        NZ98/254; Day 91 (N=38,106,144,84)
    63 (46 to 78.2)
    79 (70.3 to 86.5)
    75 (67.1 to 81.8)
    73 (61.8 to 81.8)
        M10713; Day 1 (N=36,102,138,82)
    47 (30.4 to 64.5)
    68 (57.7 to 76.6)
    62 (53.7 to 70.4)
    68 (57.1 to 78.1)
        M10713; Day 91 (N=37,103,140,83)
    70 (53 to 84.1)
    94 (87.8 to 97.8)
    88 (81.3 to 92.8)
    98 (91.6 to 99.71)
    No statistical analyses for this end point

    Primary: 3. hSBA Geometric mean titers (GMTs) against N. meningitis serogroup B strains following a 2-dose vaccination schedule.

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    End point title
    3. hSBA Geometric mean titers (GMTs) against N. meningitis serogroup B strains following a 2-dose vaccination schedule. [3]
    End point description
    Immunogenicity was assessed in terms of GMTs against N. meningitidis serogroup B indicator strains (H44/76, 5/99, and NZ98/254) and M10713 strain following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    106
    144
    85
    Units: Titers
    geometric mean (confidence interval 95%)
        H44/76; Day 1 (N=39,104,143,84)
    1.08 (0.87 to 1.33)
    1.17 (1.03 to 1.32)
    1.14 (1.03 to 1.26)
    1.15 (1.03 to 1.28)
        H44/76; Day 91 (N=39,104,143,85)
    48 (29 to 79)
    65 (48 to 88)
    60 (46 to 77)
    76 (61 to 94)
        5/99; Day 1 (N=37,103,140,82)
    0.87 (0.61 to 1.26)
    1.43 (1.16 to 1.78)
    1.26 (1.05 to 1.51)
    1.24 (1.02 to 1.52)
        5/99; Day 91 (N=38,106,144,83)
    263 (166 to 415)
    300 (230 to 392)
    290 (231 to 362)
    307 (250 to 376)
        NZ98/254; Day 1 (N=36,105,141,83)
    0.95 (0.78 to 1.16)
    1.1 (0.98 to 1.24)
    1.06 (0.96 to 1.17)
    1.05 (0.98 to 1.12)
        NZ98/254; Day 91 (N=38,106,144,84)
    8.46 (4.85 to 15)
    18 (13 to 24)
    14 (11 to 19)
    14 (10 to 18)
        M10713; Day 1 (N=36,102,138,82)
    8.57 (4.43 to 17)
    15 (10 to 22)
    13 (9.44 to 18)
    16 (11 to 22)
        M10713; Day 91 (N=37,103,140,83)
    20 (11 to 34)
    45 (33 to 62)
    36 (28 to 47)
    42 (34 to 52)
    No statistical analyses for this end point

    Primary: 4. Geometric mean ratios on Day 91 against N. meningitis serogroup B strains following a 2-dose vaccination schedule.

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    End point title
    4. Geometric mean ratios on Day 91 against N. meningitis serogroup B strains following a 2-dose vaccination schedule. [4]
    End point description
    Immunogenicity was assessed in terms of geometric mean ratios (GMRs) against N meningitidis serogroup B indicator strains (H44/76, 5/99, and NZ98/254) and M10713 strain following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    105
    143
    84
    Units: Ratios
    geometric mean (confidence interval 95%)
        H44/76; Day 91/Day 1 (N=39,104,143,84)
    44 (27 to 73)
    56 (41 to 75)
    52 (41 to 67)
    66 (52 to 83)
        5/99; Day 91/Day 1 (N=37,103,140,82)
    299 (170 to 525)
    207 (149 to 288)
    228 (173 to 302)
    245 (187 to 321)
        NZ98/254; Day 91/Day 1 (N=36,105,141,83)
    8.58 (4.9 to 15)
    16 (12 to 22)
    14 (10 to 18)
    13 (10 to 17)
        M10713; Day 91/Day 1 (N=36,102,138,82)
    2.25 (1.37 to 3.71)
    2.95 (2.21 to 3.95)
    2.75 (2.15 to 3.51)
    2.71 (2.02 to 3.65)
    No statistical analyses for this end point

    Primary: 5. Percentage of subjects with 4-fold increase in hSBA titers against N. meningitis serogroup B strains following a 2-dose vaccination.

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    End point title
    5. Percentage of subjects with 4-fold increase in hSBA titers against N. meningitis serogroup B strains following a 2-dose vaccination. [5]
    End point description
    Antibody responses were assessed in terms of percentage of subjects achieving 4-fold increase in hSBA titers against N. meningitidis serogroup B indicator strains (H44/76, 5/99, and NZ98/254) and M10713 strain on Day 91 over baseline (Day 1), following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 91 (one month after the second dose of the study vaccine).
    Notes
    [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    105
    143
    85
    Units: Percentages of Subjects
    number (confidence interval 95%)
        H44/76 (N=39,104,143,84)
    87 (72.6 to 95.7)
    94 (87.9 to 97.9)
    92 (86.7 to 96.1)
    98 (91.7 to 99.71)
        5/99 (N=37,103,140,82)
    92 (78.1 to 98.3)
    100 (96.5 to 100)
    98 (93.9 to 99.56)
    98 (91.5 to 99.7)
        NZ98/254 (N=36,105,141,83)
    61 (43.5 to 76.9)
    80 (71.1 to 87.2)
    75 (67.2 to 82.1)
    73 (62.7 to 82.6)
        M10713 (N=36,102,138,82)
    25 (12.1 to 42.2)
    33 (24.3 to 43.4)
    31 (23.6 to 39.6)
    33 (22.9 to 44.2)
    No statistical analyses for this end point

    Primary: 6. Geometric mean concentrations (GMCs) of antibodies against vaccine antigen 287-953 following a 2-dose vaccination schedule.

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    End point title
    6. Geometric mean concentrations (GMCs) of antibodies against vaccine antigen 287-953 following a 2-dose vaccination schedule. [6]
    End point description
    Immune responses were measured as ELISA GMCs of antibodies against vaccine antigen 287-953 following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61.The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [6] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    40
    106
    146
    84
    Units: Concentrations
    geometric mean (confidence interval 95%)
        Antigen 287-953; Day 1 (N=39,106,145,84)
    33 (25 to 43)
    25 (21 to 29)
    27 (23 to 31)
    27 (23 to 31)
        Antigen 287-953; Day 91 (N=40,106,146,84)
    2039 (1436 to 2894)
    3418 (2780 to 4202)
    2973 (2492 to 3546)
    2957 (2450 to 3570)
    No statistical analyses for this end point

    Primary: 7. ELISA GMRs on Day 91 against vaccine antigen 287-953 following a 2-dose vaccination schedule.

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    End point title
    7. ELISA GMRs on Day 91 against vaccine antigen 287-953 following a 2-dose vaccination schedule. [7]
    End point description
    Immune responses were measured as ELISA GMRs against vaccine antigen 287-953 following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61.The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 1 and Day 91 (one month after the second dose of the study vaccine).
    Notes
    [7] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    106
    145
    84
    Units: Ratios
    geometric mean (confidence interval 95%)
        Antigen 287-953 Day 91/Day 1 (N=39,106,145,84)
    62 (40 to 97)
    138 (107 to 178)
    112 (90 to 139)
    111 (88 to 140)
    No statistical analyses for this end point

    Primary: 8. Percentage of subjects with 4-fold increase in ELISA concentrations against N. meningitis serogroup B strains following a 2-dose vaccination schedule.

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    End point title
    8. Percentage of subjects with 4-fold increase in ELISA concentrations against N. meningitis serogroup B strains following a 2-dose vaccination schedule. [8]
    End point description
    Antibody responses were assessed in terms of percentage of subjects achieving 4-fold increase in ELISA concentrations against vaccine antigen 287-953 on Day 91 over baseline (Day 1), following 2 doses of rMenB+OMV NZ, administered on Day 1 and Day 61. The analysis was done on Full Analysis Set (FAS).
    End point type
    Primary
    End point timeframe
    Day 91 (one month after the second dose of the study vaccine).
    Notes
    [8] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    39
    106
    146
    84
    Units: Percentages of Subjects
    number (confidence interval 95%)
        Antigen 287-953 (N=39,106,145,84)
    97 (86.5 to 99.94)
    98 (93.4 to 99.77)
    98 (94.1 to 99.57)
    98 (91.7 to 99.71)
    No statistical analyses for this end point

    Primary: 9. Number Of Subjects With Solicited Local or Systemic Adverse Events.

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    End point title
    9. Number Of Subjects With Solicited Local or Systemic Adverse Events. [9]
    End point description
    Safety was assessed as the number of subjects who reported solicited local or systemic adverse events (AEs) following administration of rMenB+OMV NZ vaccine. The analysis was done on the Solicited Safety Set.
    End point type
    Primary
    End point timeframe
    Day 1 through Day 7 after any vaccination.
    Notes
    [9] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    28
    100
    128
    74 [10]
    Units: Subjects
        Any Local (< 6 years; N=12,9,21,13)
    12
    6
    18
    12
        Injection Site Tendern. (< 6 years; N=12,9,21,13)
    12
    6
    18
    12
        Injection Site Erythema (< 6 years; N=12,9,21,13)
    7
    4
    11
    6
        Injection Site Indur. (< 6 years; N=12,9,21,13)
    5
    4
    9
    5
        Any Local (≥ 6 years)
    26
    98
    124
    74
        Injection Site Pain (≥ 6 years)
    25
    97
    122
    71
        Injection Site Erythema (≥ 6 years)
    7
    19
    26
    27
        Injection Site Swelling (≥ 6 years)
    8
    24
    32
    24
        Injection Site Indur. (≥ 6 years)
    11
    27
    38
    19
        Any Systemic (< 6 years)
    11
    6
    17
    12
        Change in Eating Habits (< 6 years; N=12,9,21,13)
    5
    1
    6
    8
        Persistent Crying (< 6 years; N=12,9,21,13)
    2
    2
    4
    6
        Irritability (< 6 years; N=12,9,21,13)
    6
    2
    8
    9
        Vomiting (< 6 years; N=12,9,21,13)
    2
    0
    2
    0
        Diarrhea (< 6 years; N=12,9,21,13)
    5
    3
    8
    3
        Fever (≥38°C) (< 6 years; N=12,9,21,13)
    3
    1
    4
    4
        Rash (< 6 years; N=12,9,21,13)
    3
    0
    3
    0
        Any Others (< 6 years; N=12,9,21,13)
    12
    8
    20
    13
        Prev. Pain/Fever (< 6 years; N=12,9,21,13)
    5
    1
    6
    4
        Use of Analg./Antipyr. (< 6 years; N=12,9,21,13)
    5
    3
    8
    11
        Any Systemic (≥ 6 years)
    21
    75
    96
    60
        Nausea (≥ 6 years)
    7
    28
    35
    15
        Fatigue (≥ 6 years)
    11
    55
    66
    46
        Myalgia (≥ 6 years)
    8
    31
    39
    27
        Arthralgia (≥ 6 years)
    7
    25
    32
    18
        Headache (≥ 6 years)
    11
    47
    58
    35
        Fever (≥38°C) (≥ 6 years)
    6
    6
    12
    5
        Rash (≥ 6 years)
    7
    9
    16
    6
        Prev. Pain/Fever (≥6 years)
    5
    9
    14
    15
        Use of Analg./Antipyr. (≥ 6 years)
    14
    39
    53
    38
        Any Others (≥ 6 years)
    27
    98
    125
    74
        Sleepiness (< 6 years; N=12,9,21,13)
    7
    3
    10
    5
        Injection Site Swelling (< 6 years; N=12,9,21,13)
    6
    4
    10
    6
    Notes
    [10] - Only for Myalgia (>= 6 years) N = 28,100,128,73.
    No statistical analyses for this end point

    Primary: 10. Number Of Subjects With Unsolicited Adverse Events.

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    End point title
    10. Number Of Subjects With Unsolicited Adverse Events. [11]
    End point description
    Safety was assessed as the number of subjects who reported unsolicited AEs collected from Day 1 through Day 7 after any vaccination; serious adverse events (SAEs), AEs leading to withdrawal and medically attended AEs were collected throughout the study period. The analysis was done on the Unsolicited Safety Set.
    End point type
    Primary
    End point timeframe
    Day 1 through Day 7 after any vaccination; throughout the study period.
    Notes
    [11] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was associated to this endpoint. Analyses were run descriptively.
    End point values
    CompDef Asplenia CompDef+Asplenia Healthy Subjects
    Number of subjects analysed
    40
    110
    150
    87
    Units: Subjects
        Any AE
    17
    38
    55
    34
        At least possibly related unsolicited AEs
    9
    19
    28
    18
        Any SAEs
    1
    5
    6
    0
        At least Possibly Related SAEs
    0
    0
    0
    0
        AEs leading to death
    0
    0
    0
    0
        AEs Leading to Withdrawal
    0
    1
    1
    0
        MEdically Attended AEs
    13
    26
    39
    18
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Throughout the study period.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    CompDef
    Reporting group description
    Subjects aged ≥2 to ≤17 years with complement deficiencies received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Asplenia
    Reporting group description
    Subjects aged ≥2 to ≤17 years with Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    CompDef + Asplenia
    Reporting group description
    Subjects aged ≥2 to ≤17 years with either complement deficiencies or Asplenia received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Reporting group title
    Healthy Subjects
    Reporting group description
    Healthy subjects aged ≥2 to ≤17 years received 2 doses of rMenB+OMV NZ administered 2 months apart.

    Serious adverse events
    CompDef Asplenia CompDef + Asplenia Healthy Subjects
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 40 (2.50%)
    5 / 110 (4.55%)
    6 / 150 (4.00%)
    0 / 87 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Injury, poisoning and procedural complications
    Concussion
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Intracardiac thrombus
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory disorder
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis salmonella
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory tract infection viral
         subjects affected / exposed
    1 / 40 (2.50%)
    0 / 110 (0.00%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    0 / 40 (0.00%)
    1 / 110 (0.91%)
    1 / 150 (0.67%)
    0 / 87 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    CompDef Asplenia CompDef + Asplenia Healthy Subjects
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    39 / 40 (97.50%)
    106 / 110 (96.36%)
    145 / 150 (96.67%)
    87 / 87 (100.00%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    11 / 40 (27.50%)
    48 / 110 (43.64%)
    59 / 150 (39.33%)
    35 / 87 (40.23%)
         occurrences all number
    15
    70
    85
    59
    Somnolence
         subjects affected / exposed
    7 / 40 (17.50%)
    3 / 110 (2.73%)
    10 / 150 (6.67%)
    5 / 87 (5.75%)
         occurrences all number
    11
    4
    15
    7
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    11 / 40 (27.50%)
    55 / 110 (50.00%)
    66 / 150 (44.00%)
    46 / 87 (52.87%)
         occurrences all number
    19
    89
    108
    67
    Injection site erythema
         subjects affected / exposed
    15 / 40 (37.50%)
    23 / 110 (20.91%)
    38 / 150 (25.33%)
    34 / 87 (39.08%)
         occurrences all number
    18
    34
    52
    49
    Injection site induration
         subjects affected / exposed
    17 / 40 (42.50%)
    32 / 110 (29.09%)
    49 / 150 (32.67%)
    26 / 87 (29.89%)
         occurrences all number
    30
    48
    78
    36
    Injection site pain
         subjects affected / exposed
    37 / 40 (92.50%)
    103 / 110 (93.64%)
    140 / 150 (93.33%)
    83 / 87 (95.40%)
         occurrences all number
    72
    196
    268
    171
    Injection site swelling
         subjects affected / exposed
    14 / 40 (35.00%)
    28 / 110 (25.45%)
    42 / 150 (28.00%)
    32 / 87 (36.78%)
         occurrences all number
    23
    45
    68
    46
    Pyrexia
         subjects affected / exposed
    10 / 40 (25.00%)
    7 / 110 (6.36%)
    17 / 150 (11.33%)
    10 / 87 (11.49%)
         occurrences all number
    11
    9
    20
    11
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    7 / 40 (17.50%)
    28 / 110 (25.45%)
    35 / 150 (23.33%)
    15 / 87 (17.24%)
         occurrences all number
    12
    42
    54
    21
    Diarrhoea
         subjects affected / exposed
    5 / 40 (12.50%)
    4 / 110 (3.64%)
    9 / 150 (6.00%)
    4 / 87 (4.60%)
         occurrences all number
    5
    6
    11
    6
    Vomiting
         subjects affected / exposed
    3 / 40 (7.50%)
    0 / 110 (0.00%)
    3 / 150 (2.00%)
    0 / 87 (0.00%)
         occurrences all number
    3
    0
    3
    0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    10 / 40 (25.00%)
    9 / 110 (8.18%)
    19 / 150 (12.67%)
    6 / 87 (6.90%)
         occurrences all number
    12
    10
    22
    8
    Psychiatric disorders
    Eating disorder
         subjects affected / exposed
    5 / 40 (12.50%)
    1 / 110 (0.91%)
    6 / 150 (4.00%)
    8 / 87 (9.20%)
         occurrences all number
    8
    1
    9
    13
    Irritability
         subjects affected / exposed
    7 / 40 (17.50%)
    2 / 110 (1.82%)
    9 / 150 (6.00%)
    9 / 87 (10.34%)
         occurrences all number
    14
    5
    19
    14
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 40 (17.50%)
    25 / 110 (22.73%)
    32 / 150 (21.33%)
    18 / 87 (20.69%)
         occurrences all number
    11
    38
    49
    24
    Myalgia
         subjects affected / exposed
    8 / 40 (20.00%)
    31 / 110 (28.18%)
    39 / 150 (26.00%)
    27 / 87 (31.03%)
         occurrences all number
    13
    44
    57
    34

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    30 Jul 2014
    The first version of the protocol was issued on June 20, 2013 and subsequently 3 amendments were issued. A total of 2 protocol amendments were issued before FSFV and 1 was issued after FSFV: - Amendment 1 was issued on July 22, 2013 and occurred before any clinical trial application and aims to correct minor inconsistencies, was classified as non-substantial; - Amendment 2 was issued on October 16, 2013 and occurred before any clinical trial application and after the review of clinical study protocol by the Committee for Medicinal Products for Human Use (CHMP). It included feedback and recommendation from the CHMP, was classified as substantial; - Amendment 3 was issued on July 30, 2014 it occurred after FSFV and it was classified as substantial: Amendment no 3 of protocol was issued to allow for additional study participants. Although the additional participants allowed for greater precision in the estimation of the study parameters, the sample size for this study was driven by feasibility and regulatory considerations, and not by formal statistical assumptions. Thus, no changes in the analysis and interpretation of results were foreseen. The protocol amendment permitted the screening of subjects who have already been booked in the UK, as per recommendation of a local EC, as well as the participation of subjects in Russian centers which had received Health Authority approval after the preamendment enrollment target for patients at increased risk of meningococcal disease had been reached. According to clinical study protocol amendment no 3, approximately 240 subjects (ie, up to 160 patients at increased risk of meningococcal disease and approximately 80 matched healthy subjects) meeting all eligibility criteria were to be enrolled.

    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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