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    Clinical Trial Results:
    A Phase 4 study to evaluate the safety and immunogenicity of monovalent oral polio vaccine type 2 in healthy IPV-vaccinated children aged 1 to 5 years in Lithuania

    Summary
    EudraCT number
    2015-003544-39
    Trial protocol
    LT  
    Global end of trial date
    12 May 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    18 Dec 2019
    First version publication date
    18 Dec 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    M3-ABMG
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02582255
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Fighting Infectious Diseases in Emerging Countries (FIDEC)
    Sponsor organisation address
    2050 Coral Way, Suite 407, MIami, United States, 33145
    Public contact
    Clinic of Children Diseases, Vilnius University, Santariskiu Clinic, +37 052492414, vytautas.usonis@mf.vu.lt
    Scientific contact
    Clinic of Children Diseases, Vilnius University, Santariskiu Clinic, +37 052492414, vytautas.usonis@mf.vu.lt
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    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?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 Apr 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    12 May 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    12 May 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objectives of the study are to assess the safety (serious adverse events [SAEs] and severe adverse events [AEs] grade 3 according to CTCAE 4.03) and immunogenicity (seroprotection rate) of one dose of SABIN mOPV2 in healthy IPV-vaccinated children aged 1 to 5 years.
    Protection of trial subjects
    A DSMB monitored the safety aspects of this trial. The composition and functioning of the DSMB was documented in the DSMB charter, which was approved prior to the initiation of the study.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Oct 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Lithuania: 100
    Worldwide total number of subjects
    100
    EEA total number of subjects
    100
    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)
    40
    Children (2-11 years)
    60
    Adolescents (12-17 years)
    0
    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
    100 subjects enrolled - 50 subjects were enrolled in Group 1 (1 dose of mOPV2) and 50 subjects were enrolled in Group 2 (2 doses of mOPV2).

    Pre-assignment
    Screening details
    101 subjects were available for screening.

    Period 1
    Period 1 title
    FPI-LPO (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group 1
    Arm description
    IPV-vaccinated children to receive 1 dose of SABIN mOPV2
    Arm type
    Experimental

    Investigational medicinal product name
    mOPV2
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    All subjects were to receive mOPV2 at the same dose level. Half of the subjects (n=50, Group 1) were to receive a single dose, with the other half (n=50, Group 2) to receive a second dose, 28 days after the first dose.

    Arm title
    Group 2
    Arm description
    IPV-vaccinated children to receive 2 doses of SABIN mOPV2, administered 28 days apart .
    Arm type
    Experimental

    Investigational medicinal product name
    mOPV2
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    All subjects were to receive mOPV2 at the same dose level. Half of the subjects (n=50, Group 1) were to receive a single dose, with the other half (n=50, Group 2) to receive a second dose, 28 days after the first dose.

    Number of subjects in period 1
    Group 1 Group 2
    Started
    50
    50
    Completed
    50
    47
    Not completed
    0
    3
         Protocol deviation
    -
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group 1
    Reporting group description
    IPV-vaccinated children to receive 1 dose of SABIN mOPV2

    Reporting group title
    Group 2
    Reporting group description
    IPV-vaccinated children to receive 2 doses of SABIN mOPV2, administered 28 days apart .

    Reporting group values
    Group 1 Group 2 Total
    Number of subjects
    50 50 100
    Age categorical
    IPV vaccinated children aged 1 to 5 years
    Units: Subjects
        Infants and toddlers (28 days-23 months)
    20 20 40
        Children (2-11 years)
    30 30 60
    Gender categorical
    Units: Subjects
        Female
    26 19 45
        Male
    24 31 55

    End points

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    End points reporting groups
    Reporting group title
    Group 1
    Reporting group description
    IPV-vaccinated children to receive 1 dose of SABIN mOPV2

    Reporting group title
    Group 2
    Reporting group description
    IPV-vaccinated children to receive 2 doses of SABIN mOPV2, administered 28 days apart .

    Primary: SAEs and Severe AEs

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    End point title
    SAEs and Severe AEs
    End point description
    Incidence of SAEs and severe AEs grade 3 considered consistent with a causal association to study vaccine throughout the study period in children 1 to 5 years.
    End point type
    Primary
    End point timeframe
    3 months
    End point values
    Group 1 Group 2
    Number of subjects analysed
    50
    47
    Units: Number of participants
    0
    0
    Statistical analysis title
    Baseline safety
    Comparison groups
    Group 1 v Group 2
    Number of subjects included in analysis
    97
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.05
    Method
    Clopper-Pearson
    Confidence interval

    Primary: Seroprotection Rate of Type 2 Polio Neutralizing Antibodies

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    End point title
    Seroprotection Rate of Type 2 Polio Neutralizing Antibodies
    End point description
    Seroprotection rate at type 2 polio neutralizing antibodies measured at D28 after the first dose of mOPV2.
    End point type
    Primary
    End point timeframe
    1 month
    End point values
    Group 1 Group 2
    Number of subjects analysed
    50
    47
    Units: Number of participants
    50
    47
    Statistical analysis title
    Baseline immunogenicity seroprotection rate
    Comparison groups
    Group 1 v Group 2
    Number of subjects included in analysis
    97
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.025
    Method
    Clopper-Pearson
    Confidence interval

    Secondary: Seroprotection Rate for Type 2 Polio Neutralizing Antibodies

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    End point title
    Seroprotection Rate for Type 2 Polio Neutralizing Antibodies
    End point description
    Seroprotection rate for type 2 polio neutralizing antibodies measured at D 28 after the second dose of mOPV2.
    End point type
    Secondary
    End point timeframe
    3 months
    End point values
    Group 1 Group 2
    Number of subjects analysed
    50
    47
    Units: Number of participants
    50
    47
    Statistical analysis title
    Baseline immunogenicity seroprotection rate
    Comparison groups
    Group 2 v Group 1
    Number of subjects included in analysis
    97
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.025
    Method
    Clopper-Pearson
    Confidence interval

    Secondary: Incidence of Any Serious Adverse Events (SAEs), Any Solicited AEs, Any Unsolicited AEs, and Any Important Medical Events (IMEs).

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    End point title
    Incidence of Any Serious Adverse Events (SAEs), Any Solicited AEs, Any Unsolicited AEs, and Any Important Medical Events (IMEs).
    End point description
    Incidence, severity and relationship) of any serious adverse events (SAEs), any solicited AEs, any unsolicited AEs, and any Important Medical Events (IMEs) with the exception of severe related AEs. (primary objective), as well as any laboratory deviations of one or two doses of SABIN mOPV2 in healthy IPV-vaccinated children aged 1 to 5 years.
    End point type
    Secondary
    End point timeframe
    3 months
    End point values
    Group 1 Group 2
    Number of subjects analysed
    50
    47
    Units: Number of participants
    6
    12
    Statistical analysis title
    Baseline safety
    Comparison groups
    Group 1 v Group 2
    Number of subjects included in analysis
    97
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.05
    Method
    Clopper-Pearson
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    3 months
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    10.0
    Reporting groups
    Reporting group title
    Group 1
    Reporting group description
    IPV-vaccinated children receiving 1 dose of SABIN mOPV2.

    Reporting group title
    Group 2
    Reporting group description
    IPV-vaccinated children receiving 2 doses of SABIN mOPV2

    Serious adverse events
    Group 1 Group 2
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Bronchitis
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         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: 2%
    Non-serious adverse events
    Group 1 Group 2
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 50 (12.00%)
    12 / 50 (24.00%)
    Investigations
    Platelet count increased
         subjects affected / exposed
    0 / 50 (0.00%)
    2 / 50 (4.00%)
         occurrences all number
    0
    2
    General disorders and administration site conditions
    Abnormal crying
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences all number
    1
    0
    Appetite lost
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences all number
    1
    0
    Irritability
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    1
    1
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Fever
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Tonsillar hypertrophy
         subjects affected / exposed
    0 / 50 (0.00%)
    2 / 50 (4.00%)
         occurrences all number
    0
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 50 (2.00%)
    2 / 50 (4.00%)
         occurrences all number
    1
    3
    Conjuctivitis
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Gastroenteritis Norovirus
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 50 (2.00%)
    1 / 50 (2.00%)
         occurrences all number
    1
    1
    Pharyngitis
         subjects affected / exposed
    0 / 50 (0.00%)
    2 / 50 (4.00%)
         occurrences all number
    0
    2
    Pharyngotonsillitis
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Respiratory tract infection
         subjects affected / exposed
    1 / 50 (2.00%)
    0 / 50 (0.00%)
         occurrences all number
    2
    0
    Scarlet fever
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Sinusitis
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 50 (2.00%)
    2 / 50 (4.00%)
         occurrences all number
    2
    3
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 50 (0.00%)
    1 / 50 (2.00%)
         occurrences all number
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    14 Oct 2015
    Clarification of: • Primary and secondary objectives • Study endpoints • Clinical laboratory samples • TV and PP populations • IME reporting

    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
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