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    Clinical Trial Results:
    A Phase 3, Multicenter, Randomized, Double-Blind, Active Comparator-Controlled Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by Administration of PNEUMOVAX™23 Eight Weeks Later in Adults Infected with HIV (PNEU-WAY)

    Summary
    EudraCT number
    2017-001909-32
    Trial protocol
    FR  
    Global end of trial date
    17 Jan 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    04 Dec 2020
    First version publication date
    04 Dec 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    V114-018
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03480802
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme Corp.
    Sponsor organisation address
    2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    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
    17 Jan 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    16 Sep 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    17 Jan 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This study is designed to 1) describe the safety, tolerability, and immunogenicity of V114 and Prevnar 13™ in pneumococcal vaccine-naïve adults infected with human immunodeficiency virus (HIV); and to 2) describe the safety, tolerability, and immunogenicity of PNEUMOVAX™23 when administered 8 weeks after receipt of either V114 or Prevnar 13™.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    06 Jul 2018
    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
    France: 39
    Country: Number of subjects enrolled
    Peru: 68
    Country: Number of subjects enrolled
    South Africa: 41
    Country: Number of subjects enrolled
    Thailand: 50
    Country: Number of subjects enrolled
    United States: 104
    Worldwide total number of subjects
    302
    EEA total number of subjects
    39
    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)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    291
    From 65 to 84 years
    11
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Adults 18 years of age or older infected with human immunodeficiency virus (HIV) who did not receive a pneumococcal vaccine prior to study entry were enrolled in this study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    V114
    Arm description
    Participants received a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)
    Arm type
    Experimental

    Investigational medicinal product name
    PNEUMOVAX™23
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    23-valent pneumococcal polysaccharide vaccine with serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F (25 mcg each) in each 0.5 mL dose

    Investigational medicinal product name
    V114
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    15-valent pneumococcal conjugate vaccine with serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19F, 19A, 22F, 23F, 33F (2 mcg each), serotype 6B (4 mcg) and Merck Aluminum Phosphate Adjuvant (125 mcg) in each 0.5 mL dose

    Arm title
    Prevnar 13™
    Arm description
    Participants received a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)
    Arm type
    Active comparator

    Investigational medicinal product name
    Prevnar 13™
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    13-valent pneumococcal conjugate vaccine with serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14, 18C, 19A, 19F, 23F (2.2 mcg) and 6B (4.4 mcg) in each 0.5 ml dose

    Investigational medicinal product name
    PNEUMOVAX™23
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intramuscular use
    Dosage and administration details
    23-valent pneumococcal polysaccharide vaccine with serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F (25 mcg each) in each 0.5 mL dose

    Number of subjects in period 1
    V114 Prevnar 13™
    Started
    152
    150
    Week 8
    150
    148
    Completed
    145
    147
    Not completed
    7
    3
         Consent withdrawn by subject
    2
    1
         Lost to follow-up
    5
    1
         Relocated
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    V114
    Reporting group description
    Participants received a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)

    Reporting group title
    Prevnar 13™
    Reporting group description
    Participants received a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)

    Reporting group values
    V114 Prevnar 13™ Total
    Number of subjects
    152 150 302
    Age Categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    144 147 291
        From 65-84 years
    8 3 11
        85 years and over
    0 0 0
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    42.4 ± 12.5 41.3 ± 12.3 -
    Gender Categorical
    Units: Subjects
        Female
    32 32 64
        Male
    120 118 238
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 1 1
        Asian
    24 30 54
        Native Hawaiian or Other Pacific Islander
    0 2 2
        Black or African American
    51 43 94
        White
    41 48 89
        More than one race
    36 26 62
        Unknown or Not Reported
    0 0 0
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    49 45 94
        Not Hispanic or Latino
    102 104 206
        Unknown or Not Reported
    1 1 2

    End points

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    End points reporting groups
    Reporting group title
    V114
    Reporting group description
    Participants received a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)

    Reporting group title
    Prevnar 13™
    Reporting group description
    Participants received a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Week 8 (Vaccination 2)

    Primary: Percentage of Participants with a Solicited Injection-site Adverse Event After Vaccination 1

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    End point title
    Percentage of Participants with a Solicited Injection-site Adverse Event After Vaccination 1 [1]
    End point description
    An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited injection-site AEs consist of redness/erythema, swelling, and tenderness/pain. The 95% confidence interval (CI) were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Primary
    End point timeframe
    Up to 5 days after Vaccination 1
    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: Statistical analyses were not specified for this primary endpoint because the study was not powered for between group comparisons.
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    152
    150
    Units: Percentage of Participants
    number (confidence interval 95%)
        Injection site erythema
    4.6 (1.9 to 9.3)
    3.3 (1.1 to 7.6)
        Injection site pain
    57.2 (49.0 to 65.2)
    51.3 (43.0 to 59.6)
        Injection site swelling
    11.8 (7.2 to 18.1)
    4.0 (1.5 to 8.5)
    No statistical analyses for this end point

    Primary: Percentage of Participants with a Solicited Systemic Adverse Event After Vaccination 1

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    End point title
    Percentage of Participants with a Solicited Systemic Adverse Event After Vaccination 1 [2]
    End point description
    An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited systemic AEs consist of muscle pain (myalgia), joint pain (arthralgia), headache, and tiredness (fatigue). The 95% CI were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Primary
    End point timeframe
    Up to 14 days after Vaccination 1
    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: Statistical analyses were not specified for this primary endpoint because the study was not powered for between group comparisons.
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    152
    150
    Units: Percentage of Participants
    number (confidence interval 95%)
        Arthralgia
    3.3 (1.1 to 7.5)
    4.0 (1.5 to 8.5)
        Fatigue
    20.4 (14.3 to 27.7)
    13.3 (8.3 to 19.8)
        Headache
    13.2 (8.2 to 19.6)
    9.3 (5.2 to 15.2)
        Myalgia
    12.5 (7.7 to 18.8)
    9.3 (5.2 to 15.2)
    No statistical analyses for this end point

    Primary: Percentage of Participants with a Vaccine-related Serious Adverse Event After Vaccination 1

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    End point title
    Percentage of Participants with a Vaccine-related Serious Adverse Event After Vaccination 1 [3]
    End point description
    A serious adverse event (SAE) is an AE that is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine is determined by the investigator. The 95% CI were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Primary
    End point timeframe
    Day 1 up to 8 weeks after Vaccination 1 (Up to 8 weeks)
    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: Statistical analyses were not specified for this primary endpoint because the study was not powered for between group comparisons.
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    152
    150
    Units: Percentage of Participants
        number (confidence interval 95%)
    0 (0.0 to 2.4)
    0 (0.0 to 2.4)
    No statistical analyses for this end point

    Primary: Geometric Mean Titer (GMT) of Serotype-specific Opsonophagocytic Activity (OPA) After Vaccination 1

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    End point title
    Geometric Mean Titer (GMT) of Serotype-specific Opsonophagocytic Activity (OPA) After Vaccination 1 [4]
    End point description
    Opsonization of pneumococci for phagocytosis is an important mechanism by which antibodies to polysaccharides protect against disease in vivo. Sera from participants was used to measure geometric mean titer (GMT) of 13 serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) included in V114 and Prevnar 13™; and two serotypes (22F and 33F) which are unique to V114 using the Multiplexed Opsonophagocytic Assay (MOPA). This assay reads the reciprocal of the highest dilution (1/dil) that gives ≥50% bacterial killing, as determined by comparison to assay background controls. The 95% CIs were derived by exponentiating the CIs of the mean of the natural log values based on the t-distribution. The population analyzed was all randomized participants without deviations from the protocol that may substantially affect the results of the immunogenicity endpoint.
    End point type
    Primary
    End point timeframe
    Day 30
    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: Statistical analyses were not specified for this primary endpoint because the study was not powered for between group comparisons.
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    152
    150
    Units: 1/dil
    geometric mean (confidence interval 95%)
        Serotype 1 (n=131,131)
    238.8 (173.1 to 329.3)
    200.9 (142.7 to 282.7)
        Serotype 3 (n=131,130)
    116.8 (94.9 to 143.7)
    72.3 (58.6 to 89.2)
        Serotype 4 (n=130,131)
    824.0 (618.8 to 1097.2)
    1465.5 (1154.5 to 1860.3)
        Serotype 5 (n=131,130)
    336.7 (242.7 to 467.7)
    276.7 (197.9 to 386.7)
        Serotype 6A (n=126,128)
    6421.0 (4890.4 to 8430.7)
    5645.1 (4278.9 to 7447.4)
        Serotype 6B (n=129,130)
    4772.9 (3628.3 to 6278.7)
    3554.0 (2751.0 to 4591.4)
        Serotype 7F (n=131,131)
    6085.8 (4871.6 to 7602.8)
    6144.3 (4982.8 to 7576.6)
        Serotype 9V (n=129,128)
    2836.3 (2311.5 to 3480.4)
    2133.9 (1721.8 to 2644.5)
        Serotype 14 (n=131,130)
    3508.7 (2730.6 to 4508.5)
    3000.3 (2350.0 to 3830.5)
        Serotype 18C (n=129,129)
    3002.2 (2435.5 to 3700.8)
    1560.3 (1213.8 to 2005.6)
        Serotype 19A (n=131,131)
    4240.7 (3415.4 to 5265.3)
    3715.9 (2949.2 to 4681.8)
        Serotype 19F (n=131,131)
    2438.6 (1972.7 to 3014.6)
    2042.0 (1618.9 to 2575.5)
        Serotype 23F (n=129,127)
    1757.4 (1276.1 to 2420.2)
    1787.0 (1309.0 to 2437.9)
        Serotype 22F (n=128,116)
    3943.7 (3049.2 to 5100.5)
    109.3 (66.2 to 180.3)
        Serotype 33F (n=131,129)
    11342.4 (9184.3 to 14007.6)
    1807.6 (1357.3 to 2407.3)
    No statistical analyses for this end point

    Primary: Geometric Mean Concentration of Serotype-specific Immunoglobulin G (IgG) After Vaccination 1

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    End point title
    Geometric Mean Concentration of Serotype-specific Immunoglobulin G (IgG) After Vaccination 1 [5]
    End point description
    The geometric mean concentration of IgG serotype-specific antibodies to the 13 serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) included in V114 and Prevnar 13™; and two serotypes (22F and 33F) which are unique to V114 were quantitated from participants' sera by multiplex electrochemiluminescence (ECL) using the pneumococcal electrochemiluminescence (PnECL) v2.0 assay, based on the Meso-Scale Discovery technology, which employs disposable multi-spot microtiter plates. The 95% CIs were derived by exponentiating the CIs of the mean of the natural log values based on the t-distribution. The population analyzed was all randomized participants without deviations from the protocol that may substantially affect the results of the immunogenicity endpoint.
    End point type
    Primary
    End point timeframe
    Day 30
    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: Statistical analyses were not specified for this primary endpoint because the study was not powered for between group comparisons.
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    152
    150
    Units: μg/mL
    geometric mean (confidence interval 95%)
        Serotype 1 (n=139,138)
    3.16 (2.48 to 4.01)
    4.27 (3.31 to 5.50)
        Serotype 3 (n=139,136)
    0.57 (0.48 to 0.68)
    0.50 (0.41 to 0.60)
        Serotype 4 (n=138,138)
    1.14 (0.90 to 1.44)
    2.00 (1.56 to 2.55)
        Serotype 5 (n=139,138)
    2.38 (1.89 to 3.01)
    2.03 (1.56 to 2.64)
        Serotype 6A (n=139,138)
    5.13 (3.73 to 7.04)
    4.91 (3.49 to 6.91)
        Serotype 6B (n=139,138)
    7.17 (5.34 to 9.63)
    5.23 (3.73 to 7.35)
        Serotype 7F (n=139,138)
    2.61 (2.00 to 3.41)
    3.74 (2.91 to 4.81)
        Serotype 9V (n=139,137)
    3.35 (2.71 to 4.14)
    3.55 (2.77 to 4.56)
        Serotype 14 (n=139,138)
    15.44 (11.69 to 20.39)
    15.22 (11.56 to 20.03)
        Serotype 18C (n=139,138)
    5.58 (4.33 to 7.18)
    5.07 (3.97 to 6.48)
        Serotype 19A (n=139,138)
    9.09 (7.08 to 11.67)
    9.61 (7.36 to 12.56)
        Serotype 19F (n=139,138)
    6.41 (4.89 to 8.39)
    6.21 (4.73 to 8.15)
        Serotype 23F (n=139,138)
    3.92 (2.94 to 5.22)
    4.90 (3.54 to 6.77)
        Serotype 22F (n=139,137)
    3.97 (3.06 to 5.15)
    0.20 (0.17 to 0.25)
        Serotype 33F (n=139,138)
    6.83 (5.14 to 9.07)
    0.77 (0.62 to 0.95)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with a Solicited Injection-site Adverse Event After Vaccination 2

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    End point title
    Percentage of Participants with a Solicited Injection-site Adverse Event After Vaccination 2
    End point description
    An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited injection-site AEs consist of redness/erythema, swelling, and tenderness/pain. The 95% confidence interval (CI) were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Secondary
    End point timeframe
    Up to 5 days after Vaccination 2 (Up to Day 61)
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    150
    148
    Units: Percentage of Participants
    number (confidence interval 95%)
        Injection site erythema
    10.0 (5.7 to 16.0)
    12.2 (7.4 to 18.5)
        Injection site pain
    53.3 (45.0 to 61.5)
    61.5 (53.1 to 69.4)
        Injection site swelling
    20.0 (13.9 to 27.3)
    29.1 (21.9 to 37.1)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with a Solicited Systemic Adverse Event After Vaccination 2

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    End point title
    Percentage of Participants with a Solicited Systemic Adverse Event After Vaccination 2
    End point description
    An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Solicited systemic AEs consist of muscle pain (myalgia), joint pain (arthralgia), headache, and tiredness (fatigue). The 95% CI were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Secondary
    End point timeframe
    Up to 14 days after Vaccination 2 (Up to Day 70)
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    150
    148
    Units: Percentage of Participants
    number (confidence interval 95%)
        Arthralgia
    2.7 (0.7 to 6.7)
    1.4 (0.2 to 4.8)
        Fatigue
    12.7 (7.8 to 19.1)
    10.8 (6.3 to 17.0)
        Headache
    8.7 (4.7 to 14.4)
    8.8 (4.8 to 14.6)
        Myalgia
    11.3 (6.7 to 17.5)
    12.2 (7.4 to 18.5)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with a Vaccine-related Serious Adverse Event After Vaccination 2

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    End point title
    Percentage of Participants with a Vaccine-related Serious Adverse Event After Vaccination 2
    End point description
    A serious adverse event (SAE) is an AE that is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine is determined by the investigator. The 95% CI were based on the exact binomial method proposed by Clopper and Pearson. The population analyzed was all randomized participants who received at least 1 dose of the study vaccination they actually received.
    End point type
    Secondary
    End point timeframe
    Week 8 up to Month 6
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    150
    148
    Units: Percentage of Participants
        number (confidence interval 95%)
    0 (0.0 to 2.4)
    0 (0.0 to 2.5)
    No statistical analyses for this end point

    Secondary: Geometric Mean Titer of Serotype-specific OPA After Vaccination 2

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    End point title
    Geometric Mean Titer of Serotype-specific OPA After Vaccination 2
    End point description
    Opsonization of pneumococci for phagocytosis is an important mechanism by which antibodies to polysaccharides protect against disease in vivo. Sera from participants was used to measure GMT of 13 serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) included in V114 and Prevnar 13™; and two serotypes (22F and 33F) which are unique to V114 using the MOPA. The MOPA reads the reciprocal of the highest dilution that gives ≥50% bacterial killing, as determined by comparison to assay background controls. The population analyzed was all randomized participants without deviations from the protocol that may substantially affect the results of the outcome measure.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    150
    148
    Units: 1/dil
    geometric mean (confidence interval 95%)
        Serotype 1 (n=122,117)
    212.0 (160.5 to 280.2)
    154.0 (111.6 to 212.4)
        Serotype 3 (n=123,117)
    102.8 (83.0 to 127.2)
    96.6 (79.5 to 117.4)
        Serotype 4 (n=122,117)
    915.4 (722.9 to 1159.1)
    984.7 (772.1 to 1255.7)
        Serotype 5 (n=123,117)
    418.1 (312.1 to 560.3)
    274.5 (199.9 to 376.8)
        Serotype 6A (n=118,113)
    4065.4 (3052.1 to 5415.1)
    4593.2 (3543.0 to 5954.7)
        Serotype 6B (n=122,117)
    3661.1 (2735.1 to 4900.6)
    2826.4 (2202.7 to 3626.8)
        Serotype 7F (n=122,117)
    5983.5 (4788.9 to 7476.1)
    5516.5 (4522.2 to 6729.5)
        Serotype 9V (n=120,117)
    2454.8 (2008.7 to 3000.0)
    1929.9 (1567.7 to 2375.7)
        Serotype 14 (n=123,117)
    3634.0 (2935.6 to 4498.5)
    2539.3 (1960.6 to 3288.9)
        Serotype 18C (n=122,115)
    2511.5 (1958.7 to 3220.3)
    1753.8 (1428.6 to 2153.1)
        Serotype 19A (n=123,117)
    3358.1 (2679.6 to 4208.4)
    3300.3 (2638.7 to 4127.7)
        Serotype 19F (n=123,116)
    2230.7 (1803.6 to 2759.0)
    1994.1 (1630.7 to 2438.4)
        Serotype 23F (n=120,116)
    1641.2 (1217.2 to 2212.9)
    1266.5 (944.3 to 1698.5)
        Serotype 22F (n=121,116)
    3399.9 (2697.6 to 4285.0)
    2952.7 (2207.7 to 3949.1)
        Serotype 33F (n=123,117)
    10576.3 (8383.1 to 13343.4)
    11926.3 (9085.9 to 15654.6)
    No statistical analyses for this end point

    Secondary: Geometric Mean Concentration of Serotype-specific IgG After Vaccination 2

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    End point title
    Geometric Mean Concentration of Serotype-specific IgG After Vaccination 2
    End point description
    The geometric mean concentration of IgG serotype-specific antibodies to the 13 serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) included in V114 and Prevnar 13™; and two serotypes (22F and 33F) which are unique to V114 were quantitated from participants' sera by multiplex ECL using the PnECL v2.0 assay, based on the Meso-Scale Discovery technology, which employs disposable multi-spot microtiter plates. The population analyzed was all randomized participants without deviations from the protocol that may substantially affect the results of the immunogenicity endpoint.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    V114 Prevnar 13™
    Number of subjects analysed
    150
    148
    Units: μg/mL
    geometric mean (confidence interval 95%)
        Serotype 1 (n=130,129)
    2.80 (2.25 to 3.49)
    4.04 (3.27 to 5.00)
        Serotype 3 (n=130,128)
    0.51 (0.43 to 0.61)
    0.59 (0.50 to 0.70)
        Serotype 4 (n=130,129)
    1.26 (1.10 to 1.57)
    1.61 (1.31 to 1.98)
        Serotype 5 (n=130,129)
    2.61 (2.08 to 3.28)
    2.13 (1.69 to 2.68)
        Serotype 6A (n=130,129)
    3.12 (2.27 to 4.30)
    3.71 (2.74 to 5.03)
        Serotype 6B (n=130,129)
    4.69 (3.52 to 6.25)
    4.35 (3.23 to 5.86)
        Serotype 7F (n=130,129)
    2.45 (1.91 to 3.15)
    3.17 (2.60 to 3.87)
        Serotype 9V (n=130,128)
    2.92 (2.39 to 3.57)
    3.24 (2.62 to 4.01)
        Serotype 14 (n=130,129)
    13.68 (10.34 to 18.10)
    14.37 (11.25 to 18.36)
        Serotype 18C (n=130,129)
    3.96 (3.08 to 5.09)
    3.96 (3.18 to 4.95)
        Serotype 19A (n=130,129)
    7.23 (5.80 to 9.02)
    8.54 (6.80 to 10.72)
        Serotype 19F (n=130,129)
    5.19 (4.06 to 6.62)
    5.84 (4.67 to 7.30)
        Serotype 23F (n=130,129)
    3.21 (2.42 to 4.25)
    3.74 (2.85 to 4.91)
        Serotype 22F (n=130,129)
    3.94 (3.07 to 5.05)
    3.50 (2.75 to 4.45)
        Serotype 33F (n=130,129)
    6.18 (4.72 to 8.09)
    9.20 (7.19 to 11.77)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    V114 and Prevnar 13™: NSAEs Day 1 up to 14 days after vaccination 1; SAEs Day 1 up to Week 8. V114 (Post-PPV23) and Prevnar 13™ (Post-PPV23): NSAEs week 8 up to 14 days after vaccination 2; SAEs Week 8 vaccination up to Month 6. Mortality: Up to Month 6.
    Adverse event reporting additional description
    The population reported was all randomized participants who received study intervention at the specified timepoint. Adverse events were reported (1) following administration of either V114 or Prevnar 13™ and (2) following administration of PNEUMOVAX™23 (PPV23).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.1
    Reporting groups
    Reporting group title
    V114
    Reporting group description
    Participants received a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1).

    Reporting group title
    Prevnar 13™
    Reporting group description
    Participants received a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1).

    Reporting group title
    V114 (Post-PPV23)
    Reporting group description
    Participants received a single 0.5 mL IM injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 (PPV23) at Week 8 (Vaccination 2).

    Reporting group title
    Prevnar 13™ (Post-PPV23)
    Reporting group description
    Participants received a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PPV23 at Week 8 (Vaccination 2).

    Serious adverse events
    V114 Prevnar 13™ V114 (Post-PPV23) Prevnar 13™ (Post-PPV23)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 152 (1.97%)
    0 / 150 (0.00%)
    2 / 150 (1.33%)
    6 / 148 (4.05%)
         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
    Foot fracture
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    1 / 148 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Dry gangrene
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    1 / 148 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Transient ischaemic attack
         subjects affected / exposed
    1 / 152 (0.66%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    0 / 148 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    1 / 148 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    1 / 150 (0.67%)
    0 / 148 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Suicide attempt
         subjects affected / exposed
    1 / 152 (0.66%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    0 / 148 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Chondrocalcinosis pyrophosphate
         subjects affected / exposed
    1 / 152 (0.66%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    0 / 148 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    1 / 150 (0.67%)
    0 / 148 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    2 / 148 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    1 / 148 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Soft tissue infection
         subjects affected / exposed
    0 / 152 (0.00%)
    0 / 150 (0.00%)
    0 / 150 (0.00%)
    1 / 148 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         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
    V114 Prevnar 13™ V114 (Post-PPV23) Prevnar 13™ (Post-PPV23)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    103 / 152 (67.76%)
    88 / 150 (58.67%)
    88 / 150 (58.67%)
    99 / 148 (66.89%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    20 / 152 (13.16%)
    14 / 150 (9.33%)
    13 / 150 (8.67%)
    13 / 148 (8.78%)
         occurrences all number
    23
    15
    14
    13
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    31 / 152 (20.39%)
    20 / 150 (13.33%)
    19 / 150 (12.67%)
    16 / 148 (10.81%)
         occurrences all number
    34
    23
    20
    16
    Injection site erythema
         subjects affected / exposed
    8 / 152 (5.26%)
    5 / 150 (3.33%)
    15 / 150 (10.00%)
    18 / 148 (12.16%)
         occurrences all number
    8
    5
    15
    18
    Injection site pain
         subjects affected / exposed
    88 / 152 (57.89%)
    78 / 150 (52.00%)
    80 / 150 (53.33%)
    92 / 148 (62.16%)
         occurrences all number
    100
    86
    97
    101
    Injection site swelling
         subjects affected / exposed
    18 / 152 (11.84%)
    6 / 150 (4.00%)
    30 / 150 (20.00%)
    43 / 148 (29.05%)
         occurrences all number
    18
    6
    30
    43
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    19 / 152 (12.50%)
    14 / 150 (9.33%)
    17 / 150 (11.33%)
    18 / 148 (12.16%)
         occurrences all number
    21
    15
    18
    18

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Jul 2018
    Amendment 1: Removed the collection of medical device incidents from the protocol; made clarifications and editorial revisions.

    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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