Clinical Trial Results:
An Exploratory, Phase 2a, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Prophylactic Efficacy of a Single Immunization of Ad26.RSV.preF Against Respiratory Syncytial Virus Infection in a Virus Challenge Model in Healthy 18 to 50 Year-Old Adults
Summary
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EudraCT number |
2017-003194-33 |
Trial protocol |
GB |
Global end of trial date |
27 Nov 2018
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Results information
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Results version number |
v1 |
This version publication date |
18 Dec 2019
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First version publication date |
18 Dec 2019
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Other versions |
v2 |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
VAC18193RSV2002
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT03334695 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Janssen Vaccines and Prevention B.V.
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Sponsor organisation address |
Newtonweg 1, Leiden, Netherlands, 2333 CM
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Public contact |
Clinical Registry Group, Janssen Vaccines and Prevention B.V., ClinicalTrialsEU@its.jnj.com
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Scientific contact |
Clinical Registry Group, Janssen Vaccines and Prevention B.V., ClinicalTrialsEU@its.jnj.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
16 Apr 2019
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
27 Nov 2018
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The primary objective of this study was to assess a trend for the prophylactic efficacy of a single dose of 1*10^11 viral particles (vp) of Adenovirus Serotype 26 Based Respiratory Syncytial Virus Pre-fusion F Protein (Ad26.RSV.preF) administered intramuscularly (IM) to adults aged 18 to 50 years in the RSV challenge model in terms of the reduction of nasal wash viral load as measured by the area under the curve (AUC) over time by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) compared to placebo.
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Protection of trial subjects |
This study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki and that are consistent with Good Clinical Practice and applicable regulatory requirements. Safety was evaluated based on the following variables: adverse events (AEs), clinical laboratory tests (hematology, serum chemistry, and urinalysis), vital signs measurements, physical examinations and electrocardiograms (ECGs).
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
02 Aug 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United Kingdom: 63
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Worldwide total number of subjects |
63
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EEA total number of subjects |
63
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
63
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
- | ||||||||||||||||||||||||
Pre-assignment
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Screening details |
In total, 64 subjects were screened. Of these, 63 subjects were randomized and received the study vaccine on Day -28. | ||||||||||||||||||||||||
Period 1
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Period 1 title |
Post-vaccination (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||
Roles blinded |
Subject, Investigator | ||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Ad26.RSV.preF (1*10^11 vp) | ||||||||||||||||||||||||
Arm description |
Subjects received a single intramuscular injection of 1*10^11 viral particles (vp) of Ad26.RSV.preF on Day -28 followed by intranasal challenge with a respiratory syncytial virus (RSV)-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Ad26.RSV.preF
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Investigational medicinal product code |
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Other name |
JNJ-64400141
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Pharmaceutical forms |
Injection
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Routes of administration |
Intramuscular use
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Dosage and administration details |
Ad26.RSV.preF was administered as an intramuscular injection.
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Arm title
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Placebo | ||||||||||||||||||||||||
Arm description |
Subjects received a single intramuscular injection of matching placebo on Day -28 followed by intranasal challenge with RSV-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Injection
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Routes of administration |
Intramuscular use
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Dosage and administration details |
Subjects received an intramuscular injection of matching placebo.
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Baseline characteristics reporting groups
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Reporting group title |
Ad26.RSV.preF (1*10^11 vp)
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Reporting group description |
Subjects received a single intramuscular injection of 1*10^11 viral particles (vp) of Ad26.RSV.preF on Day -28 followed by intranasal challenge with a respiratory syncytial virus (RSV)-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Subjects received a single intramuscular injection of matching placebo on Day -28 followed by intranasal challenge with RSV-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Ad26.RSV.preF (1*10^11 vp)
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Reporting group description |
Subjects received a single intramuscular injection of 1*10^11 viral particles (vp) of Ad26.RSV.preF on Day -28 followed by intranasal challenge with a respiratory syncytial virus (RSV)-A Memphis 37b virus on Day 0. | ||
Reporting group title |
Placebo
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Reporting group description |
Subjects received a single intramuscular injection of matching placebo on Day -28 followed by intranasal challenge with RSV-A Memphis 37b virus on Day 0. |
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End point title |
Area Under the Viral Load-time Curve (VL-AUC) of RSV by Quantitative Reverse Transcriptase-polymerase Chain Reaction (qRT-PCR) | ||||||||||||
End point description |
VL-AUC for RSV was determined by qRT-PCR assay of nasal wash samples. The Intent-to-treat-Challenge (ITTc) population is a subset of the Full Analysis (FA) Set (all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects.
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End point type |
Primary
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End point timeframe |
From Day 2 to Day 12
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Statistical analysis title |
Statistical analysis | ||||||||||||
Comparison groups |
Ad26.RSV.preF (1*10^11 vp) v Placebo
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Number of subjects included in analysis |
53
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.012 | ||||||||||||
Method |
Wilcoxon Rank Sum test | ||||||||||||
Confidence interval |
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End point title |
Peak Viral Load of RSV-A Memphis 37b | ||||||||||||
End point description |
Peak viral load of RSV-A Memphis 37b was defined as the maximum viral load by quantitative RT-PCR assay of nasal wash samples. The ITTc population is a subset of the Full Analysis (FA) Set (all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects.
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End point type |
Secondary
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End point timeframe |
Between Day 2 and Day 12
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No statistical analyses for this end point |
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End point title |
Viral Load by Quantitative RT-PCR Assay on Day 6 and 7 | ||||||||||||||||||||||||
End point description |
Viral Load determined by quantitative RT-PCR assay of nasal wash samples over time was reported. The ITTc population is a subset of the FA Set (all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects. Here 'n' (number of subjects analyzed) signifies the number of subjects analyzed for this endpoint at specified timepoints.
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End point type |
Secondary
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End point timeframe |
Day 6 and 7
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No statistical analyses for this end point |
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End point title |
VL-AUC of RSV by Quantitative Culture of RSV (Plaque Assay) on Day 6 and 7 | ||||||||||||||||||||||||
End point description |
VL-AUC of RSV by the quantitative culture of nasal wash samples was determined. The ITTc population is a subset of the FA Set (all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects.
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End point type |
Secondary
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End point timeframe |
Day 6 and 7
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects with Symptomatic RSV Infections | ||||||||||||||||||
End point description |
The percentage of subjects with symptomatic RSV infections. Conservative: subject had 2 or more quantifiable RT-PCR measurements on different samples, with one of following: symptoms of 2 different categories of subject symptom card (Upper Respiratory [runny/stuffy nose, sneezing, sore throat, earache], Lower Respiratory [cough, shortness of breath, chest tightness, wheeze], Systemic [malaise, headache, muscle and/or joint ache]) regardless of grade and assessment timepoint or Grade 2 symptom from any category; Liberal (RT-PCR): had 2/more quantifiable RT-PCR measurements, with clinical symptom of any severity. ITTc population included.
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End point type |
Secondary
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End point timeframe |
From Day 2 to Day 12
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No statistical analyses for this end point |
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End point title |
Total Clinical Symptoms Score at Day 6 and 7 in Ad26.RSV.preF Versus Placebo | ||||||||||||||||||||||||||||||
End point description |
The total clinical symptom score was determined as the sum of the scores (grades) of the 13 self-reportable symptoms on the Subject Symptoms Card (SSC). The ITTc population is a subset of the FA set (all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects. Here 'n' signifies the number of subjects analyzed for the specified timepoint.
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End point type |
Secondary
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End point timeframe |
Day 6 and 7
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No statistical analyses for this end point |
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End point title |
Weight of Mucus Secretions Over Time | ||||||||||||
End point description |
The weight of mucous secretion over time was determined by the AUC of mucous secretion in gram*hour. The ITTc population is a subset of the FA set (all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects.
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End point type |
Secondary
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End point timeframe |
Day 0 up to Discharge (Day 12)
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No statistical analyses for this end point |
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End point title |
Tissue Count Over Time | |||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Number of tissues used by subjects per time point was reported. The ITTc population is a subset of the FA Set (all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations) including all randomized, vaccinated and challenged subjects.
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End point type |
Secondary
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End point timeframe |
From Day 0 to Day 12
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Unsolicited Adverse Events (AEs) | ||||||||||||||||||
End point description |
Unsolicited AEs are all AEs for which subjects were specifically not questioned in the subject diary. An AE is any untoward medical event that occurs in a subject administered an investigational product, and it does not necessarily indicate only events with a clear causal relationship with the relevant investigational product. The Full Analysis Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
Up to 28 days post-vaccination and up to 28 days post-challenge (Up to Day 28)]
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Serious Adverse Events (SAEs) | ||||||||||||
End point description |
An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. The Full Analysis Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
Up to 6 months post-vaccination
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Solicited Local and Systemic AEs | ||||||||||||||||||
End point description |
Solicited local AEs: erythema, swelling/induration, and pain/tenderness. Solicited systemic AEs: fatigue, headache, myalgia, arthralgia, chills, nausea and fever. The Full Analysis Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
7 days post-vaccination (Day -21)
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Vital Signs Abnormalities | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Vital signs measurements included body temperature (measured in degree Celsius from less than [<] 37.5 to <39.5), respiratory rate, systolic and diastolic blood pressure, and pulse rate. The Full Analysis Set included all subjects who were randomized and received study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
Up to 6 months post-vaccination
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Electrocardiogram (ECG) Abnormalities | |||||||||||||||||||||||||||
End point description |
ECG parameters included heart rate, PR, QRS, QTcB, QTcF, and the uncorrected QT interval. The ITTc population is a subset of the FA (all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations) set including all randomized, vaccinated and challenged subjects.
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End point type |
Secondary
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End point timeframe |
Within 56 days of vaccination, on Day -1 or Day -2 prior to challenge, and on Days 3, 7, and 11 after challenge
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Clinical Laboratory Abnormalities (Graded) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Percentage of subjects with post-dose (PD) and post-challenge (PC) clinical laboratory abnormalities were reported. The biochemical and hematological parameters analyzed were- Alanine aminotransferase (AA), Alkaline phosphatase (AP), Aspartate aminotransferase (AsP), Hyperkalemia, Hypernatremia, Hypoglycemia, Hypophosphatemia, Hemoglobin, Neutrophils, WBC – increase and Urine protein, which were graded by FDA Toxicity Grading Scale. The Full Analysis Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
Up to 6 months post-vaccination
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Clinical Laboratory Abnormalities (Non-graded) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Percentage of subjects with post-dose and post-challenge clinical laboratory abnormalities were reported. The biochemical and hematological parameters analyzed were- Bicarbonate, C reactive protein, Chloride, Creatine kinase, Direct bilirubin, Gamma glutamyl transferase (GGT), Lactate dehydrogenase, Lactate dehydrogenase, Urate, Eosinophils/leukocytes, Eosinophils/leukocytes, Erythrocytes mean corpuscular (EMC) HGB concentration, Erythrocytes, Hematocrit, Lymphocytes/leukocytes, Monocytes, Monocytes/leukocytes, Neutrophils/leukocytes, Reticulocytes, Urine bacteria, Urine cannabinoids, Urine cotinine, Urine crystals, Urine ketones, Urine leukocytes, Indirect bilirubin, Troponin T, EMC volume, Reticulocytes/erythrocytes, which were graded by FDA Toxicity Grading Scale. The Full Analysis Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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End point type |
Secondary
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End point timeframe |
Up to 6 months post-vaccination (28 days before challenge [Day 0])
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Up to 1.3 years
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Adverse event reporting additional description |
The Full Analysis (FA) Set included all subjects who were randomized and received at least one dose of study vaccine, regardless of the occurrence of protocol deviations.
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
21.0
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Reporting groups
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Reporting group title |
Ad26.RSV.preF (1*10^11 vp)
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Reporting group description |
Subjects received a single intramuscular injection of 1*10^11 viral particles (vp) of Ad26.RSV.preF on Day -28 followed by intranasal challenge with a respiratory syncytial virus (RSV)-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Subjects received a single intramuscular injection of matching placebo on Day -28 followed by intranasal challenge with RSV-A Memphis 37b virus on Day 0. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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24 Jul 2018 |
Issued to update the secondary endpoints. The power calculations for the present study were based on the AUC results observed in the placebo group in a historical RSV study (53718678RSV2001). The RT-PCR assay, used to measure
VL-AUC for the primary endpoint in study 53718678RSV2001, was a different assay than the assay used in the current study. Due to the explorative nature of the present study, the statistical assumptions were monitored by an unblinded monitor throughout the study. It was shown that the assay used in the historical study gave more granularity in the lower range compared to the assay used in the current study. As peak viral load should be less sensitive to the difference in the
assays compared to the AUC, this parameter was added as a secondary endpoint. The study objectives and efficacy analysis section were updated accordingly. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |