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二价rLP2086(一种B群脑膜炎球菌疫苗)与四价人乳头瘤病毒疫苗联合接种在青少年中的免疫原性、耐受性和安全性

Immunogenicity, Tolerability and Safety in Adolescents of Bivalent rLP2086, a Meningococcal Serogroup B Vaccine, Coadministered with Quadrivalent Human Papilloma Virus Vaccine.

作者信息

Senders Shelly, Bhuyan Prakash, Jiang Qin, Absalon Judith, Eiden Joseph J, Jones Thomas R, York Laura J, Jansen Kathrin U, O'Neill Robert E, Harris Shannon L, Ginis John, Perez John L

机构信息

From the *Senders Pediatrics, Cleveland, OH; †Pfizer Vaccine Clinical Research, Collegeville, PA; ‡Pfizer Vaccine Clinical Research, Pearl River, NY; §Pfizer Vaccine Research Operations and Strategy, Pearl River, NY; ¶Pfizer Medical and Scientific Affairs, Collegeville, PA; and ‖Pfizer Vaccine Research and Development, Pearl River, NY.

出版信息

Pediatr Infect Dis J. 2016 May;35(5):548-54. doi: 10.1097/INF.0000000000001072.

Abstract

BACKGROUND

This study in healthy adolescents (11 to <18 years) evaluated coadministration of quadrivalent human papillomavirus vaccine (HPV-4), with bivalent rLP2086, a meningococcal serogroup B (MnB) vaccine.

METHODS

Subjects received bivalent rLP2086 + HPV-4, bivalent rLP2086 + saline or saline + HPV-4 at 0, 2 and 6 months. Immune responses to HPV-4 antigens were assessed 1 month after doses 2 and 3. Serum bactericidal assays using human complement (hSBAs) with 4 MnB test strains expressing vaccine-heterologous human complement factor H binding protein (fHBP) variants determined immune responses to bivalent rLP2086. Coprimary objectives were to demonstrate noninferior immune responses with concomitant administration compared with either vaccine alone. Additional endpoints included the proportions of subjects achieving prespecified protective hSBA titers to all 4 MnB test strains (composite response) and ≥4-fold increases in hSBA titer from baseline for each test strain after dose 3; these endpoints served as the basis of licensure of bivalent rLP2086 in the US.

RESULTS

The noninferiority criteria were met for all MnB test strains and HPV antigens except HPV-18; ≥99% of subjects seroconverted for all 4 HPV antigens. Bivalent rLP2086 elicited a composite response in >80% of subjects and increased hSBA titers ≥4-fold in ≥77% of subjects for each test strain after dose 3. A substantial bactericidal response was also observed in a large proportion of subjects after dose 2. Local reactions and systemic events did not increase with concomitant administration.

CONCLUSIONS

Concomitant administration of bivalent rLP2086 and HPV-4 elicits robust immune responses to both vaccines without increasing reactogenicity compared with bivalent rLP2086 alone. Concurrent administration may increase compliance with both vaccine schedules.

摘要

背景

本研究在健康青少年(11至<18岁)中评估了四价人乳头瘤病毒疫苗(HPV-4)与二价重组脂蛋白2086(一种B群脑膜炎球菌(MnB)疫苗)的联合接种情况。

方法

受试者在0、2和6个月时分别接受二价rLP2086 + HPV-4、二价rLP2086 + 生理盐水或生理盐水 + HPV-4。在第2剂和第3剂接种后1个月评估对HPV-4抗原的免疫反应。使用人补体的血清杀菌试验(hSBA),采用4株表达与疫苗异源的人补体因子H结合蛋白(fHBP)变体的MnB试验菌株,确定对二价rLP2086的免疫反应。共同主要目标是证明联合接种与单独接种任一疫苗相比,免疫反应不劣。其他终点包括达到针对所有4株MnB试验菌株预先设定的保护性hSBA滴度(综合反应)的受试者比例,以及第3剂接种后各试验菌株hSBA滴度相对于基线增加≥4倍;这些终点是美国二价rLP2086获批上市的依据。

结果

除HPV-18外,所有MnB试验菌株和HPV抗原均符合非劣效标准;≥99%的受试者对所有4种HPV抗原发生血清转化。二价rLP2086在>80%的受试者中引发了综合反应,第3剂接种后,≥77%的受试者针对各试验菌株的hSBA滴度增加≥4倍。在第2剂接种后,很大比例的受试者也观察到了显著的杀菌反应。联合接种未增加局部反应和全身事件。

结论

与单独接种二价rLP2086相比,二价rLP2086和HPV-4联合接种对两种疫苗均能引发强烈的免疫反应,且不增加反应原性。同时接种可能会提高两种疫苗接种计划的依从性。

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