Sanofi Pasteur, Swiftwater, PA, USA.
Kentucky Pediatric/Adult Research, Bardstown, KY, USA.
Vaccine. 2020 Apr 23;38(19):3560-3569. doi: 10.1016/j.vaccine.2020.03.017. Epub 2020 Mar 21.
MenACYW-TT is an investigational quadrivalent meningococcal conjugate vaccine intended for use in individuals ≥6 weeks of age. We evaluated the safety and immunogenicity of MenACYW-TT when compared to a licensed quadrivalent conjugate meningococcal vaccine (Menveo®; MCV4-CRM; GlaxoSmithKline, Italy), and when co-administered with tetanus, diphtheria, acellular pertussis (Tdap) and human papilloma virus (HPV4) vaccines in healthy meningococcal vaccine-naïve adolescents (10-17 years old) in the United States of America.
In this pivotal Phase II, open-label, multicenter study, 1715 participants were randomized to receive MenACYW-TT, MCV4-CRM, MenACYW-TT co-administered with Tdap and HPV4, or Tdap and HPV4 vaccines alone (NCT02199691). The primary objective was to evaluate whether antibody responses to MenACYW-TT antigens were non-inferior to antibody responses after MCV4-CRM administration. Meningococcal antibody titers were determined using human complement serum bactericidal assay (hSBA) with titers measured at baseline, and 30 days post vaccination (D30). A vaccine seroresponse was defined as baseline titers <1:8 with post-vaccination titers ≥1:8 or baseline titers ≥1:8 with a ≥4-fold increase at post-vaccination. Safety data were collected up to six months post-vaccination.
Non-inferiority was demonstrated for MenACYW-TT vs MCV4-CRM (primary endpoint), and for MenACYW-TT co-administered with Tdap and HPV4 vs MenACYW-TT alone (secondary endpoint). The vaccine seroresponse rate was higher with MenACYW-TT than with MCV4-CRM, for each serogroup: A: 75.6% vs 66.4%; C: 97.2% vs 72.6%; W: 86.2% vs 66.6%; Y: 97.0% vs 80.8%. The safety profiles of MenACYW-TT, MCV4-CRM, and Tdap and HPV4 vaccines, administered with or without MenACYW-TT, were comparable. There were no vaccine-related serious adverse events.
The MenACYW-TT vaccine was well tolerated and generated an immune response that was non-inferior to the licensed MCV4-CRM vaccine. Immunogenicity and safety profiles were comparable when MenACYW-TT was administered with or without Tdap and HPV4 vaccines in meningococcal vaccine-naïve adolescents.
MenACYW-TT 是一种正在研究的四价脑膜炎球菌结合疫苗,旨在用于年龄在 6 周以上的人群。我们评估了 MenACYW-TT 与已上市的四价结合脑膜炎球菌疫苗(Menveo®;MCV4-CRM;葛兰素史克,意大利)相比的安全性和免疫原性,以及在未接种脑膜炎球菌疫苗的健康青少年(10-17 岁)中与破伤风、白喉、无细胞百日咳(Tdap)和人乳头瘤病毒(HPV4)疫苗联合使用时的安全性和免疫原性在美国。
在这项关键的 II 期、开放性、多中心研究中,1715 名参与者被随机分配接受 MenACYW-TT、MCV4-CRM、MenACYW-TT 联合 Tdap 和 HPV4 或 Tdap 和 HPV4 疫苗(NCT02199691)。主要目的是评估 MenACYW-TT 抗原的抗体应答是否不劣于 MCV4-CRM 给药后的抗体应答。使用人类补体血清杀菌测定法(hSBA)测定脑膜炎球菌抗体滴度,在基线和接种后 30 天(D30)测量滴度。疫苗血清反应定义为基线滴度<1:8,接种后滴度≥1:8 或基线滴度≥1:8,接种后滴度增加≥4 倍。安全性数据在接种后六个月内收集。
MenACYW-TT 与 MCV4-CRM(主要终点)和 MenACYW-TT 联合 Tdap 和 HPV4 与 MenACYW-TT 单药(次要终点)相比,非劣效性得到证实。MenACYW-TT 比 MCV4-CRM 产生更高的疫苗血清反应率,每个血清组:A:75.6%比 66.4%;C:97.2%比 72.6%;W:86.2%比 66.6%;Y:97.0%比 80.8%。MenACYW-TT、MCV4-CRM 和 Tdap 和 HPV4 疫苗的安全性概况相似,无论是否联合 MenACYW-TT 接种,MenACYW-TT 与这些疫苗的安全性概况相似。没有疫苗相关的严重不良事件。
MenACYW-TT 疫苗耐受性良好,产生的免疫应答不劣于已上市的 MCV4-CRM 疫苗。在未接种脑膜炎球菌疫苗的青少年中,MenACYW-TT 与 Tdap 和 HPV4 疫苗联合或不联合使用时,免疫原性和安全性概况相似。