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9-14 岁女孩接种 Innovax 双价人乳头瘤病毒疫苗的安全性和免疫原性:来自 3 期临床试验的中期分析。

Safety and immunogenicity of Innovax bivalent human papillomavirus vaccine in girls 9-14 years of age: Interim analysis from a phase 3 clinical trial.

机构信息

Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States.

出版信息

Vaccine. 2024 Apr 2;42(9):2290-2298. doi: 10.1016/j.vaccine.2024.02.077. Epub 2024 Mar 1.

Abstract

BACKGROUND

World Health Organization human papillomavirus (HPV) vaccination recommendations include a single- or two-dose schedule in individuals 9-20 years old and advice for generating data on single-dose efficacy or immunobridging. The ongoing Phase 3 trial of Innovax's bivalent (types 16 and 18) HPV vaccine (Cecolin®) assesses in low- and middle-income countries alternative dosing schedules and generates data following one dose in girls 9-14 years old. Interim data for the 6-month dosing groups are presented.

METHODS

In Bangladesh and Ghana, 1,025 girls were randomized to receive either two doses of Cecolin at 6-, 12-, or 24-month intervals; one dose of Gardasil® followed by one dose of Cecolin at month 24; or two doses of Gardasil 6 months apart (referent). Serology was measured by enzyme-linked immunosorbent assay (ELISA) and, in a subset, by neutralization assays. Primary objectives include immunological non-inferiority of the Cecolin schedules to referent one month after the second dose. Safety endpoints include reactogenicity and unsolicited adverse events for 7 and 30 days post-vaccination, respectively, as well as serious adverse events throughout the study.

RESULTS

Interim analyses included data from the two groups on a 0, 6-month schedule with 205 participants per group. One month after Dose 2, 100% of participants were seropositive by ELISA and had seroconverted for both antigens. Non-inferiority of Cecolin to Gardasil was demonstrated. Six months following one dose, over 96% of participants were seropositive by ELISA for both HPV antigens, with a trend for higher geometric mean concentration following Cecolin administration. Reactogenicity and safety were comparable between both vaccines.

CONCLUSIONS

Cecolin in a 0, 6-month schedule elicits robust immunogenicity. Non-inferiority to Gardasil was demonstrated one month after a 0, 6-month schedule. Immunogenicity following one dose was comparable to Gardasil up to six months. Both vaccines were safe and well tolerated (ClinicalTrials.gov No. 04508309).

摘要

背景

世界卫生组织(WHO)的人乳头瘤病毒(HPV)疫苗接种建议包括为 9-20 岁人群接种一剂或两剂,并建议在该人群中获取关于单剂效力或免疫桥接的数据。Innovax 的二价(16 型和 18 型)HPV 疫苗(Cecolin®)正在开展的 3 期临床试验评估了在中低收入国家采用替代剂量方案,并在 9-14 岁女孩中接种一剂后获得数据。现将 6 个月剂量组的中期数据报告如下。

方法

在孟加拉国和加纳,1025 名女孩被随机分配接受以下方案:两剂 Cecolin,间隔 6、12 或 24 个月;一剂 Gardasil®,间隔 24 个月后再接种一剂 Cecolin;或两剂 Gardasil,间隔 6 个月(参照组)。采用酶联免疫吸附试验(ELISA)和亚组的中和试验来检测血清学。主要目标是在第二剂后一个月,评估 Cecolin 方案相对于参照组的免疫非劣效性。安全性终点包括接种后 7 天和 30 天的局部和全身不良反应发生率,以及整个研究期间的严重不良事件。

结果

中期分析包括两组各 205 名参与者的 0、6 个月方案的数据。在接受第 2 剂后一个月,通过 ELISA 检测,100%的参与者均对两种抗原呈血清阳性,且均发生了血清转换。证明 Cecolin 不劣于 Gardasil。一剂接种后 6 个月,通过 ELISA 检测,超过 96%的参与者对两种 HPV 抗原均呈血清阳性,Cecolin 给药后,几何平均浓度呈升高趋势。两种疫苗的局部和全身不良反应发生率相似。

结论

0、6 个月方案接种 Cecolin 可产生强劲的免疫原性。0、6 个月方案接种后一个月,证明 Cecolin 不劣于 Gardasil。一剂接种后 6 个月的免疫原性与 Gardasil 相当。两种疫苗均安全且耐受良好(ClinicalTrials.gov 编号:04508309)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8856/11007388/785a8fee3faa/gr1.jpg

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