MedPath

Immunogenicity, Safety, Reactogenicity, Efficacy, Effectiveness and Lot Consistency of FluBlok

Phase 3
Completed
Conditions
Influenza
Interventions
Biological: FluBlok®
Biological: Placebo
Registration Number
NCT00539981
Lead Sponsor
Sanofi
Brief Summary

The purpose of this study was to evaluate a single dose of FluBlok in terms of safety, efficacy and effectiveness in prevention of influenza and influenza-like illness and assess clinical lot-to-lot consistency in manufacturing by evaluating and comparing the immunogenicity of three different lots of FluBlok in a subset of participants.

Detailed Description

All currently licensed influenza vaccines in the United States were produced in embryonated hen's eggs. There were several well-recognized disadvantages to the use of eggs as the substrate for influenza vaccine. Eggs required specialized manufacturing facilities and could be difficult to scale up rapidly in response to an emerging need such as a pandemic. It was usually necessary to adapt candidate vaccine viruses for high-yield growth in eggs, a process that could be time consuming, was not always successful, and could select receptor variants that might have suboptimal immunogenicity. In addition, agricultural diseases that affected chicken flocks, and that might be an important issue in a pandemic due to an avian influenza virus strain, could easily disrupt the supply of eggs for vaccine manufacturing. Therefore, development of alternative substrates for influenza vaccine production had been identified as a high-priority objective.

One potential alternative method for production of influenza vaccine was expression of the influenza virus hemagglutinin (HA) using recombinant deoxyribonucleic acid (DNA) techniques. This alternative avoided dependence on eggs and was very efficient because of the high levels of protein expression under the control of the baculovirus polyhedrin promoter.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
4648
Inclusion Criteria
  • Healthy adult aged 18-49 years.
  • Provided informed consent prior to any study procedures.
  • Able to comply with all study procedures.
  • Available for follow-up for the duration of the influenza season.
  • Women of child-bearing potential must have had a negative urine pregnancy test at the time of randomization and must be willing to use an adequate form of contraception (includes abstinence, condom with spermicide, licensed hormonal contraceptive, intrauterine device [IUD], monogamous relationship with a vasectomized partner) during the course of the study.
Exclusion Criteria
  • Long-term use of oral steroids, parenteral steroids, or high-dose inhaled steroids (greater than [>] 800 mcg/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (Nasal and topical steroids were allowed).
  • Presence of high-risk conditions or other characteristics were considered to be indication for influenza vaccination, as defined by the Advisory Committee on Immunization Practices.
  • Acute febrile illness (defined as having a temperature greater than or equal to [>=]100 degrees Fahrenheit) or upper respiratory tract illness within 72 hours of vaccination. Participants with acute febrile illness were rescheduled after fever resolved.
  • Use of experimental vaccines or any influenza vaccine other than FluBlOk after May 31st 2007 for the 2008 Southern Hemisphere or 2007 to 2008 Northern hemisphere epidemic seasons.
  • Immunosuppression as a result of an underlying illness or treatment, or used anticancer chemotherapy or radiation therapy within the preceding 36 months.
  • Any malignancy diagnosed or treated actively during the past five (5) years, with two (2) exceptions. Participant with any history of lymphoproliferative disorder were excluded. However, participants with a history of localized non-melanotic skin cancer were eligible.
  • Receipt of any other licensed vaccines within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines) prior to enrollment in this study.
  • Receipt of an experimental agent (vaccine, drug, biologic, device, blood product or medication) within 1 month prior to enrollment in this study, or expected to receive an experimental agent during study period.
  • Receipt of parenteral immunoglobulin or other blood product within the three months prior to study vaccination.
  • Major psychiatric diagnosis including schizophrenia, bipolar disease or other major depression, or any diagnosis of dementia or associated concomitant medications (e.g., Aricept) used for treating dementia.
  • Known active human immunodeficiency virus, hepatitis B, or hepatitis C infection.
  • History of alcohol or drug abuse in the last 5 years.
  • Not available for three or more consecutive weeks during flu surveillance period.
  • Any acute or chronic condition that, in the opinion of the investigator, would render vaccination unsafe or interfere with the evaluation of responses or render the participant unable to meet the requirements of the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
FluBlok (Lots A, B, C)FluBlok®Participants received a single 0.5 milliliters (mL) dose of FluBlok vaccine from any of the Lots A, B, or C, intramuscularly on Day 0 (Visit 1). Participants were followed up to 6 months after vaccination.
PlaceboPlaceboParticipants received a single dose of placebo matched to FluBlok, intramuscularly on Day 0 (Visit 1). Participants were followed up to 6 months after vaccination.
Primary Outcome Measures
NameTimeMethod
Number of Participants Reporting Solicited Systemic ReactionsWithin 7 days post vaccination

Solicited reaction (reactogenicity event) was an AE that was pre-listed in eCRF, considered to be related to vaccination recorded by the participant by means of a memory aid between the day of vaccination (Day 0) and Day 7 post vaccination. Systemic events included fever, fatigue, shivering, joint pain, muscle pain, headache, and nausea. Fever: \>=100.4 degree Fahrenheit (ºF) to \<101.1ºF; \>=101.2ºF to \<102.2ºF; \>=102.2ºF; Fatigue, shivering, joint pain, muscle pain, headache and nausea: Grade 0: didn't have it at all; Grade 1: noticed it, but it didn't interfere with usual activities at all; Grade 2: had it, and it was bad enough to prevent a significant part of usual activities; and Grade 3: had it, and it prevented most or all of normal activities, or had to see a doctor for prescription medicine. Participants with multiple symptoms in the same category were counted once per category using the symptom with the maximum grade.

Lot Consistency: Geometric Mean Titers (GMTs) of Influenza Vaccine Antibodies Following FluBlok VaccinationDay 28 post vaccination

GMTs of anti-influenza antibodies were measured using a single radial immunodiffusion (SRID) assay for 3 strains: A/Solomon Islands \[H1N1\], A/Wisconsin \[H3N2\], and B/Malaysia. Titers were expressed in terms of 1/dilution.

Number of Participants Reporting Solicited Injection Site (Local) ReactionsWithin 7 days post vaccination

Solicited reaction (reactogenicity event) was an adverse event (AE) that was pre-listed in electronic case report form(eCRF), considered to be related to vaccination and recorded by participant by means of memory aid. Injection sites reaction included pain,bruising,redness,swelling. Pain and bruising:Grade0: didn't have it at all; Grade1: noticed it, but it didn't interfere with usual activities at all; Grade2: had it, and it was bad enough to prevent a significant part of usual activities; Grade3: had it, and it prevented most or all of normal activities, or had to see a doctor for prescription medicine, Redness and swelling: participants measured largest diameter of any injection site reaction and grade them from 0 to 3, where Grade0: measured less than(\<)10 milliliters(mm); Grade1: larger than or equal to(\>=) 10mm and \<20mm; Grade 2: \>=20mm and \<50mm; Grade3: \>=50mm. Participants with multiple symptoms in same category were counted once per category using symptom with maximum grade

Number of Participants Reporting Unsolicited Adverse EventsFrom Day 0 (post-vaccination) through Day 28 post vaccination

An AE was defined as any unfavorable and unintended sign (e.g., a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a study vaccine, whether or not considered to be related to the study vaccine. An unsolicited AE was an observed AE that did not fulfill the conditions prelisted (i.e., solicited) in the eCRF in terms of symptom and/or onset post-vaccination, ascertained during follow-up visit or telephone contact up to (and including) the Day 28 contact, whether reported spontaneously by the participant or in response to general questions about current or interim health status.

Percentage of Participants With Positive Cell Culture/Culture-Confirmed Influenza Like Illness as Defined by Centers for Disease Control and Prevention (CDC-ILI)14 days post vaccination through and up to 6 months

CDC-defined ILI was defined as fever (body temperature \>=100ºF oral accompanied by cough and/or sore throat, on the same day or on consecutive days) due to strains represented in the vaccine.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Seroprotection to Influenza Vaccine Antigens After Vaccination With FluBlok28 days post vaccination

Anti-influenza antibodies were measured using an HAI assay for 3 strains: A/Solomon Islands \[H1N1\], A/Wisconsin \[H3N2\] and B/Malaysia. Seroprotection was defined as a post-vaccination HAI antibody titer of \>=1:40.

Percentage of Participants With Seroconversion to Influenza Vaccine Antigens After Vaccination With FluBlok28 days post vaccination

Anti-influenza antibodies were measured using an HAI assay for 3 strains: A/Solomon Islands \[H1N1\], A/Wisconsin \[H3N2\] and B/Malaysia. Seroconversion was defined as a post-vaccination titer of \>=1:40 in participants with undetectable baseline antibody (HI titer = \<1:10) or a \>=4-fold rise in antibody in participants with a baseline titer of \>=1:10, with the achievement of post-vaccination titer of at least 1:40.

Trial Locations

Locations (24)

Benchmark Research - Sacramento

🇺🇸

Sacramento, California, United States

Impact Clinical Trials

🇺🇸

Beverly Hills, California, United States

University Clinical Research, Inc

🇺🇸

Pembroke Pines, Florida, United States

Benchmark Research - San Francisco

🇺🇸

San Francisco, California, United States

Kentucky pediatric /Adult Research

🇺🇸

Bardstown, Kentucky, United States

Saint Louis University

🇺🇸

Saint Louis, Missouri, United States

Meridian Clinical Research

🇺🇸

Omaha, Nebraska, United States

Rochester Medical Center

🇺🇸

Rochester, New York, United States

Regional Clinical Research, Inc.

🇺🇸

Endwell, New York, United States

Sterling Research

🇺🇸

Cincinnati, Ohio, United States

Carolina Medical Trials

🇺🇸

Winston-Salem, North Carolina, United States

Benchmarch Research - Austin

🇺🇸

Austin, Texas, United States

Benchmark Research - Fort Worth

🇺🇸

Fort Worth, Texas, United States

Benchmark Research - San Angelo

🇺🇸

San Angelo, Texas, United States

University of Virginia Health System

🇺🇸

Charlottesville, Virginia, United States

University of Maryland - Baltimore

🇺🇸

Baltimore, Maryland, United States

Marshfield Clinic

🇺🇸

Marshfield, Wisconsin, United States

Primary Physicians Research - Pediatric Alliance St. Clair

🇺🇸

Pittsburgh, Pennsylvania, United States

Primary Physicians Research

🇺🇸

Pittsburgh, Pennsylvania, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

Vince and Associates

🇺🇸

Overland Park, Kansas, United States

Benchmarch Research - New Orleans

🇺🇸

Metairie, Louisiana, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Jean Brown Research

🇺🇸

Salt Lake City, Utah, United States

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