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A Study to Evaluate the Safety, Tolerability, and Immunogenicity of V114 Followed by PNEUMOVAX™23 in Adults at Increased Risk for Pneumococcal Disease (V114-017/PNEU-DAY)

Phase 3
Completed
Conditions
Pneumococcal Infections
Interventions
Biological: V114
Biological: Prevnar 13™
Biological: PNEUMOVAX™23
Registration Number
NCT03547167
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

This study is designed to 1) describe the safety, tolerability, and immunogenicity of V114 and Prevnar 13™ in pneumococcal vaccine-naïve adults at increased risk for pneumococcal disease and to 2) describe the safety, tolerability, and immunogenicity of PNEUMOVAX™23 when administered 6 months after receipt of either V114 or Prevnar 13™. Increased risk for pneumococcal disease is defined as 1) an underlying medical condition, 2) behavioral habits such as smoking or alcohol use, or 3) living in a community/environment with increased risk of disease transmission.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1515
Inclusion Criteria
  • Native American participant enrolled from any of the clinical sites of the Johns Hopkins Center for American Indian Health (CAIH) without any of the pre-specified risk conditions for pneumococcal disease listed below, OR Native American participant enrolled from any of the CAIH sites or participant from a site other than CAIH with ≥1 of the following risk conditions for pneumococcal disease:

    1. Diabetes mellitus Type 1 or Type 2 and with hemoglobin A1c (HgA1c) <10%
    2. Chronic liver disease with documented history of compensated cirrhosis (Child-Pugh Score A)
    3. Confirmed diagnosis of Chronic Obstructive Pulmonary Disease (COPD) with spirometric Global Initiative for Chronic Obstructive Lung Disease Stage 1 to 3
    4. Confirmed diagnosis of mild or moderate persistent asthma receiving guideline directed therapy
    5. Confirmed diagnosis of chronic heart disease (New York Heart Association [NYHA] heart failure Class 1 to 3, receiving guideline-directed oral heart failure treatment) due to reduced or preserved ejection fraction or due to non-cyanotic congenital heart disease.
    6. Current smoker
  • Female participant: not pregnant, not breastfeeding and 1) not of childbearing potential, or 2) of childbearing potential and agrees to practice contraception through 6 weeks after last administration of study vaccine.

Exclusion Criteria
  • History of active hepatitis within the prior 3 months
  • History of diabetic ketoacidosis, or >1 episodes of severe, symptomatic hypoglycemia within the prior 3 months
  • Myocardial infarction, acute coronary syndrome, transient ischemic attack, and ischemic or hemorrhagic stroke within the prior 3 months
  • History of severe pulmonary hypertension or history of Eisenmenger syndrome
  • History of invasive pneumococcal disease (IPD) or known history of other culture-positive pneumococcal disease within the prior 3 years
  • Known hypersensitivity to any vaccine component, pneumococcal conjugate vaccine, or diphtheria toxoid-containing vaccine
  • Known or suspected impairment of immunological function (including human immunodeficiency virus (HIV) infection or autoimmune disease)
  • History of malignancy within the prior 5 years, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer
  • History of Stage 4 or 5 Chronic Kidney Disease or nephrotic syndrome
  • History of alcohol withdrawal or alcohol withdrawal seizure within the prior 12 months
  • History of coagulation disorder contraindicating intramuscular vaccination
  • History of hospitalization within the prior 3 months
  • Planned organ transplantation (heart, liver, lung, kidney, or pancreas) or other planned major surgery during the duration of this study.
  • Expected survival for less than 1 year according to the investigator's judgment.
  • Female participant: positive urine or serum pregnancy test
  • Prior administration of any pneumococcal vaccine
  • Received systemic corticosteroids (prednisone equivalent of ≥20 mg/day) for ≥14 consecutive days and has not completed within the prior 30 days
  • Received systemic corticosteroids exceeding physiologic replacement doses within 14 days before study vaccination
  • Receiving immunosuppressive or immunomodulatory therapy with a biological agent
  • Received any licensed, non-live vaccine within 14 days before receipt of study vaccine or is scheduled to receive any licensed, non-live vaccine within 30 days following receipt of study vaccine
  • Received any live vaccine within 30 days before receipt of any study vaccine or is scheduled to receive any live vaccine within 30 days following receipt of any study vaccine
  • Received a blood transfusion or blood products within the prior 6 months
  • Receiving chronic home oxygen therapy
  • Participated in another clinical study of an investigational product within the prior 2 months
  • Current user of recreational or illicit drugs or history of drug abuse or dependence
  • Diabetes mellitus with HgA1c ≥10%
  • Chronic liver disease with Child-Pugh Class B or C cirrhosis
  • Chronic lung disease with Chronic Obstructive Pulmonary Disease (COPD) GOLD Stage 4 or severe persistent asthma
  • Chronic heart disease with NYHA heart failure Class 4.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
V114V114Participants will receive a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Month 6 (Vaccination 2)
V114PNEUMOVAX™23Participants will receive a single 0.5 mL intramuscular (IM) injection of V114 on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Month 6 (Vaccination 2)
Prevnar 13™Prevnar 13™Participants will receive a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Month 6 (Vaccination 2)
Prevnar 13™PNEUMOVAX™23Participants will receive a single 0.5 mL IM injection of Prevnar 13™ on Day 1 (Vaccination 1) and a single 0.5 mL IM injection of PNEUMOVAX™23 at Month 6 (Vaccination 2)
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With a Vaccine-related Serious Adverse Event Following V114 or Prevnar 13™Up to Month 6 (before Vaccination 2)

A serious adverse event (SAE) is an AE that is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine was determined by the investigator. Following vaccination with V114 or Prevnar 13™, the percentage of serious adverse events of V114 compared with Prevnar 13™ was assessed. Estimated CIs are calculated based on the exact binomial method proposed by Clopper and Pearson.

Percentage of Participants With Solicited Injection-site Adverse Events Following V114 or Prevnar 13™Up to 5 days after Vaccination 1

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Following Vaccination 1 with either V114 or Prevnar 13™, the percentage of participants with solicited injection-site AEs was assessed. The solicited injection-site AEs assessed were redness/erythema, swelling, and tenderness/pain. Estimated confidence intervals (CIs) are calculated based on the exact binomial method proposed by Clopper and Pearson.

Percentage of Participants With Solicited Systemic Adverse Events Following V114 or Prevnar 13™Up to 14 days after Vaccination 1

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Following vaccination with V114 or Prevnar 13™, the percentage of participants with solicited systemic AEs was assessed. The solicited systemic AEs assessed were muscle pain/myalgia, joint pain/arthralgia, headache, and tiredness/fatigue. Estimated CIs are calculated based on the exact binomial method proposed by Clopper and Pearson.

Geometric Mean Titer of Serotype-specific Opsonophagocytic Activity Day 30 Following V114 or Prevnar 13™Day 30

The geometric mean titer (GMT) of serotype-specific opsonophagocytic activity (OPA) for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a multiplex opsonophagocytic assay. The within-group 95% CIs are obtained by exponentiating the CIs of the mean of the natural log values based on the t-distribution.

Secondary Outcome Measures
NameTimeMethod
Geometric Mean Concentration of Serotype-specific Immunoglobulin G at Day 30Day 30

The geometric mean concentration (GMC) of serotype-specific immunoglobulin G (IgG) for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. The within-group 95% CIs are obtained by exponentiating the CIs of the mean of the natural log values based on the t-distribution.

Percentage of Participants With Solicited Injection-site Adverse Events Following PNEUMOVAX™23Up to 5 days after Vaccination 2 (Month 6)

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Following Vaccination 2 with PNEUMOVAX™23, the percentage of participants with solicited injection-site AEs was assessed. The solicited injection-site AEs assessed were redness/erythema, swelling, and tenderness/pain. Estimated CIs are calculated based on the exact binomial method proposed by Clopper and Pearson and are provided in accordance with the statistical analysis plan.

Percentage of Participants With Solicited Systemic Adverse Events Following PNEUMOVAX™23Up to 14 days after Vaccination 2 (Month 6)

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Following Vaccination 2 with PNEUMOVAX™23, the percentage of participants with solicited systemic AEs was assessed. The solicited systemic AEs assessed were muscle pain/myalgia, joint pain/arthralgia, headache, and tiredness/fatigue. Estimated CIs are calculated based on the exact binomial method proposed by Clopper and Pearson.

Percentage of Participants With a Vaccine-related Serious Adverse Event Following PNEUMOVAX™23From Month 6 (before Vaccination 2) to Month 7

A serious adverse event (SAE) is an AE that is life-threatening, requires or prolongs an existing hospitalization, results in persistent or significant disability or incapacity, is a congenital anomaly or birth defect, or is another important medical event deemed such by medical or scientific judgment. Relatedness of an SAE to the study vaccine was determined by the investigator. Following vaccination with PNEUMOVAX™23, the percentage of serious adverse events of V114 compared with Prevnar 13™ was assessed. Estimated CIs are calculated based on the exact binomial method proposed by Clopper and Pearson.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific IgG Day 1 to Day 30Day 1 (Baseline) and Day 30

IgG for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. The percentage of participants who had ≥ 4-fold rise in IgG concentration are calculated from baseline to postvaccination.

Geometric Mean Titer of Serotype-specific OPA at Month 7Month 7

The geometric mean titer (GMT) of serotype-specific OPA for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a multiplex opsonophagocytic assay. The within-group 95% CIs are obtained by exponentiating the CIs of the mean of the natural log values based on the t-distribution.

GMFR in Serotype-specific IgG Month 6 to Month 7Month 6 (Baseline before Vaccination 2) and Month 7

IgG for the serotypes contained in Prevnar 13™ and V114 and (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. GMFR is the geometric mean of fold rise from baseline to postvaccination.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific OPA Month 6 to Month 7Month 6 (Baseline before Vaccination 2) and Month 7

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a Multiplexed Opsonophagocytic Assay. The percentage of participants who had ≥4-fold rise in OPA titers were calculated from baseline to postvaccination.

Geometric Mean Fold Rise in Serotype-specific OPA Day 1 to Day 30Day 1 (Baseline) and Day 30

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a Multiplex Opsonophagocytic Assay. Geometric mean fold rise (GMFR) is the geometric mean of fold rise from baseline to postvaccination.

GMFR in Serotype-specific IgG Day 1 to Month 7Day 1 (Baseline) and Month 7

IgG for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. GMFR is the geometric mean of fold rise from baseline to postvaccination.

GMFR in Serotype-specific IgG Day 1 to Day 30Day 1 (Baseline) and Day 30

IgG for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. GMFR is the geometric mean of fold rise from baseline to postvaccination.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific OPA Day 1 to Day 30Day 1 (Baseline) and Day 30

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a Multiplexed Opsonophagocytic Assay. The percentage of participants who had ≥4-fold rise in OPA titers were calculated from baseline to postvaccination.

Geometric Mean Concentration of Serotype-specific IgG at Month 7Month 7

The geometric mean concentration (GMC) of serotype-specific immunoglobulin G (IgG) for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific OPA Day 1 to Month 7Day 1 (Baseline) and Month 7

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a Multiplexed Opsonophagocytic Assay. The percentage of participants who had ≥4-fold rise in OPA titers were calculated from baseline to postvaccination.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific IgG Day 1 to Month 7Day 1 (Baseline) and Month 7

IgG for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. The percentage of participants who had ≥ 4-fold rise in IgG concentration are calculated from baseline to postvaccination.

GMFR in Serotype-specific OPA Day 1 to Month 7Day 1 (Baseline) and Month 7

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using a Multiplexed Opsonophagocytic Assay. Geometric mean fold rise (GMFR) is the geometric mean of fold rise from baseline to postvaccination.

GMFR in Serotype-specific OPA Month 6 to Month 7Month 6 (Baseline before Vaccination 2) and Month 7

Activity for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using the Multiplexed Opsonophagocytic Assay. Geometric mean fold rise (GMFR) is the geometric mean of fold rise from baseline to postvaccination.

Percentage of Participants With ≥4-Fold Rise in Serotype-specific IgG Month 6 to Month 7Month 6 (Baseline before Vaccination 2) and Month 7

IgG for the serotypes contained in Prevnar 13™ and V114 (13 serotypes shared with Prevnar 13™ and 2 serotypes unique to V114) was determined using an electrochemiluminescence assay. The percentage of participants who had ≥ 4-fold rise in IgG concentration are calculated from baseline to postvaccination.

Trial Locations

Locations (78)

Dynamik Research ( Site 0095)

🇨🇦

Pointe-Claire, Quebec, Canada

Evanston Premier Healthcare & Research, LLC. ( Site 0012)

🇺🇸

Evanston, Illinois, United States

Q & T Research Sherbrooke Inc. ( Site 0097)

🇨🇦

Sherbrooke, Quebec, Canada

Lehigh Valley Health Network ( Site 0040)

🇺🇸

Allentown, Pennsylvania, United States

Holdsworth House Medical Practice ( Site 0170)

🇦🇺

Sydney, New South Wales, Australia

Marshfield Clinic ( Site 0013)

🇺🇸

Marshfield, Wisconsin, United States

Texas Center For Drug Development ( Site 0041)

🇺🇸

Houston, Texas, United States

Private Practice Leadership, LLC ( Site 0051)

🇺🇸

Houston, Texas, United States

Centrum Medyczne Ogrodowa Sp. Z o.o. ( Site 0319)

🇵🇱

Skierniewice, Poland

Synexus Polska Sp. z o.o. oddział we Wrocławiu ( Site 0234)

🇵🇱

Wroclaw, Poland

Saratov State Medical University n.a. V.I.Razumovskiy ( Site 0144)

🇷🇺

Saratov, Russian Federation

Central Phoenix Medical Clinic, LLC ( Site 0031)

🇺🇸

Phoenix, Arizona, United States

Pulmonary Associates, PA ( Site 0043)

🇺🇸

Glendale, Arizona, United States

Inland Empire Clinical Trials, LLC ( Site 0052)

🇺🇸

Rialto, California, United States

Chinle Comprehensive Health Care Facility ( Site 0001)

🇺🇸

Chinle, Arizona, United States

Fort Defiance Center for American Indian Health ( Site 0002)

🇺🇸

Fort Defiance, Arizona, United States

Indago Research & Health Center, Inc ( Site 0054)

🇺🇸

Hialeah, Florida, United States

Emory University School of Medicine at Grady Hospital ( Site 0027)

🇺🇸

Atlanta, Georgia, United States

Clinical Research Consortium ( Site 0053)

🇺🇸

Las Vegas, Nevada, United States

Triple O Research Institute, P.A. ( Site 0026)

🇺🇸

West Palm Beach, Florida, United States

Internal Medicine Associates [Bridgeton, NJ] ( Site 0015)

🇺🇸

Bridgeton, New Jersey, United States

Reid Physician Associates ( Site 0055)

🇺🇸

Richmond, Indiana, United States

ID Clinic ( Site 0235)

🇵🇱

Myslowice, Poland

Mid Hudson Medical Research ( Site 0022)

🇺🇸

New Windsor, New York, United States

Wake Research Associates, LLC ( Site 0016)

🇺🇸

Raleigh, North Carolina, United States

University of Pennsylvania ( Site 0030)

🇺🇸

Philadelphia, Pennsylvania, United States

Mountain View Clinical Research ( Site 0007)

🇺🇸

Greer, South Carolina, United States

P3 Research Ltd - Wellington ( Site 0184)

🇳🇿

Wellington, New Zealand

Smolensk State Medical University ( Site 0246)

🇷🇺

Smolensk, Russian Federation

Copperview Medical Center ( Site 0038)

🇺🇸

South Jordan, Utah, United States

Pharmakon Inc ( Site 0049)

🇺🇸

Evergreen Park, Illinois, United States

Gallup Center for American Indian Health ( Site 0003)

🇺🇸

Gallup, New Mexico, United States

Corning Center For Clinical Research ( Site 0036)

🇺🇸

Corning, New York, United States

Holston Medical Group ( Site 0025)

🇺🇸

Kingsport, Tennessee, United States

University of Texas Medical Branch at Galveston ( Site 0034)

🇺🇸

Galveston, Texas, United States

Top Medical Research, Inc ( Site 0033)

🇺🇸

Cutler Bay, Florida, United States

Whiteriver Center for American Indian Health ( Site 0005)

🇺🇸

Whiteriver, Arizona, United States

Renstar Medical Research ( Site 0008)

🇺🇸

Ocala, Florida, United States

Kootenai Health ( Site 0042)

🇺🇸

Coeur d'Alene, Idaho, United States

Shiprock Center for American Indian Health ( Site 0004)

🇺🇸

Shiprock, New Mexico, United States

AIM Trials ( Site 0060)

🇺🇸

Fort Worth, Texas, United States

Village Health Partners ( Site 0006)

🇺🇸

Plano, Texas, United States

Texas Institute Of Cardiology ( Site 0048)

🇺🇸

McKinney, Texas, United States

Timber Lane Allergy & Asthma Research, LLC ( Site 0044)

🇺🇸

South Burlington, Vermont, United States

Gundersen Health System ( Site 0021)

🇺🇸

La Crosse, Wisconsin, United States

Pulmonary & Sleep Research ( Site 0046)

🇺🇸

Spokane Valley, Washington, United States

Paratus Clinical Pty Ltd - Blacktown Clinic ( Site 0174)

🇦🇺

Blacktown, New South Wales, Australia

Paratus Clinical Kanwal ( Site 0172)

🇦🇺

Kanwal, Australia

Nepean Hospital ( Site 0176)

🇦🇺

Kingswood, Australia

Core Research Group Pty limited ( Site 0175)

🇦🇺

Brisbane, Queensland, Australia

Emeritus Research Pty Ltd ( Site 0173)

🇦🇺

Camberwell, Victoria, Australia

The Liver and Intestinal Research Centre (LAIR) ( Site 0302)

🇨🇦

Vancouver, British Columbia, Canada

GA Research Associates, Ltd/Ltee ( Site 0303)

🇨🇦

Moncton, New Brunswick, Canada

Colchester Research Group ( Site 0094)

🇨🇦

Truro, Nova Scotia, Canada

SKDS Research Inc. ( Site 0099)

🇨🇦

Newmarket, Ontario, Canada

Hamilton Medical Research Group ( Site 0092)

🇨🇦

Hamilton, Ontario, Canada

Omnispec Recherche Clinique Inc ( Site 0093)

🇨🇦

Mirabel, Quebec, Canada

Diex Recherche Quebec Inc ( Site 0091)

🇨🇦

Quebec, Canada

Centro de Investigacion Clinica UC CICUC ( Site 0104)

🇨🇱

Santiago, Chile

Clinica Arauco Salud ( Site 0100)

🇨🇱

Santiago, RM, Chile

CECIM ( Site 0101)

🇨🇱

Santiago, Chile

CESFAM Esmeralda ( Site 0102)

🇨🇱

Santiago, Chile

Southern Clinical Trials - Waitemata ( Site 0183)

🇳🇿

Auckland, New Zealand

Auckland Clinical Studies Limited ( Site 0189)

🇳🇿

Auckland, New Zealand

Hospital Dr. Hernan Henriquez Aravena ( Site 0105)

🇨🇱

Temuco, Chile

Christchurch Heart Institute ( Site 0280)

🇳🇿

Christchurch, New Zealand

Optimal Clinical Trials ( Site 0182)

🇳🇿

Auckland, New Zealand

Lakeland Clinical Trials ( Site 0181)

🇳🇿

Rotorua, New Zealand

Southern Clinical Trials Ltd ( Site 0180)

🇳🇿

Christchurch, New Zealand

Bay of Plenty Clinical School ( Site 0186)

🇳🇿

Tauranga, New Zealand

Niepubliczny Zaklad Opieki Zdrowotnej ( Site 0314)

🇵🇱

Sopot, Poland

The Center for Pharmaceutical Research PC ( Site 0050)

🇺🇸

Kansas City, Missouri, United States

Specjalistyczny osrodek .All-Med. Grazyna Pulka ( Site 0233)

🇵🇱

Krakow, Poland

WSOZ im.T.Browicza w Bydgoszczy ( Site 0317)

🇵🇱

Bydgoszcz, Poland

Centrum Medyczne Pratia Bydgoszcz ( Site 0139)

🇵🇱

Bydgoszcz, Poland

Synexus Polska Sp. z o.o. ( Site 0238)

🇵🇱

Gdansk, Poland

Wroclawskie Centrum Zdrowia SP ZOZ ( Site 0236)

🇵🇱

Wroclaw, Poland

Republican Clinical Hospital of Infectious Diseases n. a. A.F.Agafonov ( Site 0249)

🇷🇺

Kazan, Russian Federation

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