MedPath

Primary and Booster Vaccination Study With Pneumococcal Vaccine GSK1024850A and Prophylactic Antipyretic Treatment

Phase 4
Completed
Conditions
Infections, Streptococcal
Interventions
Biological: GSK1024850A (SynflorixTM)
Biological: Infanrix hexa
Biological: Infanrix-IPV/Hib
Registration Number
NCT01235949
Lead Sponsor
GlaxoSmithKline
Brief Summary

The aim of the current study is to determine whether ibuprofen, given as immediate or delayed prophylactic antipyretic treatment in a standardized manner, significantly impacts the immune response in children receiving primary vaccination with GlaxoSmithKline (GSK) Biologicals' 10-valent pneumococcal conjugate vaccine, co-administered with DTPa-combined vaccines, at 3, 4 and 5 months of age.

In addition, this study will further evaluate the impact of prophylactic administration of paracetamol following primary vaccination with immediate or delayed administration or when given in an immediate manner at the time of the booster dose.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
850
Inclusion Criteria
  • Subjects who the investigator believes that their parent(s)/Legally Acceptable Representative(s) (LAR) can and will comply with the requirements of the protocol.
  • A male or female between, and including, 12 and 16 weeks (84-118 days) of age at the time of the first vaccination.
  • Written informed consent obtained from the parent(s)/LAR(s) of the subject.
  • Free of obvious health problems as established by medical history and clinical examination before entering into the study.
  • Born after a gestation period of 36 to 42 weeks inclusive.
Exclusion Criteria
  • Use of any investigational or non-registered product other than the study vaccines/products within 30 days preceding the first dose of study vaccine/product, or planned use during the study period.
  • Concurrently participating in another clinical study, at any time during the study period, in which the subject has been or will be exposed to an investigational or a non-investigational product (.
  • Indication, other than specified in the protocol, for prophylactic or therapeutic antipyretic treatment during the study period.
  • Treatment with antipyretics in the 24 hours before study vaccination or planned administration of antipyretics in the 24 hours after study vaccination.
  • Chronic administration of immunosuppressants or other immune-modifying drugs since birth.
  • Planned administration/administration of a vaccine not foreseen by the study protocol during the period starting 30 days before each dose of study vaccine and ending 30 days after with the exception of locally recommended (pandemic) influenza vaccines, and those should be documented in the eCRF.
  • Previous vaccination against diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b and/or Streptococcus pneumoniae with the exception of the vaccines where the first dose may be given within the first two weeks of life according to the national recommendations.
  • History of intercurrent diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b disease.
  • History of any allergic disease or reaction likely to be exacerbated by any component of the vaccines or prophylactic antipyretic treatment, i.e. ibuprofen or paracetamol, as specified in the protocol.
  • History of any seizures or progressive neurological disease.
  • Acute disease and/or fever at the time of enrolment. The study entry should be delayed until the illness has improved.
  • Any confirmed or suspected immunosuppressive or immunodeficient condition, based on medical history and physical examination .
  • A family history of congenital or hereditary immunodeficiency.
  • Major congenital defects or serious chronic illness.
  • Administration of immunoglobulins and/or any blood products since birth or planned administration during entire study period.
  • Any contraindication to treatment with ibuprofen as described in the ibuprofen summary of product characteristics (SPC).
  • Any contraindication to treatment with paracetamol as described in the paracetamol SPC.
  • Body weight < 5 kg at the time of enrolment.
  • Child in care.

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Group IIBUGSK1024850A (SynflorixTM)Immediate ibuprofen group: subjects receiving immediate ibuprofen treatment after each primary vaccine dose
Group IIBUInfanrix hexaImmediate ibuprofen group: subjects receiving immediate ibuprofen treatment after each primary vaccine dose
Group IIBUInfanrix-IPV/HibImmediate ibuprofen group: subjects receiving immediate ibuprofen treatment after each primary vaccine dose
Group IIBUIbuprofenImmediate ibuprofen group: subjects receiving immediate ibuprofen treatment after each primary vaccine dose
Group DIBUGSK1024850A (SynflorixTM)Delayed ibuprofen group: subjects receiving delayed ibuprofen treatment after each primary vaccine dose
Group DIBUInfanrix hexaDelayed ibuprofen group: subjects receiving delayed ibuprofen treatment after each primary vaccine dose
Group DIBUInfanrix-IPV/HibDelayed ibuprofen group: subjects receiving delayed ibuprofen treatment after each primary vaccine dose
Group DIBUIbuprofenDelayed ibuprofen group: subjects receiving delayed ibuprofen treatment after each primary vaccine dose
Group NIBUGSK1024850A (SynflorixTM)No ibuprofen group: subjects receiving no prophylactic ibuprofen treatment after each primary vaccine dose
Group NIBUInfanrix hexaNo ibuprofen group: subjects receiving no prophylactic ibuprofen treatment after each primary vaccine dose
Group NIBUInfanrix-IPV/HibNo ibuprofen group: subjects receiving no prophylactic ibuprofen treatment after each primary vaccine dose
Group DPARAInfanrix hexaDelayed paracetamol group: subjects receiving delayed paracetamol treatment after each primary vaccine dose
Group DPARAInfanrix-IPV/HibDelayed paracetamol group: subjects receiving delayed paracetamol treatment after each primary vaccine dose
Group NPARAGSK1024850A (SynflorixTM)No paracetamol group: subjects receiving no prophylactic paracetamol treatment after each primary vaccine dose
Group NPARAInfanrix hexaNo paracetamol group: subjects receiving no prophylactic paracetamol treatment after each primary vaccine dose
Group NPARAInfanrix-IPV/HibNo paracetamol group: subjects receiving no prophylactic paracetamol treatment after each primary vaccine dose
Group IIBU-IIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary IIBU group receiving immediate ibuprofen treatment after booster vaccination
Group IIBU-IIBUInfanrix hexa1/3 of the subjects from the primary IIBU group receiving immediate ibuprofen treatment after booster vaccination
Group IIBU-IIBUInfanrix-IPV/Hib1/3 of the subjects from the primary IIBU group receiving immediate ibuprofen treatment after booster vaccination
Group IIBU-DIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary IIBU group receiving delayed ibuprofen treatment after booster vaccination
Group IPARAGSK1024850A (SynflorixTM)Immediate paracetamol group: subjects receiving immediate paracetamol treatment after each primary vaccine dose
Group IPARAInfanrix hexaImmediate paracetamol group: subjects receiving immediate paracetamol treatment after each primary vaccine dose
Group IPARAInfanrix-IPV/HibImmediate paracetamol group: subjects receiving immediate paracetamol treatment after each primary vaccine dose
Group DPARAGSK1024850A (SynflorixTM)Delayed paracetamol group: subjects receiving delayed paracetamol treatment after each primary vaccine dose
Group IIBU-DIBUInfanrix hexa1/3 of the subjects from the primary IIBU group receiving delayed ibuprofen treatment after booster vaccination
Group IIBU-DIBUInfanrix-IPV/Hib1/3 of the subjects from the primary IIBU group receiving delayed ibuprofen treatment after booster vaccination
Group IIBU-NIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary IIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group IIBU-NIBUInfanrix hexa1/3 of the subjects from the primary IIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group IIBU-NIBUInfanrix-IPV/Hib1/3 of the subjects from the primary IIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group DIBU-IIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary DIBU group receiving immediate ibuprofen treatment after booster vaccination
Group DIBU-IIBUInfanrix hexa1/3 of the subjects from the primary DIBU group receiving immediate ibuprofen treatment after booster vaccination
Group DIBU-DIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary DIBU group receiving delayed ibuprofen treatment after booster vaccination
Group DIBU-DIBUInfanrix hexa1/3 of the subjects from the primary DIBU group receiving delayed ibuprofen treatment after booster vaccination
Group DIBU-DIBUInfanrix-IPV/Hib1/3 of the subjects from the primary DIBU group receiving delayed ibuprofen treatment after booster vaccination
Group DIBU-NIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary DIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group DIBU-NIBUInfanrix hexa1/3 of the subjects from the primary DIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group DIBU-NIBUInfanrix-IPV/Hib1/3 of the subjects from the primary DIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group DIBU-IIBUInfanrix-IPV/Hib1/3 of the subjects from the primary DIBU group receiving immediate ibuprofen treatment after booster vaccination
Group NIBU-IIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary NIBU group receiving immediate ibuprofen treatment after booster vaccination
Group NIBU-IIBUInfanrix hexa1/3 of the subjects from the primary NIBU group receiving immediate ibuprofen treatment after booster vaccination
Group NIBU-IIBUInfanrix-IPV/Hib1/3 of the subjects from the primary NIBU group receiving immediate ibuprofen treatment after booster vaccination
Group NIBU-DIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary NIBU group receiving delayed ibuprofen treatment after booster vaccination
Group NIBU-DIBUInfanrix hexa1/3 of the subjects from the primary NIBU group receiving delayed ibuprofen treatment after booster vaccination
Group NIBU-DIBUInfanrix-IPV/Hib1/3 of the subjects from the primary NIBU group receiving delayed ibuprofen treatment after booster vaccination
Group NIBU-NIBUGSK1024850A (SynflorixTM)1/3 of the subjects from the primary NIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group NIBU-NIBUInfanrix hexa1/3 of the subjects from the primary NIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group NIBU-NIBUInfanrix-IPV/Hib1/3 of the subjects from the primary NIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group IPARA-NPARAGSK1024850A (SynflorixTM)subjects from the primary IPARA group receiving no paracetamol treatment after booster vaccination
Group IPARA-NPARAInfanrix hexasubjects from the primary IPARA group receiving no paracetamol treatment after booster vaccination
Group IPARA-NPARAInfanrix-IPV/Hibsubjects from the primary IPARA group receiving no paracetamol treatment after booster vaccination
Group DPARA-IPARAGSK1024850A (SynflorixTM)subjects from the primary DPARA group receiving immediate paracetamol treatment after booster vaccination
Group DPARA-IPARAInfanrix hexasubjects from the primary DPARA group receiving immediate paracetamol treatment after booster vaccination
Group DPARA-IPARAInfanrix-IPV/Hibsubjects from the primary DPARA group receiving immediate paracetamol treatment after booster vaccination
Group NPARA-IPARAGSK1024850A (SynflorixTM)subjects from the primary NPARA group receiving immediate paracetamol treatment after booster vaccination
Group NPARA-IPARAInfanrix hexasubjects from the primary NPARA group receiving immediate paracetamol treatment after booster vaccination
Group NPARA-IPARAInfanrix-IPV/Hibsubjects from the primary NPARA group receiving immediate paracetamol treatment after booster vaccination
Group DPARAParacetamolDelayed paracetamol group: subjects receiving delayed paracetamol treatment after each primary vaccine dose
Group IPARAParacetamolImmediate paracetamol group: subjects receiving immediate paracetamol treatment after each primary vaccine dose
Group IIBU-IIBUIbuprofen1/3 of the subjects from the primary IIBU group receiving immediate ibuprofen treatment after booster vaccination
Group DIBU-IIBUIbuprofen1/3 of the subjects from the primary DIBU group receiving immediate ibuprofen treatment after booster vaccination
Group IIBU-NIBUIbuprofen1/3 of the subjects from the primary IIBU group receiving no prophylactic ibuprofen treatment after booster vaccination
Group DIBU-DIBUIbuprofen1/3 of the subjects from the primary DIBU group receiving delayed ibuprofen treatment after booster vaccination
Group NIBU-IIBUIbuprofen1/3 of the subjects from the primary NIBU group receiving immediate ibuprofen treatment after booster vaccination
Group NIBU-DIBUIbuprofen1/3 of the subjects from the primary NIBU group receiving delayed ibuprofen treatment after booster vaccination
Group DPARA-IPARAParacetamolsubjects from the primary DPARA group receiving immediate paracetamol treatment after booster vaccination
Group NPARA-IPARAParacetamolsubjects from the primary NPARA group receiving immediate paracetamol treatment after booster vaccination
Primary Outcome Measures
NameTimeMethod
Number of Subjects With Antibody Concentrations Against Vaccine Pneumococcal Serotypes Greater Than or Equal to (≥) the Cut-offOne month after primary immunization (At Month 3)

Antibodies against the vaccine pneumococcal serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F (Anti-1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F) have been assessed by 22F-inhibition enzyme-linked immunosorbent assay (ELISA). The cut-off value of the assay was an antibody concentration greater than or equal to (≥) 0.2 micrograms per milliliter (μg/mL).

Antibody Concentrations Against Vaccine Pneumococcal SerotypesOne month after primary immunization (At Month 3)

Anti-pneumococcal serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F antibody concentrations have been assessed by 22F-inhibition ELISA, presented as geometric mean concentrations (GMCs) and expressed in micrograms per milliliter (μg/mL). The seropositivity cut-off for the assay was an antibody concentration ≥ 0.05 μg/mL.

Antibody Concentrations Against Protein D (Anti-PD)One month after primary immunization (At Month 3)

Anti-PD antibody concentrations were presented as geometric mean concentrations (GMCs), expressed in ELISA units (EL.U) per milliliter (EL.U/mL). The seropositivity cut-off of the assay was an antibody concentration ≥ 100 EL.U/mL.

Secondary Outcome Measures
NameTimeMethod
Antibody Concentrations Against Pertussis Toxoid (Anti-PT), Filamentous Haemagglutinin (Anti-FHA) and Pertactin (Anti-PRN)Prior to (Month 9) and one month after booster vaccination (Month 10)

Antibody concentrations assessed were presented as geometric mean concentrations (GMCs) and expressed in ELISA units per milliliter (EL.U/mL). The seropositivity cut-off for the assay was an antibody concentration ≥ 5 EL.U/mL.

Number of Subjects With Any Unsolicited Adverse Events (AEs)Within 31-days (Day 0-30) following booster vaccination

An unsolicited adverse event is any adverse event (i.e. any untoward medical occurrence in a patient or clinical investigation subject, temporally associated with use of a medicinal product, whether or not considered related to the medicinal product) reported in addition to those solicited during the clinical study and any solicited symptom with onset outside the specified period of follow-up for solicited symptoms.

Number of Subjects With Any and Grade 3 Solicited Local SymptomsWithin the 4-day (Days 0-3) period following booster vaccination

Solicited local symptoms assessed were pain, redness and swelling. Any = incidence of any local symptom regardless of intensity grade. Grade 3 pain = cried when limb was moved/spontaneously painful. Grade 3 redness/swelling = redness/swelling above 30 millimeters (mm).

Number of Subjects With Any Serious Adverse Events (SAEs)During the entire study period (Month 0 to 10)

SAEs assessed include medical occurrences that results in death, are life threatening, require hospitalization or prolongation of hospitalization, results in disability/incapacity.

Antibody Concentrations Against Diphtheria (D) and Tetanus (T) ToxoidsOne month after primary immunization (Month 3)

Anti-D and anti-T antibody concentrations were presented as geometric mean concentrations (GMCs) and expressed in international units per milliliter (IU/mL). The seroprotection cut-off for the assay was an antibody concentration ≥ 0.1 IU/mL.

Antibody Concentrations Against Diphteria (D) and Tetanus (T) ToxoidsPrior to (Month 9) and one month after booster vaccination (Month 10)

Anti-D and anti-T antibody concentrations were presented as geometric mean concentrations (GMCs) and expressed in IU/mL. The seroprotection cut-off for the assay was an antibody concentration ≥ 0.1 IU/mL.

Number of Subjects With Any, Grade 3 and Related Solicited General SymptomsWithin the 4-day (Days 0-3) period following booster vaccination

Solicited general symptoms included drowsiness, irritability, loss of appetite and fever \[rectally, greater than or equal to (≥) 38 degrees Celsius (°C)\]. Any= incidence of any symptom regardless of intensity grade or relationship to vaccination. Grade 3 drowsiness = drowsiness that interfered with normal activity. Grade 3 irritability = crying that could not be comforted/ prevented normal activity. Grade 3 loss of appetite = not eating at all. Grade 3 fever = fever above (\>) 40.0°C. Related = symptom assessed by the investigator as related to the vaccination.

Antibody Concentrations Against Vaccine Pneumococcal SerotypesPrior to (Month 9) and one month after booster vaccination (Month 10)

Anti- pneumococcal serotypes 1, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F antibody concentrations have been assessed by 22F-inhibition ELISA, presented as geometric mean concentrations (GMCs) and expressed in micrograms per milliliter (μg/mL). The seropositivity cut-off for the assay was an antibody concentration greater than or equal to (≥) 0.05 μg/mL.

Opsonophagocytic Activity (OPA) Titers Against Vaccine Pneumococcal SerotypesPrior to (Month 9) and one month after booster vaccination (Month 10)

OPA titers against pneumococcal serotypes (Opsono-1, -4, -5, -6A, -6B, -7F, -9V, -14, -18C, -19A, -19F and -23F) were presented as geometric mean titers (GMTs). The seropositivity cut-off for the assay was ≥ 8. When the number of subjects in a group for a specific category equals (=) 1, the lower limit and upper limit of the confidence interval that can't be calculated, are filled in with the GMT value (due to system constraint). Placeholder value "99999.9" has been entered when value to be entered in the system was greater than (\>) 1.0 E10.

Antibody Concentrations Against Protein D (Anti-PD)Prior to (Month 9) and one month after booster vaccination (Month 10)

Anti-PD antibody concentrations were presented as geometric mean concentrations (GMCs), expressed in ELISA units per milliliter (EL.U//mL). The seroprotection cut-off for the assay was an antibody concentration ≥ 100 EL.U/mL.

Antibody Concentrations Against Hepatitis B Surface Antigen (HBs)One month after primary immunization (Month 3)

Antibody concentrations assessed were presented as geometric mean concentrations (GMCs) and expressed in milli-international units per milliliter (mIU/mL). The seroprotection cut-off for the assay was an antibody concentration ≥ 10 mIU/mL.

Antibody Concentrations Against Hepatitis B Surface AntigenPrior to (Month 9) and one month after booster vaccination (Month 10)

Antibody concentrations assessed were presented as geometric mean concentrations (GMCs) and expressed in mIU/mL. The seroprotection cut-off for the assay was an antibody concentration ≥ 10 mIU/mL.

Antibody Concentrations Against Polyribosyl-ribitol-phosphate (PRP)Prior to (Month 9) and one month after booster vaccination (Month 10)

Antibody concentrations assessed were presented as geometric mean concentrations (GMCs) and expressed in µg/mL. The seroprotection cut-off for the assay was an antibody concentration ≥ 0.15 µg/mL.

Antibody Titers Against Poliovirus Type 1, 2 and 3Prior to (Month 9) and one month after booster vaccination (Month 10)

Antibody titers assessed were presented as geometric mean titers (GMTs). The seroprotection cut-off for the assay was a titer ≥ the value of 8.

Antibody Concentrations Against Cross-reactive Pneumococcal Serotypes 6A and 19AOne month after primary immunization (At Month 3)

Anti-pneumococcal serotype 6A and 19A antibody concentrations have been assessed by 22F-inhibition ELISA, presented as geometric mean concentrations (GMCs) and expressed in micrograms per milliliter (μg/mL). The seropositivity cut-off for the assay was an antibody concentration ≥ 0.05 μg/mL.

Trial Locations

Locations (1)

GSK Investigational Site

🇷🇴

Timisoara, Romania

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