Immunogenicity and Safety of Tetravalent Dengue Vaccine (TDV) Co-administered With an Hepatitis A Virus Vaccine

Phase 3

Completed

• Conditions: Healthy Volunteers
• Interventions: Biological: TDV; Biological: HAV Vaccine; Biological: TDV Placebo; Biological: HAV Vaccine Placebo

• Registration Number: NCT03525119
• Lead Sponsor: Takeda

Brief Summary

The purpose of this study is to investigate the immunogenicity and safety of the concomitant administration of TDV (subcutaneous \[SC\] injection) and of hepatitis A virus (HAV) vaccine (intramuscular \[IM\] injection) in healthy participants aged 18 to 60 years living in country(ies) non-endemic for both dengue and hepatitis.

Detailed Description

The vaccine tested in this study is TDV. TDV co-administered with HAV vaccine will be tested to assess immunogenicity and safety in healthy participants in non-endemic area(s) for dengue and HAV.

The study will enroll approximately 900 patients. Participants will be randomly assigned to one of the three groups-which will remain undisclosed to the observer. Participants will be randomized in 1:1:1 ratio to receive:

* Group 1: HAV vaccine (IM) and TDV placebo-matching injection (SC), co-administered at Day 1 (Month 0 \[M0\]); TDV placebo-matching injection (SC) administered at Day 90 (Month 3 \[M3\])

* Group 2: TDV (SC) and HAV placebo-matching injection (IM), co-administered at Day 1 (Month 0 \[M0\]); TDV (SC) administered at Day 90(Month 3 \[M3\])

* Group 3: TDV (SC) and HAV vaccine (IM), co-administered at Day 1 (Month 0 \[M0\]); TDV (SC) administered at Day 90 (Month 3 \[M3\])

This multi-center trial will be conducted in United Kingdom. The overall time to participate in this study is 270 days. Participants will have multiple visits to the clinic with a 6-months follow up after the last study administration, including a final visit at Day 270.

Study Timeline

• Study First Submitted: 2018-04-27
• Study First Submitted QC: 2018-05-03
• Study First Posted: 2018-05-15
• Study Start: 2018-05-16
• Primary Completion: 2018-10-03
• Study Completion: 2019-07-09
• Results First Submitted: 2020-06-24
• Results First Submitted QC: 2020-06-24
• Results First Posted: 2020-07-13
• Status Verified: 2022-08
• Last Update Submitted: 2022-08-17
• Last Update Posted: 2022-08-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 900

Inclusion Criteria

1. The participant is aged 18 to 60 years, inclusive.
2. Participants who are in good health at the time of entry into the trial as determined by medical history, physical examination (including vital signs) and the clinical judgment of the Investigator.
3. The participant signs and dates a written informed consent form and any required privacy authorization prior to the initiation of any trial procedures, after the nature of the trial has been explained according to local regulatory requirements.
4. Participants who can comply with trial procedures and are available for the duration of follow-up.

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Exclusion Criteria

1. Participants with an elevated oral temperature (≥38°C or 100.4°F) within 3 days of the intended date of vaccination.

2. Known hypersensitivity or allergy to any of the vaccine components (including excipients of the investigational vaccines or placebo).

3. Participants with behavioral or cognitive impairment or psychiatric disease that, in the opinion of the Investigator, may interfere with the participant's ability to participate in the trial.

4. Participants with any history of progressive or severe neurologic disorder, seizure disorder orneuro-inflammatory disease (eg, Guillain-Barré syndrome).

5. Participants with history or any illness that, in the opinion of the Investigator, might interfere with the results of the trial or pose additional risk to the participant due to participation in the trial.

6. Known or suspected impairment/alteration of immune function, including:

   1. Chronic use of oral steroids (equivalent to 20 mg/day prednisone ≥12 weeks/≥2 mg/kg body weight/day prednisone ≥2 weeks) within 60 days prior to Day 1 (Month 0) (use of inhaled, intranasal, or topical corticosteroids is allowed).
   2. Receipt of parenteral steroids (equivalent to 20 mg/day prednisone ≥12 weeks/≥ 2 mg/kg body weight/day prednisone ≥2 weeks) within 60 days prior to Day 1 (Month 0).
   3. Administration of immunoglobulins and/or any blood products within the 3 months prior to Day 1 (Month 0) or planned administration during the trial.
   4. Receipt of immunostimulants within 60 days prior to Day 1 (Month 0).
   5. Immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within 6 months prior to Day 1 (Month 0).
   6. Human immunodeficiency virus (HIV) infection or HIV-related disease.
   7. Hepatitis A virus (HAV) infection.
   8. Hepatitis C virus infection.
   9. Genetic immunodeficiency.

7. Abnormalities of splenic or thymic function.

8. Participants with a known bleeding diathesis, or any condition that may be associated with a prolonged bleeding time.

9. Participants with any serious chronic or progressive disease according to judgment of the Investigator (eg, neoplasm, insulin dependent diabetes, cardiac, renal or hepatic disease).

10. Participants with body mass index (BMI) greater than or equal to 35 kg/m^2 (=weight in kg/[height in meters^2]).

11. Participants participating in any clinical trial with another investigational product 30 days prior to Day 1 (Month 0) or intent to participate in another clinical trial at any time during the conduct of this trial.

12. Participants who received any other vaccine within 14 days (for inactivated vaccines) or 28 days (for live vaccines) prior to enrollment in this trial or who are planning to receive any vaccine within 28 days of trial vaccine administration.

13. Previous HAV vaccination (in a clinical trial or with an approved product).

14. Participants involved in the trial conduct or their first degree relatives.

15. Participants with history of substance or alcohol abuse within the past 2 years.

16. Female participants who are pregnant or breastfeeding.

17. Females of childbearing potential who are sexually active, and who have not used any of the acceptable contraceptive methods for at least 2 months prior to Day 1 (Month 0).

    1. Of childbearing potential is defined as status post onset of menarche and not meeting any of the following conditions: bilateral tubal ligation (at least 1 year previously), bilateral oophorectomy (at least 1 year previously) or hysterectomy
    2. Acceptable birth control methods are defined as one or more of the following:

    i. Hormonal contraceptive (such as oral, injection, transdermal patch, implant, cervical ring).

    ii. Barrier method (condom with spermicide or diaphragm with spermicide) each and every time during intercourse.

    iii. Intrauterine device (IUD). iv. Monogamous relationship with vasectomized partner (partner must have been vasectomized for at least 6 months prior to Day 1 [Month 0]).

    Other contraceptive methods may be considered in agreement with the Sponsor and implemented only after approval of a substantial amendment by the regulatory authorities and by the appropriate ethics committee.

18. Females of childbearing potential who are sexually active, and who refuse to use an acceptable contraceptive method up to 6 weeks after the last dose of trial vaccine (Day 90 [M3]). In addition, they must be advised not to donate ova during this period.

19. Any positive or indeterminate pregnancy test.

20. Previous and planned vaccination (during the trial conduct) against any flaviviruses including dengue, yellow fever (YF), Japanese Encephalitis (JE) viruses or tick-borne encephalitis.

21. Previous participation in any clinical trial of a dengue or other flavivirus (eg, West Nile [WN] virus) candidate vaccine, except for participants who received placebo in those trials.

22. Participants with a current or previous infection with a flavivirus such as dengue, Zika, YF, JE, WN fever, tick-borne encephalitis or Murray Valley encephalitis and participants with a history of prolonged (≥1 year) habitation in a dengue endemic area.

23. Participants with contraindications, warnings and/or precautions to vaccination with the HAV vaccine as specified within the product information.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
TDV 0.5 ml + HAV Vaccine 1.0 ml/ TDV 0.5 ml	TDV	TDV 0.5 ml, injection, SC, and HAV vaccine 1.0 ml, injection, IM, once on Day 1 (first dose) followed by TDV 0.5 ml, injection, SC on Day 90 (second dose).
TDV 0.5 ml + HAV Vaccine 1.0 ml/ TDV 0.5 ml	HAV Vaccine	TDV 0.5 ml, injection, SC, and HAV vaccine 1.0 ml, injection, IM, once on Day 1 (first dose) followed by TDV 0.5 ml, injection, SC on Day 90 (second dose).
HAV Vaccine 1.0 ml + Placebo/ Placebo	TDV Placebo	HAV vaccine 1.0 ml, injection, IM, and placebo-matching injection, SC, once on Day 1 (first dose) followed by placebo-matching injection, SC on Day 90 (second dose).
TDV 0.5 ml + Placebo/ TDV 0.5 ml	TDV	TDV 0.5 ml, injection, SC, and placebo-matching injection, IM, once on Day 1 (first dose) followed by TDV 0.5 ml, injection, SC on Day 90 (second dose).
HAV Vaccine 1.0 ml + Placebo/ Placebo	HAV Vaccine	HAV vaccine 1.0 ml, injection, IM, and placebo-matching injection, SC, once on Day 1 (first dose) followed by placebo-matching injection, SC on Day 90 (second dose).
TDV 0.5 ml + Placebo/ TDV 0.5 ml	HAV Vaccine Placebo	TDV 0.5 ml, injection, SC, and placebo-matching injection, IM, once on Day 1 (first dose) followed by TDV 0.5 ml, injection, SC on Day 90 (second dose).

Primary Outcome Measures

Name	Time	Method
Percentage of Participants HAV/Dengue Virus (DENV)-Naive at Baseline Who Are Seroprotected Against HAV at Day 30	One month post first vaccination (Day 30)	Seroprotection is defined as serum anti-HAV antibody levels ≥12.5 mIU/mL, measured by enzyme-linked immunosorbent assay (ELISA). Immunological naivety to HAV/DENV is defined as anti-HAV antibody levels \<12.5 mIU/mL and reciprocal neutralizing titers for all 4 dengue serotypes \<10. The 4 dengue virus serotypes were DENV-1, DENV-2, DENV-3 and DENV-4.

Secondary Outcome Measures

Name	Time	Method
Geometric Mean Titers (GMTs) of Neutralizing Antibodies for Each of the 4 Dengue Serotypes at Day 30 and Day 120 in Participants HAV/DENV-naive at Baseline	One month post first vaccination (Day 30) and one month post second vaccination (Day 120)	GMTs of neutralizing antibodies were measured by microneutralization test 50% \[MNT50\] for each of the 4 Dengue Serotypes. The 4 dengue virus serotypes were DENV-1, DENV-2, DENV-3 and DENV-4.
Percentage of Participants HAV/DENV-naive at Baseline Who Are Seropositive for Each of the 4 Dengue Serotypes at Day 30 and Day 120	One month post first vaccination (Day 30) and one month post second vaccination (Day 120)	Seropositivity is defined as a reciprocal neutralizing titer ≥10. The 4 dengue virus serotypes were DENV-1, DENV-2, DENV-3 and DENV-4.
Geometric Mean Concentrations (GMC) of Anti-HAV Antibodies at Day 30 in Participants HAV/DENV-naive at Baseline	One month post first vaccination (Day 30)	GMC of anti-HAV antibodies were measured by ELISA.
Percentage of Participants With Solicited (Local Injection) Site Adverse Events (AEs) by Severity After Each Vaccination	Within 7 days after each vaccination	Solicited local AEs (at injection site) were collected by participants using diary cards within 7 days after vaccination and included pain (none, mild: no interference with daily activity, moderate: interference with daily activity with or without treatment and severe: prevents daily activity with or without treatment), redness (erythema) (\<2.5 cm, mild: 2.5-5 cm, moderate: \>5 to \<=10 cm, severe: \>10 cm) and swelling (edema/induration) (\<2.5 cm, mild: 2.5-5 cm, moderate: \>5 to \<=10 cm, severe: \>10 cm ). The percentages were rounded off to the first decimal place.
Percentage of Participants With Solicited Systemic Adverse Events (AEs) by Severity After Each Vaccination	Within 14 days after each vaccination	Solicited systemic AEs include fever, headache, asthenia, malaise and myalgia that occurred within 14 days after each vaccination. Solicited systemic AEs (headache, asthenia, malaise and myalgia) was graded from 0 to 3 by severity; where 0=None, 1=Mild: No interference with daily activity, 2=Moderate: Interference with daily activity, 3=Severe: Prevents daily activity; A systemic AE of fever (defined as ≥38°C or ≥100.4°F) was derived from a daily temperature reading recorded within 14 days after vaccination. Fever was excluded from the overall count as no severity grading was applied for it. The percentages were rounded off to the first decimal place.
Percentage of Participants With Any Unsolicited Adverse Events (AEs) After Each Vaccination	Up to 28 days (Day of Vaccination+27 Subsequent Days) after each vaccination	An AE is defined as any untoward medical occurrence in a clinical investigation participant administered a trial vaccine; it does not necessarily have to have a causal relationship with trial vaccine administration.
Percentage of Participants With Serious Adverse Events (SAEs)	From the first vaccination on Day 1 until the end of the trial (Day 270)	A SAE is defined as any untoward medical occurrence that: 1) results in death, 2) is life-threatening, 3) requires inpatient hospitalization or prolongation of existing hospitalization, 4) results in persistent or significant disability/incapacity, 5) leads to a congenital anomaly/birth defect in the offspring of the participant or 6) is an medically important event that satisfies any of the following: a) May require intervention to prevent items 1 through 5 above. b) May expose the participant to danger, even though the event is not immediately life threatening or fatal or does not result in hospitalization.
Percentage of Participants With Medically Attended AEs (MAAEs)	From the first vaccination on Day 1 until the end of the trial (Day 270)	MAAEs are defined as AEs leading to a medical visit to or by a healthcare professional, including visits to an emergency department, but not fulfilling seriousness criteria.

Trial Locations

Locations (10)

Synexus - Midlands; 🇬🇧 Edgbaston, Birmingham, United Kingdom

Synexus - Lancashire; 🇬🇧 Chorley, Lancashire, United Kingdom

Synexus - Manchester; 🇬🇧 Manchester, United Kingdom

North East Clinical Research Centre, Hexham General Hospital; 🇬🇧 Hexham, United Kingdom

Synexus - Wales; 🇬🇧 Cardiff, United Kingdom

Synexus - Scotland; 🇬🇧 Glasgow, United Kingdom

Synexus - Merseyside; 🇬🇧 Waterloo, Liverpool, United Kingdom

Royal Hallamshire Hospital; 🇬🇧 Sheffield, Yorkshire, United Kingdom

Synexus - Thames Valley; 🇬🇧 Reading, United Kingdom

North Tees Clinical Research Centre, Middlefield Centre, University Hospital of North Tees; 🇬🇧 Stockton-on-Tees, United Kingdom