Hepatitis A, Hepatitis B
Conditions
Keywords
Combined hepatitis A and B vaccine, Twinrix™
Brief summary
To evaluate the persistence of anti-hepatitis A virus (HAV) and anti-hepatitis B surface antigen (HBs) antibodies up to 2, 3, 4 and 5 years after administration of the first dose of the study vaccine. The Protocol Posting has been updated in order to comply with the FDA Amendment Act, Sep 2007.
Detailed description
Open, randomised, self-contained, multicentric, multinational, long-term antibody persistence studies. Immune persistence was compared between subjects who received either two dose or three doses of GSK Biologicals combined hepatitis A and hepatitis B vaccine. The long-term follow-up studies involved taking blood samples at approximately 2, 3, 4 and 5 years after the primary vaccination of combined hepatitis A and B vaccine to assess antibody persistence. No additional subjects will be recruited during the long term follow-up period.
Interventions
Intramuscular injection in the left deltoid, 2 doses, Adult formulation in primary study.
Intramuscular injection in the left deltoid, 3 doses, junior formulation in primary study.
Sponsors
Study design
Eligibility
Inclusion criteria
* Participation in primary study * Written informed consent obtained before each long term follow up visit.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anti-hepatitis A (HAV) Antibody Concentrations | Year 2 (Month 24), Year 3 (Month 36), Year 4 (Month 48) and Year 5 (Month 60) | Geometric mean concentration for anti-HAV antibodies expressed as Milli-International Units per milliliter (mIU/mL) |
| Anti-hepatitis B (HBs) Antibody Concentrations | Year 2 (Month 24), Year 3 (Month 36), Year 4 (Month 48) and Year 5 (Month 60) | Geometric mean concentration for anti-HBs antibodies expressed as Milli-International Units per milliliter (mIU/mL). |
| Anti-HAV Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Before and one month after additional vaccination | Any subjects becoming seronegative for anti-HAV antibodies (i.e. titres \< 15 mIU/ml) at any long term time point, were to receive an additional vaccine dose administered between 6 to 12 months after Year 5 time point. |
| Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Before and One month after additional vaccination | Subjects losing seroprotective anti-HBs antibody titres (i.e. titres \< 10 mIU/ml) at any long term time point, received an Engerix challenge dose. The table presents the geometric mean concentrations for anti-HBs antibodies, expressed as Milli-International Units per milliliter (mIU/mL). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Subjects Reporting Serious Adverse Events (SAEs) Determined by the Investigator to Have a Causal Relationship to Primary Vaccination or Due to Lack of Vaccine Efficacy. | From last study visit of the primary study up to Year 5 long term follow-up | A serious adverse event (SAE) is any untoward medical occurrence that: results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study subject, or may evolve into one of the outcomes listed above. |
| Number of Subjects Receiving an Additional Vaccine Dose and Reporting Any Serious Adverse Events | At least one month after additional vaccination | A serious adverse event (SAE) is any untoward medical occurrence that: results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study subject, or may evolve into one of the outcomes listed above. |
| Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | during the 4-day follow-up period after additional vaccination | Solicited local symptoms assessed include pain, redness and swelling at the vaccine injection site. Any= regardless of intensity grade; Grade 3 Pain= spontaneously painful |
| Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | During the 4-day follow-up period after additional vaccination | Solicited general symptoms assessed include fatigue, fever, gastrointestinal symptoms and headache. Any= regardless of intensity grade or relationship to vaccination; grade 3= prevented normal activity; Related= considered by the investigator to be causally related to the vaccination |
| Number of Subjects Receiving an Additional Vaccine Dose and Reporting Unsolicited Adverse Events (AEs). | During the 30-day follow-up period after additional vaccination. | An Adverse Event is any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. |
Countries
Australia, Belgium, Spain
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Twinrix Adult Subjects previously received 2 doses of combined hepatitis A / hepatitis B vaccine (adult formulation). | 139 |
| Twinrix Junior Subjects previously received 3 doses of combined hepatitis A / hepatitis B vaccine (junior formulation). | 137 |
| Total | 276 |
Baseline characteristics
| Characteristic | Twinrix Adult | Twinrix Junior | Total |
|---|---|---|---|
| Age, Continuous | 11.6 years STANDARD_DEVIATION 2.97 | 11.2 years STANDARD_DEVIATION 3.11 | 11.4 years STANDARD_DEVIATION 3.04 |
| Sex: Female, Male Female | 59 Participants | 64 Participants | 123 Participants |
| Sex: Female, Male Male | 80 Participants | 73 Participants | 153 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 7 / 11 | 0 / 5 |
| serious Total, serious adverse events | 0 / 139 | 0 / 137 |
Outcome results
Anti-HAV Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose.
Any subjects becoming seronegative for anti-HAV antibodies (i.e. titres \< 15 mIU/ml) at any long term time point, were to receive an additional vaccine dose administered between 6 to 12 months after Year 5 time point.
Time frame: Before and one month after additional vaccination
Population: None of the subjects became seronegative for anti-HAV antibodies during the Year 2 to Year 5 long term follow-up. Hence none of the subjects received an additional Havrix dose.
Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose.
Subjects losing seroprotective anti-HBs antibody titres (i.e. titres \< 10 mIU/ml) at any long term time point, received an Engerix challenge dose. The table presents the geometric mean concentrations for anti-HBs antibodies, expressed as Milli-International Units per milliliter (mIU/mL).
Time frame: Before and One month after additional vaccination
Population: Analysis was performed on the Total vaccinated cohort for the challenge dose, including all subjects who received an additional vaccine dose between 6 to 12 months after year 5.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| Twinrix Adult | Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Before vaccination | 4.9 mIU/mL |
| Twinrix Adult | Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Post vaccination | 521.3 mIU/mL |
| Twinrix Junior | Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Before vaccination | 2.4 mIU/mL |
| Twinrix Junior | Anti-HBs Antibody Concentrations in Subjects Receiving the Additional Vaccine Dose. | Post vaccination | 509.7 mIU/mL |
Anti-hepatitis A (HAV) Antibody Concentrations
Geometric mean concentration for anti-HAV antibodies expressed as Milli-International Units per milliliter (mIU/mL)
Time frame: Year 2 (Month 24), Year 3 (Month 36), Year 4 (Month 48) and Year 5 (Month 60)
Population: Analysis was performed on the Long Term According to Protocol cohort for analysis of immunogenicity (LT ATP immunogenicity cohort) which included all subjects that complied with the protocol and for whom data concerning immunogenicity endpoint measures were available for the particular time point measured.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| Twinrix Adult | Anti-hepatitis A (HAV) Antibody Concentrations | At year 2 | 1122.2 mIU/mL |
| Twinrix Adult | Anti-hepatitis A (HAV) Antibody Concentrations | At year 3 | 998.6 mIU/mL |
| Twinrix Adult | Anti-hepatitis A (HAV) Antibody Concentrations | At year 4 | 737.5 mIU/mL |
| Twinrix Adult | Anti-hepatitis A (HAV) Antibody Concentrations | At year 5 | 576.8 mIU/mL |
| Twinrix Junior | Anti-hepatitis A (HAV) Antibody Concentrations | At year 5 | 698.4 mIU/mL |
| Twinrix Junior | Anti-hepatitis A (HAV) Antibody Concentrations | At year 2 | 1377.8 mIU/mL |
| Twinrix Junior | Anti-hepatitis A (HAV) Antibody Concentrations | At year 4 | 915.9 mIU/mL |
| Twinrix Junior | Anti-hepatitis A (HAV) Antibody Concentrations | At year 3 | 1347.1 mIU/mL |
Anti-hepatitis B (HBs) Antibody Concentrations
Geometric mean concentration for anti-HBs antibodies expressed as Milli-International Units per milliliter (mIU/mL).
Time frame: Year 2 (Month 24), Year 3 (Month 36), Year 4 (Month 48) and Year 5 (Month 60)
Population: Analysis was performed on the Long Term According to Protocol cohort for analysis of immunogenicity (LT ATP immunogenicity cohort) which included all subjects that complied with the protocol and for whom data concerning immunogenicity endpoint measures were available for the particular time point measured.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| Twinrix Adult | Anti-hepatitis B (HBs) Antibody Concentrations | At year 2 | 479.9 mIU/mL |
| Twinrix Adult | Anti-hepatitis B (HBs) Antibody Concentrations | At year 3 | 325.1 mIU/mL |
| Twinrix Adult | Anti-hepatitis B (HBs) Antibody Concentrations | At year 4 | 270.2 mIU/mL |
| Twinrix Adult | Anti-hepatitis B (HBs) Antibody Concentrations | At year 5 | 150.2 mIU/mL |
| Twinrix Junior | Anti-hepatitis B (HBs) Antibody Concentrations | At year 5 | 283.7 mIU/mL |
| Twinrix Junior | Anti-hepatitis B (HBs) Antibody Concentrations | At year 2 | 830.6 mIU/mL |
| Twinrix Junior | Anti-hepatitis B (HBs) Antibody Concentrations | At year 4 | 519.7 mIU/mL |
| Twinrix Junior | Anti-hepatitis B (HBs) Antibody Concentrations | At year 3 | 695.1 mIU/mL |
Number of Subjects Receiving an Additional Vaccine Dose and Reporting Any Serious Adverse Events
A serious adverse event (SAE) is any untoward medical occurrence that: results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study subject, or may evolve into one of the outcomes listed above.
Time frame: At least one month after additional vaccination
Population: Analysis was performed on the Total vaccinated cohort for the challenge dose, including all subjects who received an additional vaccine dose between 6 to 12 months after year 5.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Any Serious Adverse Events | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Any Serious Adverse Events | 0 Participants |
Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms.
Solicited general symptoms assessed include fatigue, fever, gastrointestinal symptoms and headache. Any= regardless of intensity grade or relationship to vaccination; grade 3= prevented normal activity; Related= considered by the investigator to be causally related to the vaccination
Time frame: During the 4-day follow-up period after additional vaccination
Population: Analysis was performed on the Total vaccinated cohort for the challenge dose, including all subjects who received an additional vaccine dose between 6 to 12 months after year 5.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, any | 3 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, grade 3 | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, related | 3 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), ≥37°C | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), >39.5°C | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), related | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, any | 2 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, grade 3 | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, related | 2 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, any | 4 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, grade 3 | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, related | 4 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, grade 3 | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, any | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, any | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, grade 3 | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, any | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fatigue, related | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, grade 3 | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), ≥37°C | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Headache, related | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), >39.5°C | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Gastrointestinal, related | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited General Symptoms. | Fever (axillary), related | 0 Participants |
Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms
Solicited local symptoms assessed include pain, redness and swelling at the vaccine injection site. Any= regardless of intensity grade; Grade 3 Pain= spontaneously painful
Time frame: during the 4-day follow-up period after additional vaccination
Population: Analysis was performed on the Total vaccinated cohort for the challenge dose, including all subjects who received an additional vaccine dose between 6 to 12 months after year 5.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Pain, any | 6 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Pain, grade 3 | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Redness, any | 1 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Redness, >20mm | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Swelling, any | 0 Participants |
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Swelling, >20mm | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Swelling, any | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Pain, any | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Redness, >20mm | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Pain, grade 3 | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Swelling, >20mm | 0 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Solicited Local Symptoms | Redness, any | 0 Participants |
Number of Subjects Receiving an Additional Vaccine Dose and Reporting Unsolicited Adverse Events (AEs).
An Adverse Event is any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Time frame: During the 30-day follow-up period after additional vaccination.
Population: Analysis was performed on the Total vaccinated cohort for the challenge dose, including all subjects who received an additional vaccine dose between 6 to 12 months after year 5.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Twinrix Adult | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Unsolicited Adverse Events (AEs). | 2 Participants |
| Twinrix Junior | Number of Subjects Receiving an Additional Vaccine Dose and Reporting Unsolicited Adverse Events (AEs). | 0 Participants |
Number of Subjects Reporting Serious Adverse Events (SAEs) Determined by the Investigator to Have a Causal Relationship to Primary Vaccination or Due to Lack of Vaccine Efficacy.
A serious adverse event (SAE) is any untoward medical occurrence that: results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect in the offspring of a study subject, or may evolve into one of the outcomes listed above.
Time frame: From last study visit of the primary study up to Year 5 long term follow-up
Population: The analysis was performed on the Long term Total vaccinated cohort wich included all subjects who returned at a specified follow-up study
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Twinrix Adult | Number of Subjects Reporting Serious Adverse Events (SAEs) Determined by the Investigator to Have a Causal Relationship to Primary Vaccination or Due to Lack of Vaccine Efficacy. | 0 Participants |
| Twinrix Junior | Number of Subjects Reporting Serious Adverse Events (SAEs) Determined by the Investigator to Have a Causal Relationship to Primary Vaccination or Due to Lack of Vaccine Efficacy. | 0 Participants |