Rotavirus
Conditions
Keywords
Rotarix, HRV, Healthy infants, Liquid formulation, Lyophilized formulation, Human rotavirus vaccine
Brief summary
The purpose of this study is to evaluate the immunogenicity, reactogenicity and safety of GSK Biologicals' HRV liquid vaccine compared to GSK Biologicals' HRV lyophilized vaccine when administered as a two-dose primary vaccination in healthy infants aged 6-10 weeks at dose one, with no previous history of rotavirus illness or vaccination. While the lyophilized formulation of the HRV vaccine was licensed in India in February 2008, this study is conducted to generate additional clinical data for the liquid formulation of the HRV vaccine in India, as recommended by New Drug Advisory Committee on Vaccines (NDAC-Vaccines) of Drug Controller General of India (DCGI).
Interventions
BIOLOGICALHRV Liquid
Two doses administered orally according to a 0, 1-month schedule.
BIOLOGICALHRV Lyophilized
Two doses administered orally according to a 0, 1-month schedule.
Sponsors
GlaxoSmithKline
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Weeks to 10 Weeks
Healthy volunteers
Yes
Inclusion criteria
* Subjects' parent(s)/ Legally Acceptable Representative (s) \[LAR(s)\] who, in the opinion of the investigator, can and will comply, with the requirements of the protocol. * Written informed consent obtained from the parent(s)/ LAR(s) of the subject prior to performing any study specific procedure. * A male or female between, and including, 6 and 10 weeks of age at the time of the first vaccination. * Healthy subjects as established by medical history and clinical examination before entering into the study. * Birth weight \>2000 grams.
Exclusion criteria
* Child in care. * Use of any investigational or non-registered product other than the study vaccines during the period starting 30 days before the first dose of study vaccine (Day-29 to Day 1), or planned use during the study period. * Chronic administration (defined as more than 14 days in total) of immunosuppressants or other immune-modifying drugs since birth. For corticosteroids, this will mean prednisone 0.5 mg/kg/day, or equivalent. Inhaled and topical steroids are allowed. * Administration of any chronic drug therapy to be continued during the study period. * Planned administration/administration of a vaccine not foreseen by the study protocol in the period starting 30 days before the first dose of vaccine administration and ending at Visit 3; with the exception of the inactivated influenza vaccine, which is allowed at any time during the study, and other licensed routine childhood vaccinations, according to the local immunization practice. * 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. * History of confirmed RV GE. * Previous vaccination against RV. * Any confirmed or suspected immunosuppressive or immunodeficient condition, (including Severe Combined Immunodeficiency \[SCID\] disorder) based on medical history and physical examination. * Uncorrected congenital malformation (such as Meckel's diverticulum) of the gastrointestinal tract that would predispose for Intussusception (IS). * History of IS. * Very prematurely born infants (born ≤28 weeks of gestation). * Hypersensitivity to latex. * Family history of congenital or hereditary immunodeficiency. * History of any reaction or hypersensitivity likely to be exacerbated by any component of the vaccine. * Major congenital defects or serious chronic illness. * History of any neurological disorders or seizures. * Acute disease and/or fever at the time of enrolment. This warrants deferral of vaccination. * Fever is defined as temperature ≥38.0°C/100.4°F. The preferred location for measuring temperature in this study will be the oral cavity, the axilla or the rectum. * Subjects with a minor illness (such as mild diarrhea, mild upper respiratory infection) without fever may, be enrolled at the discretion of the investigator. * Acute or chronic, clinically significant pulmonary, cardiovascular, hepatic or renal functional abnormality, as determined by physical examination or medical history. * Administration of immunoglobulins and/or any blood products since birth or planned administration during the study period. * Administration of long-acting immune-modifying drugs at any time during the study period (e.g., infliximab). * GE within 7 days preceding the study vaccine administration (warrants deferral of the vaccination).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anti-rotavirus (Anti-RV) Immunoglobulin A (IgA) Antibody Concentrations | At Month 2 | Serum anti-RV IgA antibody concentrations were expressed as geometric mean concentrations (GMCs). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Seroconverted Subjects for Anti-RV IgA Antibodies | At Month 2 | Seroconversion is defined as: - for subjects with a pre-vaccination anti-RV IgA antibody concentration lower than (\<) 20 U/mL, seroconversion is achieved when the post-vaccination concentration is greater than or equal to (≥) 20 U/mL and \- for subjects with a pre-vaccination anti-RV IgA antibody concentration ≥ 20 U/mL, seroconversion is achieved when the post-vaccination concentration is ≥ 2 times the pre-vaccination concentration. |
| Number of Subjects With Any Solicited General Adverse Events (AEs) | During the 8-day follow-up period after each vaccination (vaccines administered at Day 1 and Month 1) | Solicited general AEs assessed were fever (defined as temperature ≥ 38.0°C/100.4°F, the preferred location for measuring temperature in this study being the oral cavity, the axilla and the rectum), irritability/fussiness, diarrhea (defined as passage of three or more looser than normal stools within a day), vomiting (defined as one or more episodes of forceful emptying of partially digested stomach contents ≥1 hour after feeding within a day), loss of appetite and cough/runny nose. Any = occurrence of AE regardless of intensity grade or relation to study vaccination. |
| Number of Subjects With Any Unsolicited AEs | During the 31-day follow-up period across doses (vaccines administered at Day 1 and Month 1) | An unsolicited AE is defined as 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, and reported in addition to those solicited during the clinical study and any 'solicited' AE with onset outside the specified period of follow-up for solicited AE. Any = occurrence of AE regardless of intensity grade or relation to study vaccination. |
| Number of Subjects With Any Serious Adverse Events (SAEs) | Throughout the study period (from Day 1 up to Month 2) | SAEs assessed included any untoward medical occurrence that resulted in death, was life-threatening, required hospitalization or prolongation of existing hospitalization and/or resulted in disability/incapacity. Any = occurrence of SAE regardless of intensity grade or relation to study vaccination. |
Countries
India
Participant flow
Recruitment details
The study was conducted at 8 centers in India.
Pre-assignment details
Out of 451 subjects enrolled in the study, 1 subject did not receive any study treatment and 1 vaccinated subject was eliminated from all analysis due to incorrect impartial witness. 449 subjects were vaccinated and included in the Exposed Set, 419 subjects completed the study.
Participants by arm
| Arm | Count |
|---|---|
| HRV Liq Group Subjects aged 6 to 10 weeks at the time of first vaccination, who received two oral doses of Liquid Human Rotavirus Vaccine (HRV) according to a two-dose schedule, at Day 1 and Month 1. | 224 |
| HRV Lyo Group Subjects aged 6 to 10 weeks at the time of first vaccination who received two oral doses of Lyophilized Human Rotavirus Vaccine (HRV) according to a two-dose schedule, at Day 1 and Month 1. | 225 |
| Total | 449 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | CONSENT WITHDRAWAL NOT DUE TO AE | 1 | 2 |
| Overall Study | Lost to Follow-up | 2 | 1 |
| Overall Study | MIGRATED / MOVED FROM THE STUDY AREA | 3 | 5 |
| Overall Study | NOT WILLING TO PARTICIPATE THIS VISIT | 9 | 7 |
Baseline characteristics
| Characteristic | HRV Liq Group | HRV Lyo Group | Total |
|---|---|---|---|
| Age, Continuous | 6.8 Weeks STANDARD_DEVIATION 1 | 6.8 Weeks STANDARD_DEVIATION 1.1 | 6.8 Weeks STANDARD_DEVIATION 1 |
| Race/Ethnicity, Customized Asian | 224 Participants | 225 Participants | 449 Participants |
| Sex: Female, Male Female | 100 Participants | 120 Participants | 220 Participants |
| Sex: Female, Male Male | 124 Participants | 105 Participants | 229 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 224 | 0 / 225 |
| other Total, other adverse events | 146 / 224 | 162 / 225 |
| serious Total, serious adverse events | 7 / 224 | 2 / 225 |
Outcome results
Primary
Anti-rotavirus (Anti-RV) Immunoglobulin A (IgA) Antibody Concentrations
Serum anti-RV IgA antibody concentrations were expressed as geometric mean concentrations (GMCs).
Time frame: At Month 2
Population: Analysis was performed on Per Protocol Set (PPS) for immunogenicity, which included all eligible subjects who received both doses of HRV vaccine, complied with vaccination schedule and for whom immunogenicity data were available at the specified time point.
| Arm | Measure | Value (GEOMETRIC_MEAN) |
|---|---|---|
| HRV Liq Group | Anti-rotavirus (Anti-RV) Immunoglobulin A (IgA) Antibody Concentrations | 90.25 U/mL |
| HRV Lyo Group | Anti-rotavirus (Anti-RV) Immunoglobulin A (IgA) Antibody Concentrations | 94.16 U/mL |
Comparison: Anti-RV IgA GMCs (non-inferiority): Non-inferiority comparison between GSK Biologicals' HRV liquid vaccine (HRV Liq Group) and GSK Biologicals' HRV lyophilized vaccine (HRV Lyo Group) in terms of geometric mean concentrations (GMCs) for anti-RV antibodies, one month after the administration of the second dose of study vaccine.95% CI: [0.65, 1.34]ANCOVA
Secondary
Number of Subjects With Any Serious Adverse Events (SAEs)
SAEs assessed included any untoward medical occurrence that resulted in death, was life-threatening, required hospitalization or prolongation of existing hospitalization and/or resulted in disability/incapacity. Any = occurrence of SAE regardless of intensity grade or relation to study vaccination.
Time frame: Throughout the study period (from Day 1 up to Month 2)
Population: Analysis was performed on the ES, which included all subjects with at least one study vaccine administration documented.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| HRV Liq Group | Number of Subjects With Any Serious Adverse Events (SAEs) | 7 Participants |
| HRV Lyo Group | Number of Subjects With Any Serious Adverse Events (SAEs) | 2 Participants |
Secondary
Number of Subjects With Any Solicited General Adverse Events (AEs)
Solicited general AEs assessed were fever (defined as temperature ≥ 38.0°C/100.4°F, the preferred location for measuring temperature in this study being the oral cavity, the axilla and the rectum), irritability/fussiness, diarrhea (defined as passage of three or more looser than normal stools within a day), vomiting (defined as one or more episodes of forceful emptying of partially digested stomach contents ≥1 hour after feeding within a day), loss of appetite and cough/runny nose. Any = occurrence of AE regardless of intensity grade or relation to study vaccination.
Time frame: During the 8-day follow-up period after each vaccination (vaccines administered at Day 1 and Month 1)
Population: Analysis was performed on the Exposed Set (ES), which included all subjects with at least one study vaccine administration documented and with the diary card completed.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Cough/Runny Nose (Dose 1), Any | 22 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Cough/Runny Nose (Dose 2), Any | 17 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Diarrhea (Dose 1), Any | 4 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Diarrhea (Dose 2), Any | 3 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Fever (Dose 1), ≥ 38.0°C | 57 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Fever (Dose 2), ≥ 38.0°C | 50 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Irritability/Fussiness (Dose 1), Any | 71 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Irritability/Fussiness (Dose 2), Any | 56 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Loss of appetite (Dose 1), Any | 33 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Loss of appetite (Dose 2), Any | 28 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Vomiting (Dose 1), Any | 22 Participants |
| HRV Liq Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Vomiting (Dose 2), Any | 15 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Vomiting (Dose 1), Any | 22 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Cough/Runny Nose (Dose 1), Any | 24 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Irritability/Fussiness (Dose 1), Any | 83 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Cough/Runny Nose (Dose 2), Any | 23 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Loss of appetite (Dose 2), Any | 25 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Diarrhea (Dose 1), Any | 2 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Irritability/Fussiness (Dose 2), Any | 61 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Diarrhea (Dose 2), Any | 3 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Vomiting (Dose 2), Any | 13 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Fever (Dose 1), ≥ 38.0°C | 48 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Loss of appetite (Dose 1), Any | 42 Participants |
| HRV Lyo Group | Number of Subjects With Any Solicited General Adverse Events (AEs) | Fever (Dose 2), ≥ 38.0°C | 53 Participants |
Secondary
Number of Subjects With Any Unsolicited AEs
An unsolicited AE is defined as 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, and reported in addition to those solicited during the clinical study and any 'solicited' AE with onset outside the specified period of follow-up for solicited AE. Any = occurrence of AE regardless of intensity grade or relation to study vaccination.
Time frame: During the 31-day follow-up period across doses (vaccines administered at Day 1 and Month 1)
Population: Analysis was performed on the ES, which included all subjects with at least one study vaccine administration documented.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| HRV Liq Group | Number of Subjects With Any Unsolicited AEs | 54 Participants |
| HRV Lyo Group | Number of Subjects With Any Unsolicited AEs | 58 Participants |
Secondary
Percentage of Seroconverted Subjects for Anti-RV IgA Antibodies
Seroconversion is defined as: - for subjects with a pre-vaccination anti-RV IgA antibody concentration lower than (\<) 20 U/mL, seroconversion is achieved when the post-vaccination concentration is greater than or equal to (≥) 20 U/mL and \- for subjects with a pre-vaccination anti-RV IgA antibody concentration ≥ 20 U/mL, seroconversion is achieved when the post-vaccination concentration is ≥ 2 times the pre-vaccination concentration.
Time frame: At Month 2
Population: Analysis was performed on PPS for immunogenicity, which included all eligible subjects who received both doses of HRV vaccine, complied with vaccination schedule and for whom immunogenicity data were available at the specified time point.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| HRV Liq Group | Percentage of Seroconverted Subjects for Anti-RV IgA Antibodies | 54.5 Percentage of subjects |
| HRV Lyo Group | Percentage of Seroconverted Subjects for Anti-RV IgA Antibodies | 50.0 Percentage of subjects |