Randomized, double-blind, placebo-controlled, phase 3 trial to demonstrate lot-to-lot consistency of 3 lots of the simplified formulation of Butantan-dengue vaccine
Érique José Farias Peixoto de Miranda , José Alfredo de Sousa Moreira , Regiane da Silva Braga , Daniela Haydee Ramos Silveira , Vanessa Infante , Lucas Bassolli de Oliveira Alves , Juliana de Camargo Vieira Tenorio , Gabriel Ferreira dos Santos Silva , Elizabeth Gonzalez Patiño , Pedro Henrique Theotonio de Mesquita Pacheco , Fabiano Ramos , Danise Senna Oliveira , Esper Georges Kallás , Fernanda Castro Boulos
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引用次数: 0
Abstract
Summary
Background
We aimed to evaluate the consistency of the immune response on Day 28 postvaccination with three consecutive lots of simplified formulation of Butantan-Dengue Vaccine (Butantan-DV) and to describe the frequency of vaccine-related adverse events from vaccination through Day 21 postvaccination in comparison to placebo.
Methods
We included 700 participants allocated in a ratio 2:2:2:1 in parallel arms to receive any of three lots of simplified Butantan-DV or placebo, aged 18 to 59 years, without previous exposure to dengue in two study sites from a non-endemic area in Southern of Brazil. The consistency of three lots of the Butantan-DV were evaluated by analyzing the serum neutralizing antibody titers against four dengue virus serotypes by virus reduction neutralization test (VRNT60), on the Day 28 post-vaccination. Criterion for lot-to-lot consistency was two-sided 95 % confidence interval (95 % CI) of geometric mean titers (GMT) ratio within the margins of equivalence of >1/2 and < 2.0 for 12 possible pairwise comparison for the three lots and four serotypes in the Per-Protocol Set. Adverse events were analysed according to the frequency and Miettinen & Nurminen method to build 95 % CI for the difference in the binomial proportions of each lot with the placebo group. This trial is registered with ClinicalTrials.gov, NCT02406729.
Findings
Between November 4th, 2022 and January 16th, 2023, 700 participants were randomized and vaccinated, while 607 (86.7 %) were included in the Per-Protocol Set. From the 12 possible pairwise comparison between three lots and four serotypes of DENV, 10 met the endpoint of equivalence of lots and 2 failed marginally. The overall frequency of vaccine-related adverse events was 90.8 % (544/599) in Butantan-DV group and 76 % (76/100) in placebo group.
Interpretation
Three lots of simplified formulation were safe and achieved the endpoint of equivalence of lots.
Funding
Intramural Research Program US NIH National Institute of Allergy and Infectious Diseases, Brazilian National Bank for Economic and Social Development, and Fundação Butantan.
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