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This is a phase III, randomized, controlled, open label study with two vaccine regimens. The study will assess the relative safety and immunogenicity of vaccine regimens comparing adjuvanted versus non-adjuvanted formulations of A(H1N1) inactivated influenza virus vaccine in subjects with Chronic Pulmonary Disease, Chronic Heart Disease, or Diabetes Mellitus, and to compare safety and immunogenicity data with a contemporaneously enrolled control group of age-comparable, healthy subjects.
Because certain individuals may be hypo-responsive to influenza vaccination, additional studies with high-risk groups are warranted in order to determine the optimal vaccine formulation and dosing schedule for prevention of novel H1N1 virus infection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chronic Disease Subjects Receiving Vaccine with Adjuvant | Experimental | Each subject received two doses of vaccine with adjuvant (Focetria® or Fluad®), the first on Study Day 1, and the second on Study Day 22. |
|
| Chronic Disease Subjects Receiving Vaccine without Adjuvant | Experimental | Each subject received two doses of vaccine without adjuvant (Begrivac®), the first on Study Day 1, and the second on Study Day 22. |
|
| Healthy Subjects Receiving Vaccine with Adjuvant | Experimental | Each subject received two doses of vaccine with adjuvant (Focetria® or Flaud®), the first on Study Day 1, and the second on Study Day 22. |
|
| Healthy Subjects Receiving Vaccine without Adjuvant | Experimental | Each subject received two doses of vaccine without adjuvant (Begrivac®), the first on Study Day 1, and the second on Study Day 22. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Focetria® | Biological | 7.5 ug of HA antigen; adjuvanted; monovalent |
|
| Measure | Description | Time Frame |
|---|---|---|
| Geometric Mean HI Titer by Visit | Geometric mean hemagglutinin inhibition (HI) titer = GMT | 13 months after vaccination (Day 1, Day 22, Day 43, Day 133, Day 223 and Day 403) |
| Geometric Mean Ratio by Visit | The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). | 13 months after vaccination (Day 22/Day1, Day 43/Day 1, Day 43/Day 22, Day 133/Day 43, Day 223/Day 43 and Day 403/Day 223) |
| Ratio of Immunogenicity Data by Visit (Vaccine With Adjuvant : Vaccine Without Adjuvant) | The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). Comparisons were made by vaccine group using ratios of immunogenicity data and were presented with 95% confidence intervals. | 13 months after vaccination (Day 1, Day 22, Day 22/Day1, Day 43, Day 43/Day 1, Day 43/Day 22, Day 133, Day 133/Day 43, Day 223, Day 223/Day 43 and Day 403, Day 403/Day 223) |
| Percentage of Subjects Who Reached Seroprotection by Visit | The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). The percentage of subjects that reached seroprotection in comparison to the pre-vaccination result are presented by visit. Seroprotection was defined as HI titer ≥40. | 13 months after vaccination (Day 22, Day 43, Day 133, Day 223 and Day 403) |
| Percent of Subjects Who Seroconverted or Had a Significant Increase in Geometric Mean Titer by Visit |
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Inclusion Criteria:
For Subjects with Chronic Diseases:
Subjects between 18 and 70 years of age (inclusive)
Any sex or ethnicity
Outpatient or hospitalized subjects
Confirmed diagnosis of chronic pulmonary and/or cardiac, and/or diabetes mellitus based on the investigator's assessment (subjects may present one or more of such conditions)
Childbearing potential women must be willing to use an acceptable contraceptive method. Acceptable contraceptive methods are defined as one or more of the following:
Subjects capable of following all the study procedures and available for all visits scheduled to the investigation site
Subjects capable of understanding the nature and risk of the study proposed and sign the consent form
The study subjects may have other underlying chronic diseases that do not involve immunosuppression (e.g. osteoarticular diseases, stable, non-progressive, non-severe neurologic disorders without cognitive impairment, ophthalmologic diseases, hypothyroidism, etc.), but their symptoms/signs must be under control through medical follow-ups and drug therapy
For Healthy Subjects:
Subjects between 18 and 70 years of age (inclusive)
Any sex and ethnicity
Subjects with good health as determined by medical history, physical evaluation, and investigator's clinical opinion
Childbearing potential women must be willing to use an acceptable contraceptive method. Acceptable contraceptive methods are defined as one or more of the following:
Subjects capable of respecting all the study procedures and available for all the visits scheduled at the investigation site
Subjects capable of understanding the nature and risk of the study proposed and sign the consent form
Exclusion Criteria:
For Subjects with Chronic Diseases
For Healthy Subjects:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centro de Estudos de Pneumologia da Faculdade de Medicina do ABC | Santo André | São Paulo | Brazil | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19815860 | Background | ANZIC Influenza Investigators; Webb SA, Pettila V, Seppelt I, Bellomo R, Bailey M, Cooper DJ, Cretikos M, Davies AR, Finfer S, Harrigan PW, Hart GK, Howe B, Iredell JR, McArthur C, Mitchell I, Morrison S, Nichol AD, Paterson DL, Peake S, Richards B, Stephens D, Turner A, Yung M. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009 Nov 12;361(20):1925-34. doi: 10.1056/NEJMoa0908481. Epub 2009 Oct 8. | |
| Background | Bridges CB, Katz JM, Levandowski RA, Cox NJ. Inactivated influenza vaccines. In. Plotkin SA, Orenstein WA, Offit PA. Vaccines 5th ed. WB Saunders. Phila PA 2008; 291-309 | ||
| 19745215 |
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| Fluad® | Biological | 15 ug of HA antigen; adjuvanted; trivalent |
|
| Begrivac® | Biological | 15 ug of antigen; non-adjuvanted; trivalent |
|
The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). The percentage of subjects that reached seroconversion or had a significant increase in comparison to the pre-vaccination result were presented by visit. Seroconversion or a significant increase was defined as HI titer ≥40 in subjects with negative results at pre-vaccination (HI titer <10) or an increase of at least 4 times in HI titer for individuals with positive results at pre-vaccination (HI titer >10) at Day 22 and Day 43 in comparison to the pre-vaccination result.
| 13 Months after vaccination (Day 22, Day 43, Day 133, Day 223 and Day 403) |
| Difference in the Seroprotection Rates by Visit (Vaccine With Adjuvant - Vaccine Without Adjuvant) | The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). Comparisons were made by vaccine group using differences in the percentage of subjects with seroprotection and were presented with 95% confidence intervals. | 13 Months after vaccination (Day 22, Day 43, Day 133, Day 223 and Day 403) |
| Differences in the Seroconversion Rates or Significant Increase by Visit (Vaccine With Adjuvant - Vaccine Without Adjuvant) | The primary objective of this study is to determine the optimal influenza vaccination strategy in patients with chronic diseases (chronic cardiac diseases, chronic pulmonary diseases and diabetes mellitus). Comparisons were made by vaccine group using differences in the percentage of subjects with seroconversion/significant increase and were presented with 95% confidence intervals. | 13 Months after vaccination (Day 22, Day 43, Day 133, Day 223 and Day 403) |
| Instituto de Ensino e Pesquisa em Geriatria e Gerontologia |
| São Paulo |
| São Paulo |
| Brazil |
| Background |
| Clark TW, Pareek M, Hoschler K, Dillon H, Nicholson KG, Groth N, Stephenson I. Trial of 2009 influenza A (H1N1) monovalent MF59-adjuvanted vaccine. N Engl J Med. 2009 Dec 17;361(25):2424-35. doi: 10.1056/NEJMoa0907650. Epub 2009 Sep 10. |
| 19423869 | Background | Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team; Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009 Jun 18;360(25):2605-15. doi: 10.1056/NEJMoa0903810. Epub 2009 May 7. |
| 19822626 | Background | Dominguez-Cherit G, Lapinsky SE, Macias AE, Pinto R, Espinosa-Perez L, de la Torre A, Poblano-Morales M, Baltazar-Torres JA, Bautista E, Martinez A, Martinez MA, Rivero E, Valdez R, Ruiz-Palacios G, Hernandez M, Stewart TE, Fowler RA. Critically Ill patients with 2009 influenza A(H1N1) in Mexico. JAMA. 2009 Nov 4;302(17):1880-7. doi: 10.1001/jama.2009.1536. Epub 2009 Oct 12. |
| 19815859 | Background | Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, Sugerman DE, Druckenmiller JK, Ritger KA, Chugh R, Jasuja S, Deutscher M, Chen S, Walker JD, Duchin JS, Lett S, Soliva S, Wells EV, Swerdlow D, Uyeki TM, Fiore AE, Olsen SJ, Fry AM, Bridges CB, Finelli L; 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med. 2009 Nov 12;361(20):1935-44. doi: 10.1056/NEJMoa0906695. Epub 2009 Oct 8. |
| 19822627 | Background | Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA; Canadian Critical Care Trials Group H1N1 Collaborative. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA. 2009 Nov 4;302(17):1872-9. doi: 10.1001/jama.2009.1496. Epub 2009 Oct 12. |
| 19712643 | Background | Vaillant L, La Ruche G, Tarantola A, Barboza P; epidemic intelligence team at InVS. Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill. 2009 Aug 20;14(33):19309. doi: 10.2807/ese.14.33.19309-en. |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D008171 | Lung Diseases |
| D006331 | Heart Diseases |
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D012140 | Respiratory Tract Diseases |
| D002318 | Cardiovascular Diseases |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
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| ID | Term |
|---|---|
| C558220 | focetria |
| C478243 | fluad vaccine |
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