A Phase IIa Controlled Human Malaria Infection and Immunogenicity Study of RTS,S/AS01E and RTS,S/AS01B Delayed Fractional Dose Regimens in Malaria-Naive …
JE Moon, C Ockenhouse, JA Regules… - The Journal of …, 2020 - academic.oup.com
The Journal of Infectious Diseases, 2020•academic.oup.com
Abstract Background A previous RTS, S/AS01B vaccine challenge trial demonstrated that a
3-dose (0-1-7–month) regimen with a fractional third dose can produce high vaccine efficacy
(VE) in adults challenged 3 weeks after vaccination. This study explored the VE of different
delayed fractional dose regimens of adult and pediatric RTS, S/AS01 formulations. Methods
A total of 130 participants were randomized into 5 groups. Four groups received 3 doses of
RTS, S/AS01B or RTS, S/AS01E on a 0-1-7–month schedule, with the final 1 or 2 doses …
3-dose (0-1-7–month) regimen with a fractional third dose can produce high vaccine efficacy
(VE) in adults challenged 3 weeks after vaccination. This study explored the VE of different
delayed fractional dose regimens of adult and pediatric RTS, S/AS01 formulations. Methods
A total of 130 participants were randomized into 5 groups. Four groups received 3 doses of
RTS, S/AS01B or RTS, S/AS01E on a 0-1-7–month schedule, with the final 1 or 2 doses …
Background
A previous RTS,S/AS01B vaccine challenge trial demonstrated that a 3-dose (0-1-7–month) regimen with a fractional third dose can produce high vaccine efficacy (VE) in adults challenged 3 weeks after vaccination. This study explored the VE of different delayed fractional dose regimens of adult and pediatric RTS,S/AS01 formulations.
Methods
A total of 130 participants were randomized into 5 groups. Four groups received 3 doses of RTS,S/AS01B or RTS,S/AS01E on a 0-1-7–month schedule, with the final 1 or 2 doses being fractional (one-fifth dose volume). One group received 1 full (month 0) and 1 fractional (month 7) dose of RTS,S/AS01E. Immunized and unvaccinated control participants underwent Plasmodium falciparum–infected mosquito challenge (controlled human malaria infection) 3 months after immunization, a timing chosen to potentially discriminate VEs between groups.
Results
The VE of 3-dose formulations ranged from 55% (95% confidence interval, 27%–72%) to 76% (48%–89%). Groups administered equivalent formulations of RTS,S/AS01E and RTS,S/AS01B demonstrated comparable VE. The 2-dose group demonstrated lower VE (29% [95% confidence interval, 6%–46%]). All regimens were well tolerated and immunogenic, with trends toward higher anti-circumsporozoite antibody titers in participants protected against infection.
Conclusions
RTS,S/AS01E can provide VE comparable to an equivalent RTS,S/AS01B regimen in adults, suggesting a universal formulation may be considered. Results also suggest that the 2-dose regimen is inferior to the 3-dose regimens evaluated.
Clinical Trial Registration
NCT03162614
Oxford University Press