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Co-administration of human papillomavirus-16/18 AS04-adjuvanted vaccine with hepatitis B vaccine: randomized study in healthy girls
Authors:Schmeink Channa E  Bekkers Ruud L M  Josefsson Ann  Richardus Jan H  Berndtsson Blom Katarina  David Marie-Pierre  Dobbelaere Kurt  Descamps Dominique
Affiliation:a Department of Obstetrics/Gynecology 791, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
b Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
c Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, Rotterdam 3011 EN, Netherlands
d Ladulaas Kliniska Studier, Industrigatan 2, SE-511 62 Skene, Sweden
e GlaxoSmithKline Biologicals, Wavre, Belgium
Abstract:

Background

To evaluate co-administration of GlaxoSmithKline Biologicals’ human papillomavirus-16/18 AS04-adjuvanted vaccine (HPV) and hepatitis B vaccine (HepB).

Methods

This was a randomized, controlled, open, multicenter study. Healthy girls, aged 9-15 years, were randomized to receive HPV (n = 247), HepB (n = 247) or HPV co-administered with HepB (HPV + HepB; n = 247) at Months 0, 1 and 6. Antibodies against hepatitis B surface antigen (HBs), HPV-16 and HPV-18 were measured, and reactogenicity and safety monitored. Co-primary objectives were to demonstrate non-inferiority of hepatitis B and HPV-16/18 immune responses at Month 7 for co-administered vaccines, compared with vaccines administered alone, in the according-to-protocol cohort.

Results

The pre-defined criteria for non-inferiority were met for all co-primary immunogenicity endpoints at Month 7. Anti-HBs seroprotection rates ≥10 mIU/mL were achieved by 97.9% and 100% of girls, respectively, following co-administration or HepB alone. Anti-HBs geometric mean titers (GMTs) (95% confidence interval) were 1280.9 (973.3-1685.7) and 3107.7 (2473.1-3905.1) milli-international units/mL, respectively. Anti-HPV-16 and -18 seroconversion rates were achieved by ≥99% of girls following co-administration or HPV alone. Anti-HPV-16 GMTs were 19819.8 (16856.9-23303.6) and 21712.6 (19460.2-24225.6) ELISA units (ELU)/mL, respectively. Anti-HPV-18 GMTs were 8835.1 (7636.3-10222.1) and 8838.6 (7948.5-9828.4) ELU/mL, respectively. Co-administration was generally well tolerated.

Conclusions

The study results support the co-administration of HPV-16/18 AS04-adjuvanted vaccine with hepatitis B vaccine in adolescent girls aged 9-15 years.

Clinical trials registration

ClinicalTrials.gov registration number NCT00652938.
Keywords:Anti-HBs, antibody to hepatitis B surface antigen   Anti-HBc, antibody to hepatitis B core antigen   AS04, GlaxoSmithKline Biologicals&rsquo   proprietary adjuvant system (containing aluminium hydroxide and 3-O-desacyl-4&prime  -monophosphoryl lipid A)   ATP, according-to-protocol   ELISA, enzyme-linked immunosorbent assay   ELU, enzyme-linked immunosorbent assay units   HepB, hepatitis B vaccine   HPV, human papillomavirus (vaccine)   GMT, geometric mean antibody titer   mIU, milli-international units   SAE, serious adverse event
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