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A Study to Evaluate the Safety of MEDI8897 for the Prevention of Medically Attended Respiratory Syncytial Virus(RSV) Lower Respiratory Track Infection (LRTI) in High-risk Children

Primary Purpose

Respiratory Syncytial Virus Infections

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
MEDI8897
Palivizumab
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Respiratory Syncytial Virus Infections focused on measuring Respiratory Syncytial Virus Infections, Preterm Infants, Lower Respiratory Infection

Eligibility Criteria

0 Years - 1 Year (Child)All SexesDoes not accept healthy volunteers

Inclusion criteria

  1. For the preterm cohort (excluding subjects with CLD or hemodynamically significant CHD): preterm infants in their first year of life and born ≤ 35 weeks 0 days GA eligible to receive palivizumab in accordance with national or local guidelines, including those with:

    1. Uncomplicated small atrial or ventricular septal defects or patent ductus arteriosus, or
    2. Aortic stenosis, pulmonic stenosis, or coarctation of the aorta alone
  2. For the CLD/CHD cohort:

    1. Subjects with CLD - infants in their first year of life and a diagnosis of CLD of prematurity requiring medical intervention/management (ie, supplemental oxygen, bronchodilators, or diuretics) within the 6 months prior to randomization
    2. Subjects with CHD - infants in their first year of life and documented, hemodynamically significant CHD (must be unoperated or partially corrected CHD) Note: Infants with hemodynamically significant acyanotic cardiac lesions must have pulmonary hypertension (≥ 40 mmHg measured pressure in the pulmonary artery) or the need for daily medication to manage CHD
  3. Infants who are entering their first RSV season at the time of screening
  4. Written informed consent and any locally required authorization (eg, Health Insurance Portability and Accountability Act in the USA, EU Data Privacy Directive in the EU) obtained from the subject's parent(s)/legal representative(s) prior to performing any protocol-related procedures, including screening evaluations
  5. Subject's parent(s)/legal representative(s) able to understand and comply with the requirements of the protocol including follow-up and illness visits as judged by the investigator
  6. Subject is available to complete the follow-up period, which will be 1 year after Season 1/ Dose 1 for subjects without CLD/CHD, or 1 year after Season 2/Dose 1 (or last replacement dose as applicable for CHD) for subjects with CLD/CHD

Exclusion criteria

  1. Any fever (≥ 100.4°F [≥ 38.0°C], regardless of route) or acute illness within 7 days prior to randomization
  2. Any history of LRTI or active LRTI prior to, or at the time of, randomization
  3. Known history of RSV infection or active RSV infection prior to, or at the time of, randomization
  4. Hospitalization at the time of randomization, unless discharge is expected within the 7 days after randomization
  5. Requirement for mechanical ventilation, extracorporeal membrane oxygenation, CPAP, or other mechanical respiratory or cardiac support at the time of randomization
  6. Anticipated cardiac surgery within 2 weeks after randomization
  7. Anticipated survival of < 6 months after randomization
  8. Receipt of any investigational drug
  9. Known renal impairment
  10. Known hepatic dysfunction including known or suspected active or chronic hepatitis infection
  11. Clinically significant congenital anomaly of the respiratory tract
  12. Chronic seizure, or evolving or unstable neurologic disorder
  13. Prior history of a suspected or actual acute life-threatening event
  14. Known immunodeficiency, including human immunodeficiency virus (HIV)
  15. Mother with HIV infection (unless the child has been proven to be not infected)
  16. Any known allergy, including to immunoglobulin products, or history of allergic reaction
  17. Receipt of palivizumab or other RSV mAb or any RSV vaccine, including maternal RSV vaccination
  18. Receipt of any monoclonal or polyclonal antibody (for example, hepatitis B immune globulin, intravenous immunoglobulin) or anticipated use during the study
  19. Any condition that, in the opinion of the investigator, would interfere with evaluation of the study drug or interpretation of subject safety or study results
  20. Concurrent enrollment in another interventional study
  21. Children of employees of the sponsor, clinical study site, or any other individuals involved with the conduct of the study, or immediate family members of such individuals

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Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

MEDI8897

Palivizumab

Arm Description

anti-RSV monoclonal antibody with an extended half-life

anti-RSV monoclonal antibody

Outcomes

Primary Outcome Measures

Safety and Tolerability of MEDI8897 as Assessed by the Occurrence of All Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs) and Adverse Events of Special Interest (AESIs) and New Onset Chronic Disease (NOCD)
Safety and tolerability of MEDI8897 will be assessed by the occurrence of all treatment-emergent adverse events (TEAEs), treatment-emergent serious adverse events (TESAEs) , adverse events of special interest (AESIs), and new onset chronic diseases (NOCDs)

Secondary Outcome Measures

Serum Concentrations of MEDI8897 and Palivizumab
Summary of individual MEDI8897 and palivizumab serum concentration data by treatment group along with descriptive statistics.
Incidence of Anti-drug Antibody (ADA) to MEDI8897 and Palivizumab in Serum
Incidence of ADA to MEDI8897 and palivizumab as assessed by the percentage of participants with any post-baseline ADA positive by treatment group.
Incidence of Medically Attended Lower Respiratory Track Infection (LRTI) and Hospitalization Due to Reverse Transcriptase Chain Reaction (RT-PCR) Confirmed Respiratory Syncytial Virus (RSV) Through 150 Days Post First Dose
Incidence of medically attended LRTI (inpatient and outpatient) due to RT-PCR-confirmed RSV through 150 days after Dose 1 for season 1 and season 2. Incidence of LRTI hospitalizations due to RT-PCR-confirmed RSV through 150 days after Dose 1 for season 1 and season 2.

Full Information

First Posted
May 21, 2019
Last Updated
September 20, 2023
Sponsor
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT03959488
Brief Title
A Study to Evaluate the Safety of MEDI8897 for the Prevention of Medically Attended Respiratory Syncytial Virus(RSV) Lower Respiratory Track Infection (LRTI) in High-risk Children
Official Title
A Phase 2/3 Randomized, Double-blind, Palivizumab-controlled Study to Evaluate the Safety of MEDI8897, a Monoclonal Antibody With an Extended Half-life Against Respiratory Syncytial Virus, in High-risk Children (MEDLEY)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Completed
Study Start Date
July 30, 2019 (Actual)
Primary Completion Date
May 3, 2021 (Actual)
Study Completion Date
January 20, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and tolerability of MEDI8897 compared to palivizumab when administered to preterm infants entering their first RSV season and children with chronic lung disease (CLD) and congenital heart disease (CHD) entering their first and second RSV season.
Detailed Description
This study is a pivotal Phase 2/3 randomized, double-blind, palivizumab-controlled study to evaluate the safety, pharmacokinetics (PK), anti-drug antibody (ADA) response, and descriptive efficacy for MEDI8897 in high-risk infants eligible to receive palivizumab when entering their first or second RSV season (Season 1 or Season 2, respectively). Approximately 900 palivizumab-eligible infants entering their first RSV season will be enrolled into one of 2 cohorts: (1) preterm cohort, including approximately 600 preterm infants (≤ 35 weeks gestational age [GA]) without CLD/CHD, or (2) CLD/CHD cohort, including approximately 300 infants with CLD of prematurity or hemodynamically significant CHD. A minimum of 100 infants with hemodynamically significant CHD will be enrolled. Within each cohort, randomization will be stratified by hemisphere (northern, southern) and subject age at the time of Season 1 randomization (≤ 3 months, > 3 to ≤ 6 months, > 6 months).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Syncytial Virus Infections
Keywords
Respiratory Syncytial Virus Infections, Preterm Infants, Lower Respiratory Infection

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
925 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MEDI8897
Arm Type
Experimental
Arm Description
anti-RSV monoclonal antibody with an extended half-life
Arm Title
Palivizumab
Arm Type
Active Comparator
Arm Description
anti-RSV monoclonal antibody
Intervention Type
Drug
Intervention Name(s)
MEDI8897
Intervention Description
Anti-RSV monoclonal antibody with an extended half-life
Intervention Type
Drug
Intervention Name(s)
Palivizumab
Intervention Description
Approved anti-RSV monoclonal antibody
Primary Outcome Measure Information:
Title
Safety and Tolerability of MEDI8897 as Assessed by the Occurrence of All Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs) and Adverse Events of Special Interest (AESIs) and New Onset Chronic Disease (NOCD)
Description
Safety and tolerability of MEDI8897 will be assessed by the occurrence of all treatment-emergent adverse events (TEAEs), treatment-emergent serious adverse events (TESAEs) , adverse events of special interest (AESIs), and new onset chronic diseases (NOCDs)
Time Frame
360 days post first dose
Secondary Outcome Measure Information:
Title
Serum Concentrations of MEDI8897 and Palivizumab
Description
Summary of individual MEDI8897 and palivizumab serum concentration data by treatment group along with descriptive statistics.
Time Frame
Day 15, Day 31, Day 151 post first dose in Season 1 and Season 2
Title
Incidence of Anti-drug Antibody (ADA) to MEDI8897 and Palivizumab in Serum
Description
Incidence of ADA to MEDI8897 and palivizumab as assessed by the percentage of participants with any post-baseline ADA positive by treatment group.
Time Frame
360 days post first dose
Title
Incidence of Medically Attended Lower Respiratory Track Infection (LRTI) and Hospitalization Due to Reverse Transcriptase Chain Reaction (RT-PCR) Confirmed Respiratory Syncytial Virus (RSV) Through 150 Days Post First Dose
Description
Incidence of medically attended LRTI (inpatient and outpatient) due to RT-PCR-confirmed RSV through 150 days after Dose 1 for season 1 and season 2. Incidence of LRTI hospitalizations due to RT-PCR-confirmed RSV through 150 days after Dose 1 for season 1 and season 2.
Time Frame
150 days post first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
0 Years
Maximum Age & Unit of Time
1 Year
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria For the preterm cohort (excluding subjects with CLD or hemodynamically significant CHD): preterm infants in their first year of life and born ≤ 35 weeks 0 days GA eligible to receive palivizumab in accordance with national or local guidelines, including those with: Uncomplicated small atrial or ventricular septal defects or patent ductus arteriosus, or Aortic stenosis, pulmonic stenosis, or coarctation of the aorta alone For the CLD/CHD cohort: Subjects with CLD - infants in their first year of life and a diagnosis of CLD of prematurity requiring medical intervention/management (ie, supplemental oxygen, bronchodilators, or diuretics) within the 6 months prior to randomization Subjects with CHD - infants in their first year of life and documented, hemodynamically significant CHD (must be unoperated or partially corrected CHD) Note: Infants with hemodynamically significant acyanotic cardiac lesions must have pulmonary hypertension (≥ 40 mmHg measured pressure in the pulmonary artery) or the need for daily medication to manage CHD Infants who are entering their first RSV season at the time of screening Written informed consent and any locally required authorization (eg, Health Insurance Portability and Accountability Act in the USA, EU Data Privacy Directive in the EU) obtained from the subject's parent(s)/legal representative(s) prior to performing any protocol-related procedures, including screening evaluations Subject's parent(s)/legal representative(s) able to understand and comply with the requirements of the protocol including follow-up and illness visits as judged by the investigator Subject is available to complete the follow-up period, which will be 1 year after Season 1/ Dose 1 for subjects without CLD/CHD, or 1 year after Season 2/Dose 1 (or last replacement dose as applicable for CHD) for subjects with CLD/CHD Exclusion criteria Any fever (≥ 100.4°F [≥ 38.0°C], regardless of route) or acute illness within 7 days prior to randomization Any history of LRTI or active LRTI prior to, or at the time of, randomization Known history of RSV infection or active RSV infection prior to, or at the time of, randomization Hospitalization at the time of randomization, unless discharge is expected within the 7 days after randomization Requirement for mechanical ventilation, extracorporeal membrane oxygenation, CPAP, or other mechanical respiratory or cardiac support at the time of randomization Anticipated cardiac surgery within 2 weeks after randomization Anticipated survival of < 6 months after randomization Receipt of any investigational drug Known renal impairment Known hepatic dysfunction including known or suspected active or chronic hepatitis infection Clinically significant congenital anomaly of the respiratory tract Chronic seizure, or evolving or unstable neurologic disorder Prior history of a suspected or actual acute life-threatening event Known immunodeficiency, including human immunodeficiency virus (HIV) Mother with HIV infection (unless the child has been proven to be not infected) Any known allergy, including to immunoglobulin products, or history of allergic reaction Receipt of palivizumab or other RSV mAb or any RSV vaccine, including maternal RSV vaccination Receipt of any monoclonal or polyclonal antibody (for example, hepatitis B immune globulin, intravenous immunoglobulin) or anticipated use during the study Any condition that, in the opinion of the investigator, would interfere with evaluation of the study drug or interpretation of subject safety or study results Concurrent enrollment in another interventional study Children of employees of the sponsor, clinical study site, or any other individuals involved with the conduct of the study, or immediate family members of such individuals
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Anaheim
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California
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United States
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Long Beach
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California
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United States
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Los Angeles
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California
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United States
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National City
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California
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Paramount
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California
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United States
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West Covina
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California
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United States
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Colorado Springs
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Colorado
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Washington
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District of Columbia
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Atlanta
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Georgia
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Chicago
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Illinois
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Indianapolis
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South Bend
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West Des Moines
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Iowa
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Louisville
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Jackson
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Mississippi
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Columbia
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Mineola
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New York
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Syracuse
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New York
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Durham
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Greenville
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North Carolina
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27834
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Cincinnati
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Columbus
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Ohio
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43205
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Greenville
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South Carolina
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29607
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Corpus Christi
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Texas
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Layton
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Utah
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84041
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Saint George
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Utah
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Charlottesville
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Seattle
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Morgantown
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Graz
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8036
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Austria
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Bruxelles
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Belgium
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Gent
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9000
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Belgium
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Montana
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3400
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Bulgaria
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Pazardzhik
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4400
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Bulgaria
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Pleven
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5800
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Bulgaria
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Plovdiv
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4000
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Bulgaria
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Plovdiv
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4003
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Bulgaria
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Ruse
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7002
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Bulgaria
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Sliven
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8800
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Bulgaria
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Sofia
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1309
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Bulgaria
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Sofia
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1407
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Bulgaria
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Veliko Tarnovo
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5000
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Bulgaria
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Edmonton
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Vancouver
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British Columbia
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Praha 4
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14710
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Czechia
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Tallinn
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13419
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Estonia
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Tartu
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51014
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Estonia
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Tampere
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33100
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Finland
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Amiens Cedex 1
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80054
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France
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Bordeaux
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33000
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France
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Brest
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29609
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France
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Bron
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France
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Caen
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France
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France
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Grenoble Cedex 9
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France
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Marseille
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France
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Pau Cedex
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Frankenthal
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Germany
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Leipzig
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Germany
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Mannheim
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68161
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Germany
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Baja
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Hungary
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Budapest
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Hungary
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Debrecen
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Hungary
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Kecskemét
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Hungary
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Miskolc
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Hungary
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Pisa
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Italy
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Verona
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37126
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Italy
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Fukui-shi
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Japan
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Fukuoka-shi
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813-0017
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Japan
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Kitakyusyu-shi
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806-8501
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Japan
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Maebashi-shi
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371-0811
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Japan
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Saitama shi
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Japan
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Setagaya-ku
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Japan
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Ansan-si
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15355
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Korea, Republic of
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Seoul
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06351
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Korea, Republic of
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Suwon-si
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16499
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Korea, Republic of
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Jekabpils
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LV-5201
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Latvia
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City
Riga
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1004
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Latvia
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Riga
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LV1002
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Latvia
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Kaunas
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48259
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Lithuania
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Kaunas
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50161
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Lithuania
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Cuernavaca
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62290
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Mexico
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Mexico
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06720
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Mexico
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Christchurch
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8011
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New Zealand
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Bydgoszcz
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Poland
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Gdańsk
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80-214
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Poland
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Krakow
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31-624
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Poland
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Kraków
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30-348
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Poland
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Wrocław
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51-169
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Poland
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Kazan
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420012
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Russian Federation
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Novosibirsk
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630089
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Russian Federation
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Perm
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614066
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Russian Federation
Facility Name
Research Site
City
Saint Petersburg
ZIP/Postal Code
191025
Country
Russian Federation
Facility Name
Research Site
City
Saint Petersburg
ZIP/Postal Code
197341
Country
Russian Federation
Facility Name
Research Site
City
St Petersburg
ZIP/Postal Code
193312
Country
Russian Federation
Facility Name
Research Site
City
Yaroslavl
ZIP/Postal Code
150003
Country
Russian Federation
Facility Name
Research Site
City
Cape Town
ZIP/Postal Code
7505
Country
South Africa
Facility Name
Research Site
City
Cape Town
ZIP/Postal Code
7800
Country
South Africa
Facility Name
Research Site
City
Johannesburg
ZIP/Postal Code
2112
Country
South Africa
Facility Name
Research Site
City
Johannesburg
ZIP/Postal Code
2193
Country
South Africa
Facility Name
Research Site
City
Pretoria
ZIP/Postal Code
0087
Country
South Africa
Facility Name
Research Site
City
Pretoria
ZIP/Postal Code
0101
Country
South Africa
Facility Name
Research Site
City
Soweto
ZIP/Postal Code
2013
Country
South Africa
Facility Name
Research Site
City
Alicante
ZIP/Postal Code
03010
Country
Spain
Facility Name
Research Site
City
Boadilla del Monte
ZIP/Postal Code
28660
Country
Spain
Facility Name
Research Site
City
Elche
ZIP/Postal Code
03203
Country
Spain
Facility Name
Research Site
City
Leganes
ZIP/Postal Code
28911
Country
Spain
Facility Name
Research Site
City
Lleida
ZIP/Postal Code
25198
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Research Site
City
Malaga
ZIP/Postal Code
29004
Country
Spain
Facility Name
Research Site
City
Pozuelo de Alarcon
ZIP/Postal Code
28223
Country
Spain
Facility Name
Research Site
City
Sant Cugat del Valles
ZIP/Postal Code
08190
Country
Spain
Facility Name
Research Site
City
Tarragona
ZIP/Postal Code
43007
Country
Spain
Facility Name
Research Site
City
Stockholm
ZIP/Postal Code
118 83
Country
Sweden
Facility Name
Research Site
City
Adana
ZIP/Postal Code
01330
Country
Turkey
Facility Name
Research Site
City
Izmir
ZIP/Postal Code
35100
Country
Turkey
Facility Name
Research Site
City
Kocaeli
ZIP/Postal Code
41380
Country
Turkey
Facility Name
Research Site
City
Chernivtsі
ZIP/Postal Code
58001
Country
Ukraine
Facility Name
Research Site
City
Dnipro
ZIP/Postal Code
49006
Country
Ukraine
Facility Name
Research Site
City
Ivano-Frankivsk
ZIP/Postal Code
76014
Country
Ukraine
Facility Name
Research Site
City
Kharkiv Region
ZIP/Postal Code
61093
Country
Ukraine
Facility Name
Research Site
City
Odesa
ZIP/Postal Code
65031
Country
Ukraine
Facility Name
Research Site
City
Sumy
ZIP/Postal Code
40022
Country
Ukraine
Facility Name
Research Site
City
Vinnytsia
ZIP/Postal Code
21000
Country
Ukraine
Facility Name
Research Site
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
Research Site
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom
Facility Name
Research Site
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing Time Frame
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing Access Criteria
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing URL
https://astrazenecagroup-dt.pharmacm.com/DT/Home
Citations:
PubMed Identifier
35235733
Citation
Domachowske J, Madhi SA, Simoes EAF, Atanasova V, Cabanas F, Furuno K, Garcia-Garcia ML, Grantina I, Nguyen KA, Brooks D, Chang Y, Leach A, Takas T, Yuan Y, Griffin MP, Mankad VS, Villafana T; MEDLEY Study Group. Safety of Nirsevimab for RSV in Infants with Heart or Lung Disease or Prematurity. N Engl J Med. 2022 Mar 3;386(9):892-894. doi: 10.1056/NEJMc2112186. No abstract available.
Results Reference
derived
Links:
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&amp;parentIdentifier=D5290C00005&amp;attachmentIdentifier=7817621f-6d8e-41e6-a839-c1ccdfed21c7&amp;fileName=d5290c00005-study-synopsis.pdf&amp;versionIdentifier=
Description
CSR Synopsis
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&amp;parentIdentifier=D5290C00005&amp;attachmentIdentifier=ba02bb70-712d-4844-908a-a17816e1e918&amp;fileName=D5290C00005-Protocol.pdf&amp;versionIdentifier=
Description
MEDLEY Protocol
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&amp;parentIdentifier=D5290C00005&amp;attachmentIdentifier=1ed84f06-335c-4887-8739-15ccaa840cb3&amp;fileName=D5290C00005-SAP.pdf&amp;versionIdentifier=
Description
Statistical Analysis Plan (SAP)

Learn more about this trial

A Study to Evaluate the Safety of MEDI8897 for the Prevention of Medically Attended Respiratory Syncytial Virus(RSV) Lower Respiratory Track Infection (LRTI) in High-risk Children

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