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GARDASIL™ Study in Healthy Females Between 9 and 26 Years of Age in Sub-Saharan Africa (V501-046)

Primary Purpose

Papillomavirus Infections

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine (GARDASIL™)
Placebo
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Papillomavirus Infections focused on measuring Cervical cancer, vulvar cancer, vaginal cancer, genital warts, human papillomavirus

Eligibility Criteria

9 Years - 26 Years (Child, Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria :

  • Healthy subjects who are native to and living in a participating Sub-Saharan African country.
  • Subject agrees to provide study personnel with a primary telephone number as well as an alternate telephone number for follow-up purposes. If potential subject does not have a telephone number, the subject must provide an address at which he or she may be contacted.
  • Post-pubertal female subjects must not be pregnant
  • Subjects who are sexually active must agree to use effective contraception or remain abstinent through Month 7 of the study.
  • Subjects who have not yet had sexual intercourse must either agree to remain abstinent through Month 7 of the study, or if they become sexually active during the vaccination phase of the study, to use effective contraception through Month 7.
  • Subjects who have had sexual intercourse in the two weeks prior to enrollment must have been using effective contraception as defined above. (Emergency contraception is not considered effective contraception for enrollment in the study.)

Exclusion Criteria :

  • Subject is pregnant as determined by a positive pregnancy test
  • Subject has had a temperature ≥ 37.8 °C or ≥ 100 °F within 24 hours prior to the first injection.
  • Subject is currently enrolled in another clinical study of an investigational agent or agents.
  • Subject has a history of known prior vaccination with a HPV vaccine, or was previously enrolled in an HPV vaccine study and received either active agent or placebo.
  • Subject has received any inactivated vaccine within 14 days prior to enrollment or any live vaccine within 21 days prior to enrollment.
  • Subject has a history of severe allergic reaction to any agent (e.g., swelling of the mouth and throat, difficulty breathing, hypotension, or shock) that required medical intervention.
  • Subject has known allergy to any vaccine component, including aluminum, yeast or BENZONASE™ (nuclease, Nycomed™ [used to remove residual nucleic acids from this and other vaccines]).
  • Subject has received any immune globulin preparation or blood-derived products within the 6 months prior to the first injection, or plans to receive any such products during the course of the study.
  • Subject has a history of splenectomy, known autoimmune disorder (e.g., systemic lupus erythematosus, rheumatoid arthritis), or is receiving immunosuppressives (e.g., substances or treatments known to diminish immune response such as radiation therapy, administration of antimetabolites, antilymphocytic sera, systemic corticosteroids). Individuals who have received periodic treatments with immunosuppressives, defined as at least 3 courses of systemic corticosteroids each lasting at least 1 week in duration for the year prior to enrollment, will be excluded. Subjects using topical steroids (i.e., inhaled or nasal) will be eligible for vaccination.
  • Subject is immunocompromised or has been diagnosed as having Human Immunodeficiency Virus (HIV) infection
  • Subject has known thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections.
  • Subject has known sickle cell anemia disease, active malaria or active tuberculosis.
  • Subject has any condition which in the opinion of the investigator might interfere with the evaluation of the study objectives.
  • Subject has a history of recent or ongoing alcohol or other drug abuse.
  • Female subject has a prior history of abnormal Pap test showing squamous intraepithelial lesion (SIL), atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells, cannot rule out a high grade lesion (ASC-H), or biopsy showing cervical intraepithelial neoplasia (CIN) or worse.
  • Subject has any prior history (or at Day 1) of genital warts or treatment for genital warts.
  • Subject with >4 lifetime sexual partners.
  • Subject has undergone hysterectomy with removal of the cervix.
  • Subject plans to permanently relocate from the area prior to the completion of the study or to leave for an extended period of time when study visits would need to be scheduled.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    GARDASIL™ 9 to 12 Years Old

    GARDASIL™ 13 to 15 Years Old

    GARDASIL™ 16 to 26 Years Old

    Placebo 9 to 12 Years Old

    Arm Description

    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.

    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.

    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.

    Placebo to GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. After database lock and unblinding for study Phase A, participants will have the option to receive GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase B.

    Outcomes

    Primary Outcome Measures

    Number of Participants Who Seroconvert to Human Papillomavirus (HPV) Type 6
    Seroconversion was defined as achieving an anti-HPV Type 6 competitive Luminex Immunoassay (cLIA) level of >=20 milli Merck U/mL. The dilution-corrected limit of detection for the Type 6 cLIA was 4.2 milli Merck U/mL.
    Number of Participants Who Seroconvert to HPV Type 11
    Seroconversion was defined as achieving an anti-HPV Type 11 cLIA level of >=16 milli Merck U/mL. The dilution-corrected limit of detection for the Type 11 cLIA was 3.9 milli Merck U/mL.
    Number of Participants Who Seroconvert to HPV Type 16
    Seroconversion was defined as achieving an anti-HPV Type 16 cLIA level of >=20 milli Merck U/mL. The dilution-corrected limit of detection for the Type 16 cLIA was 9.7 milli Merck U/mL.
    Number of Participants Who Seroconvert to HPV Type 18
    Seroconversion was defined as achieving an anti-HPV Type 18 cLIA level of >=24 milli Merck U/mL. The dilution-corrected limit of detection for the Type 18 cLIA was 5.8 milli Merck U/mL.
    Number of Participants With Injection-site Adverse Experiences
    Participants were prompted to report injection-site experiences of pain, erythema, or swelling and were also asked to report any other injection-site adverse experiences
    Number of Participants With Elevated Temperature (Oral Temperature >=100 °F)
    Number of Participants With Serious Adverse Experiences
    A serious adverse experience is any adverse experience that results in death, is life threatening, results in persistent or significant disability/incapacity, results in or prolongs existing inpatient hospitalization, is a congenital anomaly/birth defect, is a cancer, is an overdose, or is another important medical event that may jeopardize the participant and may require medical or surgical intervention

    Secondary Outcome Measures

    Geometric Mean Titer (GMT) of Anti-HPV Type 6 Antibody
    Anti-HPV Type 6 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 20 milli Merck U/mL.
    GMT of Anti-HPV Type 11 Antibody
    Anti-HPV Type 11 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 16 milli Merck U/mL.
    GMT of Anti-HPV Type 16 Antibody
    Anti-HPV Type 16 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 20 milli Merck U/mL.
    GMT of Anti-HPV Type 18 Antibody
    Anti-HPV Type 18 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 24 milli Merck U/mL.

    Full Information

    First Posted
    November 19, 2010
    Last Updated
    October 19, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01245764
    Brief Title
    GARDASIL™ Study in Healthy Females Between 9 and 26 Years of Age in Sub-Saharan Africa (V501-046)
    Official Title
    Evaluation of Safety and Immunogenicity of GARDASIL™ in Healthy Females Between 9 and 26 Years of Age in SubSaharan Africa
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    March 21, 2011 (Actual)
    Primary Completion Date
    April 15, 2013 (Actual)
    Study Completion Date
    April 15, 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The study is designed to determine the safety, tolerability and immunogenicity of a 3-dose regimen of GARDASIL™ administered to healthy females between 9 and 26 years of age, in Sub-Saharan Africa. Data from the current study are needed in order to complement existing extensive safety data from the GARDASIL™ clinical trials program, and confirm that GARDASIL™ may be administered safely and will induce immune responses in populations from and living in Sub-Saharan Africa, as GARDASIL™ has not previously been studied in this region of the world.
    Detailed Description
    In Phase A of the study, healthy females between 9 and 12 years of age will be randomized (4:1) to receive the 3-dose regimen of GARDASIL™ or placebo, and those between 13 and 26 years old will receive GARDASIL™. In Phase B of the study, participants who received placebo in Phase A will have the option to receive the 3-dose regimen of GARDASIL™.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Papillomavirus Infections
    Keywords
    Cervical cancer, vulvar cancer, vaginal cancer, genital warts, human papillomavirus

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    250 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    GARDASIL™ 9 to 12 Years Old
    Arm Type
    Experimental
    Arm Description
    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.
    Arm Title
    GARDASIL™ 13 to 15 Years Old
    Arm Type
    Experimental
    Arm Description
    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.
    Arm Title
    GARDASIL™ 16 to 26 Years Old
    Arm Type
    Experimental
    Arm Description
    GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. Participants will not continue to study Phase B.
    Arm Title
    Placebo 9 to 12 Years Old
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo to GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase A. After database lock and unblinding for study Phase A, participants will have the option to receive GARDASIL™ 0.5 mL injection at the Day 1, Month 2, and Month 6 visits in study Phase B.
    Intervention Type
    Biological
    Intervention Name(s)
    Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine (GARDASIL™)
    Intervention Type
    Biological
    Intervention Name(s)
    Placebo
    Primary Outcome Measure Information:
    Title
    Number of Participants Who Seroconvert to Human Papillomavirus (HPV) Type 6
    Description
    Seroconversion was defined as achieving an anti-HPV Type 6 competitive Luminex Immunoassay (cLIA) level of >=20 milli Merck U/mL. The dilution-corrected limit of detection for the Type 6 cLIA was 4.2 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    Number of Participants Who Seroconvert to HPV Type 11
    Description
    Seroconversion was defined as achieving an anti-HPV Type 11 cLIA level of >=16 milli Merck U/mL. The dilution-corrected limit of detection for the Type 11 cLIA was 3.9 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    Number of Participants Who Seroconvert to HPV Type 16
    Description
    Seroconversion was defined as achieving an anti-HPV Type 16 cLIA level of >=20 milli Merck U/mL. The dilution-corrected limit of detection for the Type 16 cLIA was 9.7 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    Number of Participants Who Seroconvert to HPV Type 18
    Description
    Seroconversion was defined as achieving an anti-HPV Type 18 cLIA level of >=24 milli Merck U/mL. The dilution-corrected limit of detection for the Type 18 cLIA was 5.8 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    Number of Participants With Injection-site Adverse Experiences
    Description
    Participants were prompted to report injection-site experiences of pain, erythema, or swelling and were also asked to report any other injection-site adverse experiences
    Time Frame
    Up to Day 5 after any vaccination in study Phase A
    Title
    Number of Participants With Elevated Temperature (Oral Temperature >=100 °F)
    Time Frame
    Up to Day 5 after any vaccination in study Phase A
    Title
    Number of Participants With Serious Adverse Experiences
    Description
    A serious adverse experience is any adverse experience that results in death, is life threatening, results in persistent or significant disability/incapacity, results in or prolongs existing inpatient hospitalization, is a congenital anomaly/birth defect, is a cancer, is an overdose, or is another important medical event that may jeopardize the participant and may require medical or surgical intervention
    Time Frame
    From the time of informed consent is signed through the last study visit (up to 19 months)
    Secondary Outcome Measure Information:
    Title
    Geometric Mean Titer (GMT) of Anti-HPV Type 6 Antibody
    Description
    Anti-HPV Type 6 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 20 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    GMT of Anti-HPV Type 11 Antibody
    Description
    Anti-HPV Type 11 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 16 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    GMT of Anti-HPV Type 16 Antibody
    Description
    Anti-HPV Type 16 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 20 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)
    Title
    GMT of Anti-HPV Type 18 Antibody
    Description
    Anti-HPV Type 18 antibodies were measured by cLIA. The seropositive cut-off threshold for this assay is defined as 24 milli Merck U/mL.
    Time Frame
    Month 7 (1 month postdose 3 in study Phase A)

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    9 Years
    Maximum Age & Unit of Time
    26 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria : Healthy subjects who are native to and living in a participating Sub-Saharan African country. Subject agrees to provide study personnel with a primary telephone number as well as an alternate telephone number for follow-up purposes. If potential subject does not have a telephone number, the subject must provide an address at which he or she may be contacted. Post-pubertal female subjects must not be pregnant Subjects who are sexually active must agree to use effective contraception or remain abstinent through Month 7 of the study. Subjects who have not yet had sexual intercourse must either agree to remain abstinent through Month 7 of the study, or if they become sexually active during the vaccination phase of the study, to use effective contraception through Month 7. Subjects who have had sexual intercourse in the two weeks prior to enrollment must have been using effective contraception as defined above. (Emergency contraception is not considered effective contraception for enrollment in the study.) Exclusion Criteria : Subject is pregnant as determined by a positive pregnancy test Subject has had a temperature ≥ 37.8 °C or ≥ 100 °F within 24 hours prior to the first injection. Subject is currently enrolled in another clinical study of an investigational agent or agents. Subject has a history of known prior vaccination with a HPV vaccine, or was previously enrolled in an HPV vaccine study and received either active agent or placebo. Subject has received any inactivated vaccine within 14 days prior to enrollment or any live vaccine within 21 days prior to enrollment. Subject has a history of severe allergic reaction to any agent (e.g., swelling of the mouth and throat, difficulty breathing, hypotension, or shock) that required medical intervention. Subject has known allergy to any vaccine component, including aluminum, yeast or BENZONASE™ (nuclease, Nycomed™ [used to remove residual nucleic acids from this and other vaccines]). Subject has received any immune globulin preparation or blood-derived products within the 6 months prior to the first injection, or plans to receive any such products during the course of the study. Subject has a history of splenectomy, known autoimmune disorder (e.g., systemic lupus erythematosus, rheumatoid arthritis), or is receiving immunosuppressives (e.g., substances or treatments known to diminish immune response such as radiation therapy, administration of antimetabolites, antilymphocytic sera, systemic corticosteroids). Individuals who have received periodic treatments with immunosuppressives, defined as at least 3 courses of systemic corticosteroids each lasting at least 1 week in duration for the year prior to enrollment, will be excluded. Subjects using topical steroids (i.e., inhaled or nasal) will be eligible for vaccination. Subject is immunocompromised or has been diagnosed as having Human Immunodeficiency Virus (HIV) infection Subject has known thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections. Subject has known sickle cell anemia disease, active malaria or active tuberculosis. Subject has any condition which in the opinion of the investigator might interfere with the evaluation of the study objectives. Subject has a history of recent or ongoing alcohol or other drug abuse. Female subject has a prior history of abnormal Pap test showing squamous intraepithelial lesion (SIL), atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells, cannot rule out a high grade lesion (ASC-H), or biopsy showing cervical intraepithelial neoplasia (CIN) or worse. Subject has any prior history (or at Day 1) of genital warts or treatment for genital warts. Subject with >4 lifetime sexual partners. Subject has undergone hysterectomy with removal of the cervix. Subject plans to permanently relocate from the area prior to the completion of the study or to leave for an extended period of time when study visits would need to be scheduled.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    25912475
    Citation
    Mugo N, Ansah NA, Marino D, Saah A, Garner EI. Evaluation of safety and immunogenicity of a quadrivalent human papillomavirus vaccine in healthy females between 9 and 26 years of age in Sub-Saharan Africa. Hum Vaccin Immunother. 2015;11(6):1323-30. doi: 10.1080/21645515.2015.1008877.
    Results Reference
    result
    Available IPD and Supporting Information:
    Available IPD/Information Type
    CSR Synopsis
    Available IPD/Information URL
    http://www.merck.com/clinical-trials/study.html?id=V501-046&kw=V501-046&tab=access

    Learn more about this trial

    GARDASIL™ Study in Healthy Females Between 9 and 26 Years of Age in Sub-Saharan Africa (V501-046)

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