Inicio | SOBERANA 02-FaseIII
30 Octubre 2021 - 1:03pm por FINLAY23 Junio 2022 - 5:35pm por FINLAY

Final analysis were included.

Cambios a Authorization date
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2021-03-03 00:00:00
Cambios a Recruitment status
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Pending
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Complete
Cambios a Data sharing plan
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No
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Yes
Cambios a Date of first enrollment
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2021-03-05 00:00:00
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2021-03-08 00:00:00
Cambios a Description of Data Sharing Plan
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The protocol and other supporting clinical documents, including statistical analysis plan, informed consent and the interim and final reports will be available after publication in specialized journals.
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Any additional interest should be be sent to: mariaeugenia@ipk.sld.cu or vicente.verez@finlay.edu.cu.
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These proposals must be reviewed and approved by the sponsor and investigator. Finally, data access agreement must be signed.
Cambios a URL for additional information
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https://www.finlay.edu.cu/blog/category/sala-cientifica/
Cambios a Final enrolment number
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44031
Cambios a Record Verification Date
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2021/10/30
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2022/06/23
Cambios a Next update date
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2022/10/30
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2023/06/23
Cambios a Participant flow
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Between 3/4/21 and 03/31/2021, 45 184 subjects were evaluated, including 44 031 (97.4%); in Placebo Group: 14,675, Experimental Group 1 (two doses): 14,679, Experimental Group: 2 (three doses heterologous schedule): 14,677.
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Subjects not included 1,153 , in general, the main causes of non-inclusion were: No inclusion criteria: 41, Non-voluntary: 191, Exclusion criteria: 766, Other causes: 15
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The 44031 subjects included in the ITT population received the first dose of the planned scheme in the protocol, which represents 100%. Of these, 43,268 received the first two doses of the schedule provided for in the protocol, which represents 98.3% of the total included, and from the 3-dose schedule, a total of 13,979 subjects (95.2%) received the 3 planned doses.
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Placebo group: 14,675, included in efficacy analysis: 13,070
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2-dose group: 14,679, included in efficacy analysis: 12,610
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3-dose group: 14,677, included in efficacy analysis: 13,843
Cambios a Baseline characteristics
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The demographic and baseline characteristics of the entire included sample are summarized. The median age in the 3 groups was 50 years; with a slight predominance of the female sex (52%), 59% were white-skinned and 41% had some comorbidity, being arterial hypertension with 31%, Diabetes Mellitus with 8.3% and Bronchial Asthma with a 6.6% the most frequent. In relation to the distribution of subjects by strata, those older than or equal to 65 years old represent 18%, in accordance with what was planned in the protocol and representative of that age in the selected municipalities, those under 65 years old without comorbidity 54%, and those under 65 years of age with comorbidity 54%. For COVID-19, 22 subjects were PCR positive at baseline for 0.1% of all subjects, with a percentage distribution of less than 0.1% in each of the treatment groups. 133 subjects had a positive antigen test that represented 0.3%, with similar behavior between groups.
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Cambios a Outcome measures
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Primary efficacy variable:
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Vaccine efficacy against symptomatic disease was 69.7% in treatment group 2 (two doses of FINLAY-FR-2 (0-28 d)), and 92.0% in group 3 (FINLAY-FR-2 (0 -28 d) + FINLAY-FR-1A (56 d)). The lower limits of the 95% CI are greater than 55% in both treatments, rejecting the null hypothesis H0: EV* ≤ 30% with a type 1 error probability p<0.001.
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Secondary efficacy variable:
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- Efficacy against severe disease and death 28 subjects with severe disease were observed from 14 days after the end of each regimen, which represents 0.07% of the PP population. The percentages of subjects with severe systemic disease were higher in subjects in the placebo group (82%) compared to the 2-dose group (18% and 0% for the 2- and 3-dose schedules, respectively), in this category. no subjects with 3 doses. The efficacy in the prevention of severe systemic disease is 74.9% for the 2-dose schedule and 100% for the 3-dose schedule (6 cases in the placebo group during the comparison period with the 3-dose schedule), with very wide confidence intervals, given the small number of cases. Eight intensive care unit hospitalizations occurred (ICU: 6, 2, 0 in the 2-dose and 3-dose placebo groups).
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-Efficacy in preventing severe disease leading to ICU hospitalization was 63.6% (95% CI: 103.5, 96.4) for the 2-dose schedule and 100% for the 3-dose schedule. The frequency of deaths due to complications of COVID-19 in the subjects who fell ill 14 days after completion of each regimen was 5 subjects, of whom 3 were in the placebo group and 2 in the two-week treatment group. dose. During the observation period for the efficacy of 3 doses, there were no deceased subjects in either the placebo group or the 3-dose schedule. Of the 5 deceased, 2 were older than 65 years and 3 were younger than 65 years with associated comorbidities, all 3 referred hypertension, and 1 of them diabetes mellitus and obesity. Given the small number of cases in the 3 groups, it is not considered reasonable to estimate the efficacy for this variable.
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Efficacy against infection: The frequency of subjects reported with SARS-Cov-2 infection is shown in Table 21. 423 PCR-positive subjects were observed, representing 0.99% of the PP population. The percentages of infected subjects were higher in subjects in the placebo group (50%) compared to the group vaccinated with 2 and 3 doses (37 and 13%), respectively. This is also reflected in each stratum separately. Efficacy in preventing infection in the PP population in the stratified Cox regression model, a reduction in the risk of infection greater than 65% compared to the Placebo group is obtained for treatment with 3 doses
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Cambios a Adverse events
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For the analysis of the adverse events, 44 031 subjects were included, of whom 5 225 reported at least one adverse event (11.9%), more frequently in the groups treated with the vaccine, with a total of 8 465 adverse events, of which they were mild. 90.4% and only 2.4% were classified as severe (4.0%, 2.1%, and 1.9% in the placebo, 2-dose, and 3-dose groups, respectively).
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- 90.8% of the events were consistent with vaccination (more than 70% classified as A1) and 66.3% of the requested type, although only 49.6% in the placebo group.
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- 98.2% were completely recovered - The number of events decreased with the number of doses up to 0.3% with the third.
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- Local events predominate, accounting for 52% of all events, with pain being the most frequent with 3,192 reports (37.7% of all reported events).
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Solicited local adverse events occurred more frequently in the vaccine group than in the placebo group after the first dose (7.7% vs. 2.6%) and the second dose (1.9% vs. 0. 44%). After the third dose, the frequency of subjects with local AEs was reduced to 0.3%. In the vaccinated groups (treatment 2 and treatment 3), local adverse events were predominantly grade 1 (97.5% were of mild intensity) and lasted a median of 2 days after the first, second, and third doses. The most common local AE was pain at the injection site (2.6% vs. 8.2% in placebo and vaccine, respectively). There were 5 serious adverse events consistent with vaccination (<0.1% in each group), 3 in the placebo group (abdominal pain, hypertension, and anaphylactic shock: abdominal pain was disabling, hypertension required hospitalization, and life-threatening anaphylactic shock). life); 1 event of precordial pain after the 1st dose of FINLAY-FR-2 that required hospitalization and one event of cutaneous paresthesia after the 1st dose of FINLAY-FR-2, which also required hospitalization. All of these events were resolved; only anaphylactic shock was classified with type A1 causality. There were 54 grade 3 (severe) systemic events consistent with vaccination in 51 subjects (17, 15, and 19 subjects in the placebo, 2-dose, and 3-dose groups, respectively) and 11 local events in 48 subjects and 11 in placebo groups. local type in 8 subjects (1, 3, and 4 subjects in the placebo, 2-dose, and 3-dose groups, respectively). .
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Cambios a Summary study
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SAFETY RESULTS: The vaccine candidate was generally found to be safe and well tolerated. There was a predominance of local events, with pain being the most frequent, the events generally lasting between 1 to 3 days and the frequency of their appearance decreased in the second and third injections. EFFICACY RESULTS: The per-protocol population efficacy analysis of the FINLAY-FR-2 vaccine candidate based on a randomized, blinded, placebo-controlled trial that included 42,511 subjects from the total study population (44,031), shows a overall efficacy for the prevention of symptomatic disease of 69.7% (95% CI 56.5-78.9) for the two-dose scheme; 92.0% (95% CI 80.4–96.7%) for the three-dose heterologous schedule, considering the analysis performed with respect to the Placebo group from 14 days after completion of the 2-dose vaccination schedule (for the efficacy analysis of 2 dose) and from 42 days after completion of the 2-dose vaccination schedule (for the placebo group in the 3-dose efficacy analysis) to ensure concurrent comparison. Efficacy estimation was also performed according to the analysis originally planned in the protocol, in which the placebo observation period started from 14 days after the 2nd dose (for the efficacy of both schemes) so it was not exactly concurrent with the observation period of the 3-dose schedule. The estimate based on this planned analysis shows that the efficacy of the 2-dose schedule is 70.7% (95% CI: 58.8; 79.1) and 92.4% (95% CI: 86.9-95.6) for the 3-dose schedule. Additionally, and before the appearance of intercurrent events, efficacy was estimated using a synthetic placebo group (based on the incidence of the municipalities where the CT was performed) and this estimate was consistent with the demonstrated clinical efficacy. Efficacy in preventing severe disease is 74.9% (95% CI 33.7-90.5) for the two-dose schedule of the FINLAY-FR-2 candidate, and 63.6% for avoiding hospitalization in intensive care units. In both cases, the efficacy is 100% after completion of the 3-dose heterologous regimen.
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CONCLUSIONS: This report shows that the FINLAY-FR-2 vaccine candidate was safe and well tolerated, the most frequent adverse event was local pain. The FINLAY-FR-2 vaccine candidate in a two-dose schedule achieved a clinical efficacy of 69.7% in the prevention of symptomatic disease, which increases to 92.0% when the third heterologous dose with FINLAY-FR1A is administered. In both schemes, the efficacy in the prevention of symptomatic disease is higher than what was proposed in the study hypothesis (60%) and the 50% established as the minimum criterion according to the World Health Organization (7) to validate its emergency use in the current COVID-19 pandemic.
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Revisión de 23 Junio 2022 - 5:35pm