First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children.

RTS,S Clinical Trials Partnership; Selidji TodagbeAgnandji; BertrandLell; Solange SolmeheimSoulanoudjingar; José FranciscoFernandes; Béatrice PeggyAbossolo; CorneliaConzelmann; Barbara Gaelle Nfono OndoMethogo; YannickDoucka; ArnaudFlamen; +132 more... BenjaminMordmüller; SaadouIssifou; Peter GottfriedKremsner; JahitSacarlal; PedroAide; MiguelLanaspa; John JAponte; ArlindoNhamuave; DianaQuelhas; QuiqueBassat; SofiaMandjate; EusébioMacete; PedroAlonso; SalimAbdulla; NahyaSalim; OmarJuma; MwanajaaShomari; KafurukiShubis; FranciscaMachera; Ali SaidHamad; RoseMinja; AliMtoro; AlmaSykes; SaumuAhmed; Alwisa MartinUrassa; Ali MohammedAli; GraceMwangoka; MarcelTanner; HalidouTinto; Umberto D'Alessandro ORCID logo; HermannSorgho; InnocentValea; Marc ChristianTahita; WilliamKaboré; SayoubaOuédraogo; YaraSandrine; Robert TingaGuiguemdé; Jean BoscoOuédraogo; Mary JHamel; SimonKariuki; ChrisOdero; MartinaOneko; KephasOtieno; NorbertAwino; JacktonOmoto; JohnWilliamson; VincentMuturi-Kioi; Kayla FLaserson; LaurenceSlutsker; WalterOtieno; LucasOtieno; OtsyulaNekoye; StaceyGondi; AllanOtieno; BernhardsOgutu; RuthWasuna; VictorineOwira; DavidJones; Agnes AkothOnyango; PatriciaNjuguna; RomaChilengi; PaulineAkoo; ChristineKerubo; JesseGitaka; CharityMaingi; TrudieLang; AllyOlotu; BenjaminTsofa; PhilipBejon; NorbertPeshu; KevinMarsh; SethOwusu-Agyei; Kwaku PokuAsante; KingsleyOsei-Kwakye; OwusuBoahen; SamuelAyamba; KingsleyKayan; RuthOwusu-Ofori; David Dosoo ORCID logo; IsaacAsante; GeorgeAdjei; GeorgeAdjei; Daniel Chandramohan ORCID logo; Brian Greenwood ORCID logo; JohnLusingu; SamwelGesase; AnangisyeMalabeja; OmariAbdul; HassanKilavo; ColineMahende; EdwinLiheluka; MarthaLemnge; ThorTheander; Chris Drakeley ORCID logo; DanielAnsong; TsiriAgbenyega; SamuelAdjei; Harry OwusuBoateng; TheresaRettig; JohnBawa; JusticeSylverken; DavidSambian; AlexAgyekum; LarkoOwusu; FrancisMartinson; IrvingHoffman; TisunganeMvalo; PortiaKamthunzi; RuthendoNkomo; AlbansMsika; AllanJumbe; NelecyChome; DalitsoNyakuipa; JosephChintedza; W RipleyBallou; MyriamBruls; JoeCohen; YolandaGuerra; ErikJongert; DidierLapierre; AmandaLeach; MarcLievens; OpokuaOfori-Anyinam; JohanVekemans; TerrellCarter; DidierLeboulleux; ChristianLoucq; AfiyaRadford; BarbaraSavarese; David Schellenberg ORCID logo; MarlaSillman; PreetiVansadia; (2011) First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children. The New England journal of medicine, 365 (20). pp. 1863-1875. ISSN 0028-4793 DOI: 10.1056/NEJMoa1102287
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BACKGROUND: An ongoing phase 3 study of the efficacy, safety, and immunogenicity of candidate malaria vaccine RTS,S/AS01 is being conducted in seven African countries. METHODS: From March 2009 through January 2011, we enrolled 15,460 children in two age categories--6 to 12 weeks of age and 5 to 17 months of age--for vaccination with either RTS,S/AS01 or a non-malaria comparator vaccine. The primary end point of the analysis was vaccine efficacy against clinical malaria during the 12 months after vaccination in the first 6000 children 5 to 17 months of age at enrollment who received all three doses of vaccine according to protocol. After 250 children had an episode of severe malaria, we evaluated vaccine efficacy against severe malaria in both age categories. RESULTS: In the 14 months after the first dose of vaccine, the incidence of first episodes of clinical malaria in the first 6000 children in the older age category was 0.32 episodes per person-year in the RTS,S/AS01 group and 0.55 episodes per person-year in the control group, for an efficacy of 50.4% (95% confidence interval [CI], 45.8 to 54.6) in the intention-to-treat population and 55.8% (97.5% CI, 50.6 to 60.4) in the per-protocol population. Vaccine efficacy against severe malaria was 45.1% (95% CI, 23.8 to 60.5) in the intention-to-treat population and 47.3% (95% CI, 22.4 to 64.2) in the per-protocol population. Vaccine efficacy against severe malaria in the combined age categories was 34.8% (95% CI, 16.2 to 49.2) in the per-protocol population during an average follow-up of 11 months. Serious adverse events occurred with a similar frequency in the two study groups. Among children in the older age category, the rate of generalized convulsive seizures after RTS,S/AS01 vaccination was 1.04 per 1000 doses (95% CI, 0.62 to 1.64). CONCLUSIONS: The RTS,S/AS01 vaccine provided protection against both clinical and severe malaria in African children. (Funded by GlaxoSmithKline Biologicals and the PATH Malaria Vaccine Initiative; RTS,S ClinicalTrials.gov number, NCT00866619 .).



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