Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia

被引：1199

作者：

Logunov, Denis Y. ^{[1
]}

Dolzhikova, Inna V. ^{[1
]}

Shcheblyakov, Dmitry V. ^{[1
]}

Tukhvatulin, Amir I. ^{[1
]}

Zubkova, Olga V. ^{[1
]}

Dzharullaeva, Alina S. ^{[1
]}

Kovyrshina, Anna V. ^{[1
]}

Lubenets, Nadezhda L. ^{[1
]}

Grousova, Daria M. ^{[1
]}

Erokhova, Alina S. ^{[1
]}

Botikov, Andrei G. ^{[1
]}

Izhaeva, Fatima M. ^{[1
]}

Popova, Olga ^{[1
]}

Ozharovskaya, Tatiana A. ^{[1
]}

Esmagambetov, Ilias B. ^{[1
]}

Favorskaya, Irina A. ^{[1
]}

Zrelkin, Denis I. ^{[1
]}

Voronina, Daria V. ^{[1
]}

Shcherbinin, Dmitry N. ^{[1
]}

Semikhin, Alexander S. ^{[1
]}

Simakova, Yana V. ^{[1
]}

Tokarskaya, Elizaveta A. ^{[1
]}

Egorova, Daria A. ^{[1
]}

Shmarov, Maksim M. ^{[1
]}

Nikitenko, Natalia A. ^{[1
]}

Gushchin, Vladimir A. ^{[1
]}

Smolyarchuk, Elena A. ^{[2
]}

Zyryanov, Sergey K. ^{[3
]}

Borisevich, Sergei V. ^{[4
]}

Naroditsky, Boris S. ^{[1
]}

Gintsburg, Alexander L. ^{[1
,2
]}

机构：

[1] Minist Hlth Russian Federat, Fed State Budget Inst, Natl Res Ctr Epidemiol & Microbiol, Moscow 123098, Russia

[2] Sechenov Univ, IM Sechenov First Moscow State Med Univ, Minist Hlth Russian Federat, Fed State Autonomous Educ Inst Higher Educ, Moscow, Russia

[3] RUDN Univ, Peoples Friendship Univ Russia, Moscow, Russia

[4] Minist Def Russian Federat, Cent Res Inst 48, Moscow, Russia

来源：

LANCET | 2021年 / 397卷 / 10275期

关键词：

D O I：

10.1016/S0140-6736(21)00234-8

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background A heterologous recombinant adenovirus (rAd)-based vaccine, Gam-COVID-Vac (Sputnik V), showed a good safety profile and induced strong humoral and cellular immune responses in participants in phase 1/2 clinical trials. Here, we report preliminary results on the efficacy and safety of Gam-COVID-Vac from the interim analysis of this phase 3 trial. Methods We did a randomised, double-blind, placebo-controlled, phase 3 trial at 25 hospitals and polyclinics in Moscow, Russia. We included participants aged at least 18 years, with negative SARS-CoV-2 PCR and IgG and IgM tests, no infectious diseases in the 14 days before enrolment, and no other vaccinations in the 30 days before enrolment. Participants were randomly assigned (3:1) to receive vaccine or placebo, with stratification by age group. Investigators, participants, and all study staff were masked to group assignment. The vaccine was administered (0.5 mL/dose) intramuscularly in a prime-boost regimen: a 21-day interval between the first dose (rAd26) and the second dose (rAd5), both vectors carrying the gene for the full-length SARS-CoV-2 glycoprotein S. The primary outcome was the proportion of participants with PCR-confirmed COVID-19 from day 21 after receiving the first dose. All analyses excluded participants with protocol violations: the primary outcome was assessed in participants who had received two doses of vaccine or placebo, serious adverse events were assessed in all participants who had received at least one dose at the time of database lock, and rare adverse events were assessed in all participants who had received two doses and for whom all available data were verified in the case report form at the time of database lock. The trial is registered at ClinicalTrials.gov (NCT04530396). Findings Between Sept 7 and Nov 24, 2020, 21 977 adults were randomly assigned to the vaccine group (n=16 501) or the placebo group (n=5476). 19 866 received two doses of vaccine or placebo and were included in the primary outcome analysis. From 21 days after the first dose of vaccine (the day of dose 2), 16 (0.1%) of 14 964 participants in the vaccine group and 62 (1.3%) of 4902 in the placebo group were confirmed to have COVID-19; vaccine efficacy was 91.6% (95% CI 85.6-95.2). Most reported adverse events were grade 1 (7485 [94.0%] of 7966 total events). 45 (0.3%) of 16 427 participants in the vaccine group and 23 (0.4%) of 5435 participants in the placebo group had serious adverse events; none were considered associated with vaccination, with confirmation from the independent data monitoring committee. Four deaths were reported during the study (three [<0.1%] of 16 427 participants in the vaccine group and one [<0.1%] of 5435 participants in the placebo group), none of which were considered related to the vaccine. Interpretation This interim analysis of the phase 3 trial of Gam-COVID-Vac showed 91.6% efficacy against COVID-19 and was well tolerated in a large cohort. Copyright (C) 2021 Elsevier Ltd. All rights reserved.

引用

页码：671 / 681

页数：11

共 16 条

[1]

Altman DG., 1991, PRACTICAL STAT MED R, DOI DOI 10.1002/SIM.4780101015

[2]

[Anonymous], INTERIM CLIN GUIDANC

[3]

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine [J].

Baden, Lindsey R. ;

El Sahly, Hana M. ;

Essink, Brandon ;

Kotloff, Karen ;

Frey, Sharon ;

Novak, Rick ;

Diemert, David ;

Spector, Stephen A. ;

Rouphael, Nadine ;

Creech, C. Buddy ;

McGettigan, John ;

Khetan, Shishir ;

Segall, Nathan ;

Solis, Joel ;

Brosz, Adam ;

Fierro, Carlos ;

Schwartz, Howard ;

Neuzil, Kathleen ;

Corey, Larry ;

Gilbert, Peter ;

Janes, Holly ;

Follmann, Dean ;

Marovich, Mary ;

Mascola, John ;

Polakowski, Laura ;

Ledgerwood, Julie ;

Graham, Barney S. ;

Bennett, Hamilton ;

Pajon, Rolando ;

Knightly, Conor ;

Leav, Brett ;

Deng, Weiping ;

Zhou, Honghong ;

Han, Shu ;

Ivarsson, Melanie ;

Miller, Jacqueline ;

Zaks, Tal .

NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (05) :403-416

[4]

Safety and immunogenicity of GamEvac-Combi, a heterologous VSV- and Ad5-vectored Ebola vaccine: An open phase I/II trial in healthy adults in Russia [J].

Dolzhikova, I. V. ;

Zubkova, O. V. ;

Tukhvatulin, A. I. ;

Dzharullaeva, A. S. ;

Tukhvatulina, N. M. ;

Shcheblyakov, D. V. ;

Shmarov, M. M. ;

Tokarskaya, E. A. ;

Simakova, Y. V. ;

Egorova, D. A. ;

Scherbinin, D. N. ;

Tutykhina, I. L. ;

Lysenko, A. A. ;

Kostarnoy, A. V. ;

Gancheva, P. G. ;

Ozharovskaya, T. A. ;

Belugin, B. V. ;

Kolobukhina, L. V. ;

Pantyukhov, V. B. ;

Syromyatnikova, S. I. ;

Shatokhina, I. V. ;

Sizikova, T. V. ;

Rumyantseva, I. G. ;

Andrus, A. F. ;

Boyarskaya, N. V. ;

Voytyuk, A. N. ;

Babira, V. F. ;

Volchikhina, S. V. ;

Kutaev, D. A. ;

Bel'skih, A. N. ;

Zhdanov, K. V. ;

Zakharenko, S. M. ;

Borisevich, S. V. ;

Logunov, D. Y. ;

Naroditsky, B. S. ;

Gintsburg, A. L. .

HUMAN VACCINES & IMMUNOTHERAPEUTICS, 2017, 13 (03) :613-620

[5]

Kovyrshina A. V., 2020, Immunologiya, V41, P135, DOI 10.33029/0206-4952-2020-41-2-135-143

[6]

Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomised phase 1/2 studies from Russia [J].

Logunov, Denis Y. ;

Dolzhikova, Inna V. ;

Zubkova, Olga V. ;

Tukhvatullin, Amir I. ;

Shcheblyakov, Dmitry V. ;

Dzharullaeva, Alina S. ;

Grousova, Daria M. ;

Erokhova, Alina S. ;

Kovyrshina, Anna V. ;

Botikov, Andrei G. ;

Izhaeva, Fatima M. ;

Popova, Olga ;

Ozharovskaya, Tatiana A. ;

Esmagambetov, Ilias B. ;

Favorskaya, Irina A. ;

Zrelkin, Denis I. ;

Voronina, Daria V. ;

Shcherbinin, Dmitry N. ;

Semikhin, Alexander S. ;

Simakova, Yana V. ;

Tokarskaya, Elizaveta A. ;

Lubenets, Nadezhda L. ;

Egorova, Daria A. ;

Shmarov, Maksim M. ;

Nikitenko, Natalia A. ;

Morozova, Lola F. ;

Smolyarchuk, Elena A. ;

Kryukov, Evgeny V. ;

Babira, Vladimir F. ;

Borisevich, Sergei V. ;

Naroditsky, Boris S. ;

Gintsburg, Alexander L. .

LANCET, 2020, 396 (10255) :887-897

[7]

Heterologous prime-boost vaccination [J].

Lu, Shan .

CURRENT OPINION IN IMMUNOLOGY, 2009, 21 (03) :346-351

[8]

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine [J].

Polack, Fernando P. ;

Thomas, Stephen J. ;

Kitchin, Nicholas ;

Absalon, Judith ;

Gurtman, Alejandra ;

Lockhart, Stephen ;

Perez, John L. ;

Perez Marc, Gonzalo ;

Moreira, Edson D. ;

Zerbini, Cristiano ;

Bailey, Ruth ;

Swanson, Kena A. ;

Roychoudhury, Satrajit ;

Koury, Kenneth ;

Li, Ping ;

Kalina, Warren V. ;

Cooper, David ;

Frenck, Robert W., Jr. ;

Hammitt, Laura L. ;

Tureci, Ozlem ;

Nell, Haylene ;

Schaefer, Axel ;

Unal, Serhat ;

Tresnan, Dina B. ;

Mather, Susan ;

Dormitzer, Philip R. ;

Sahin, Ugur ;

Jansen, Kathrin U. ;

Gruber, William C. .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (27) :2603-2615

[9]

Adenoviruses as vaccine vectors [J].

Tatsis, N ;

Ertl, HCJ .

MOLECULAR THERAPY, 2004, 10 (04) :616-629

[10]

Adenoviral vectors for gene transfer and therapy [J].

Volpers, C ;

Kochanek, S .

JOURNAL OF GENE MEDICINE, 2004, 6 :S164-S171

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