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Cervical Intraepithelial Neoplasm (CIN)-Warts Efficacy Trial in Women (Gardasil)(V501-013)(COMPLETED)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Merck Sharp & Dohme Corp.
ClinicalTrials.gov Identifier:
NCT00092521
First received: September 23, 2004
Last updated: August 26, 2014
Last verified: August 2014
Results First Received: August 3, 2009  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Double Blind (Subject, Investigator);   Primary Purpose: Prevention
Conditions: Cervical Cancer
Genital Warts
Interventions: Biological: V501
Biological: Comparator: Placebo
Biological: Human Papillomavirus (HPV) 16 Monovalent

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
The study Protocol 013 (NCT00092521) (N =5759 total randomized) was comprised of two sub-studies: Protocol 011 (NCT00517309) (N=1877 total randomized) and Protocol 012 (NCT00092482) (N=3882 total randomized). Final safety data are presented in the results for Protocol 013 (NCT00092521): the final participant visit took place on 19 January 2009.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
No text entered.

Reporting Groups
  Description
Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 1 were vaccinated (at Day 1, Month 2 and Month 6) with the Quadrivalent Human papillomavirus (HPV) vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Quadrivalent HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 2 - Base Study Monovalent HPV (Type 16) Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 2 were vaccinated (at Day 1, Month 2 and Month 6) with the Monovalent (HPV 16) HPV vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Monovalent (HPV 16) HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 2 Base Study Monovalent HPV (Type 16) Vaccine was not part of the pre-specified efficacy analysis population.

Group 3 - Base Study Placebo

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 3 were vaccinated (at Day 1, Month 2 and Month 6) with placebo.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received placebo; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 4 - Quadrivalent Human Papillomavirus Vaccine Extension This group includes subjects who entered the extension including subjects who in the base study received fewer than the full three doses of Quadrivalent HPV vaccine during the base study (i.e., subjects who received placebo in the base study; subjects who received monovalent [type 16] HPV vaccine in the base study, or subjects who received <=2 doses of quadrivalent HPV vaccine in the base study). Subjects who discontinued the base portion of the study could enter the extension portion of the study. In the extension period subjects designated as "Completed Period" are those who received three doses of quadrivalent HPV vaccine and completed all required follow-up visits. Subjects designated as "Not Completed" are those who: a) Received all three vaccinations, but did not complete follow-up; b) Did not receive all vaccinations, but completed follow-up, or c) Did not receive all vaccinations, and did not complete follow-up.

Participant Flow for 3 periods

Period 1:   Vaccination (Day 1 Through Month 7)
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 2 - Base Study Monovalent HPV (Type 16) Vaccine     Group 3 - Base Study Placebo     Group 4 - Quadrivalent Human Papillomavirus Vaccine Extension  
STARTED     2723     304     2732     0  
COMPLETED     2583     290     2586     0  
NOT COMPLETED     140     14     146     0  
Randomized Not Vaccinated                 6                 0                 7                 0  
Adverse Event                 1                 0                 7                 0  
Death                 0                 0                 1                 0  
Lost to Follow-up                 51                 6                 44                 0  
Pregnancy                 5                 0                 7                 0  
Withdrawal by Subject                 59                 7                 62                 0  
Moved                 14                 1                 18                 0  
Unblinded                 2                 0                 0                 0  
New Medical History (Not AE)                 2                 0                 0                 0  

Period 2:   Follow-Up (After Month 7)
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 2 - Base Study Monovalent HPV (Type 16) Vaccine     Group 3 - Base Study Placebo     Group 4 - Quadrivalent Human Papillomavirus Vaccine Extension  
STARTED     2599 [1]   291 [1]   2607 [1]   0  
COMPLETED     2353     155     1959     0  
NOT COMPLETED     246     136     648     0  
Subjects Continuing                 34                 4                 35                 0  
Subjects in Extension                 13                 109                 412                 0  
Adverse Event                 1                 0                 0                 0  
Death                 2                 0                 1                 0  
Lost to Follow-up                 113                 14                 108                 0  
Protocol Violation                 1                 1                 5                 0  
Withdrawal by Subject                 40                 6                 51                 0  
Moved                 32                 2                 28                 0  
Site Terminated                 3                 0                 3                 0  
Travel                 2                 0                 0                 0  
Visits Compressed                 5                 0                 5                 0  
[1] Includes subjects who did not receive 3 doses of vaccine/placebo but continued into the follow-up

Period 3:   Extension Study (Group 4)
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 2 - Base Study Monovalent HPV (Type 16) Vaccine     Group 3 - Base Study Placebo     Group 4 - Quadrivalent Human Papillomavirus Vaccine Extension  
STARTED     0     0     0     844  
Initiated Extension Study     0     0     0     829  
Received >=1 Dose in Extension Study     0     0     0     801  
COMPLETED     0     0     0     635  
NOT COMPLETED     0     0     0     209  
Excluded ineligible for extension                 0                 0                 0                 23  
Adverse Event                 0                 0                 0                 2  
Lost to Follow-up                 0                 0                 0                 87  
Pregnancy                 0                 0                 0                 4  
Protocol Violation                 0                 0                 0                 2  
Withdrawal by Subject                 0                 0                 0                 46  
Moved                 0                 0                 0                 16  
Site Terminated                 0                 0                 0                 4  
Unable/unwilling to return                 0                 0                 0                 25  



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 1 were vaccinated (at Day 1, Month 2 and Month 6) with the Quadrivalent HPV vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Quadrivalent HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 2 - Base Study Monovalent HPV (Type 16) Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 2 were vaccinated (at Day 1, Month 2 and Month 6) with the Monovalent (HPV 16) HPV vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Monovalent (HPV 16) HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 3 - Base Study Placebo

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 3 were vaccinated (at Day 1, Month 2 and Month 6) with placebo.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received placebo; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Total Total of all reporting groups

Baseline Measures
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 2 - Base Study Monovalent HPV (Type 16) Vaccine     Group 3 - Base Study Placebo     Total  
Number of Participants  
[units: participants]
  2723     304     2732     5759  
Age  
[units: years]
Mean ± Standard Deviation
  20.2  ± 1.8     20.2  ± 1.74     20.3  ± 1.8     20.3  ± 1.8  
Age  
[units: Years]
Median ( Full Range )
  20  
  ( 16 to 24 )  
  20  
  ( 16 to 24 )  
  20  
  ( 16 to 24 )  
  20  
  ( 16 to 24 )  
Age, Customized [1]
[units: Participants]
       
16 to 24 Years of Age     2723     304     2732     5759  
Gender  
[units: participants]
       
Female     2723     304     2732     5759  
Male     0     0     0     0  
Race/Ethnicity, Customized  
[units: participants]
       
Asian     151     27     165     343  
Black     136     5     167     308  
Hispanic American     567     93     566     1226  
Native American     10     2     10     22  
White     1600     171     1558     3329  
Other - Unspecified     259     6     266     531  
[1] Although the upper age limit for this study was 23 years old, four subjects aged 24 were randomized into the study.



  Outcome Measures
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1.  Primary:   Incidence of HPV 6/11/16/18-related Cervical Intraepithelial Neoplasia (CIN)(Any Grade), Adenocarcinoma In Situ (AIS) or Cervical Cancer   [ Time Frame: Follow-up through end of study (4 years) ]

Measure Type Primary
Measure Title Incidence of HPV 6/11/16/18-related Cervical Intraepithelial Neoplasia (CIN)(Any Grade), Adenocarcinoma In Situ (AIS) or Cervical Cancer
Measure Description No text entered.
Time Frame Follow-up through end of study (4 years)  
Safety Issue No  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
Per-protocol population: subjects must have no major protocol violations, must be seronegative to the relevant type at Day 1 and Polymerase Chain Reaction (PCR) negative to the relevant type through Month 7, and must provide follow-up data. Group 2 Base Study Monovalent HPV Vaccine was not part of the pre-specified efficacy analysis population.

Reporting Groups
  Description
Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 1 were vaccinated (at Day 1, Month 2 and Month 6) with the Quadrivalent HPV vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Quadrivalent HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 3 - Base Study Placebo

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 3 were vaccinated (at Day 1, Month 2 and Month 6) with placebo.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received placebo; from completion of the Vaccination Period at Month 7 through Month 48 of the study.


Measured Values
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 3 - Base Study Placebo  
Number of Participants Analyzed  
[units: participants]
  2241     2258  
Incidence of HPV 6/11/16/18-related Cervical Intraepithelial Neoplasia (CIN)(Any Grade), Adenocarcinoma In Situ (AIS) or Cervical Cancer  
[units: incidence rate per 100 person-years]
  0     1.2  


Statistical Analysis 1 for Incidence of HPV 6/11/16/18-related Cervical Intraepithelial Neoplasia (CIN)(Any Grade), Adenocarcinoma In Situ (AIS) or Cervical Cancer
Groups [1] All groups
Percent relative risk reduction [2] 100
95% Confidence Interval ( 95.1 to 100 )
[1] Additional details about the analysis, such as null hypothesis and power calculation:
  No text entered.
[2] Other relevant estimation information:
  Confidence Interval (CI) based on binomial tail probabilities and not from a dispersion parameter



2.  Primary:   Incidence of HPV 6/11/16/18-related External Genital Lesions (EGL) [Genital Warts, Vulvar/Vaginal Intraepithelial Neoplasia (Any Grade), Vulvar/Vaginal Cancer]   [ Time Frame: Follow-up through end of study (4 years) ]

Measure Type Primary
Measure Title Incidence of HPV 6/11/16/18-related External Genital Lesions (EGL) [Genital Warts, Vulvar/Vaginal Intraepithelial Neoplasia (Any Grade), Vulvar/Vaginal Cancer]
Measure Description No text entered.
Time Frame Follow-up through end of study (4 years)  
Safety Issue No  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.

Per-protocol population: subjects must have no major protocol violations, must be seronegative to the relevant type at Day 1 and PCR negative to the relevant type through Month 7, and must provide follow-up data.

Group 2 Base Study Monovalent HPV (Type 16) Vaccine was not part of the pre-specified efficacy analysis population.


Reporting Groups
  Description
Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 1 were vaccinated (at Day 1, Month 2 and Month 6) with the Quadrivalent HPV vaccine.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received the Quadrivalent HPV vaccine; from completion of the Vaccination Period at Month 7 through Month 48 of the study.

Group 3 - Base Study Placebo

The Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 3 were vaccinated (at Day 1, Month 2 and Month 6) with placebo.

The Follow-up Period for the Base Study encompassed the follow-up of subjects who had received placebo; from completion of the Vaccination Period at Month 7 through Month 48 of the study.


Measured Values
    Group 1 - Base Study Quadrivalent Human Papillomavirus Vaccine     Group 3 - Base Study Placebo  
Number of Participants Analyzed  
[units: participants]
  2261     2279  
Incidence of HPV 6/11/16/18-related External Genital Lesions (EGL) [Genital Warts, Vulvar/Vaginal Intraepithelial Neoplasia (Any Grade), Vulvar/Vaginal Cancer]  
[units: incidence rate per 100 person-years]
  0     1.1  


Statistical Analysis 1 for Incidence of HPV 6/11/16/18-related External Genital Lesions (EGL) [Genital Warts, Vulvar/Vaginal Intraepithelial Neoplasia (Any Grade), Vulvar/Vaginal Cancer]
Groups [1] All groups
Percent relative risk reduction [2] 100
95% Confidence Interval ( 94.9 to 100 )
[1] Additional details about the analysis, such as null hypothesis and power calculation:
  No text entered.
[2] Other relevant estimation information:
  CI based on binomial tail probabilities and not from a dispersion parameter




  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
  Hide Limitations and Caveats

Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.


  More Information