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The Human Rotavirus Vaccine RIX4414 in Infants: A Review of Safety and Tolerability

Cheuvart, Brigitte PhD*; Friedland, Leonard R. MD; Abu-Elyazeed, Remon MD, PhD; Han, Htay Htay MD; Guerra, Yolanda MD*; Verstraeten, Thomas MD*

The Pediatric Infectious Disease Journal: March 2009 - Volume 28 - Issue 3 - p 225-232
doi: 10.1097/INF.0b013e31819715fa
Original Studies

Background: An oral, live attenuated human rotavirus vaccine, RIX4414 has been developed to prevent rotavirus gastroenteritis. An integrated safety summary of 8 randomized, placebo-controlled, double-blind phase II and III trials of vaccine at potency licensed for use worldwide was performed.

Methods: Healthy 1- to 18-week-old infants (N = 71209) were enrolled to receive 2 doses of RIX4414/placebo according to 0, 1 or 0, 2 month schedules. Solicited (fever, fussiness/irritability, loss of appetite, vomiting, diarrhea, cough/rhinorrhea) and unsolicited adverse events (AEs) were recorded for 8 days and 31 days, respectively, after each dose. Serious adverse events (SAEs) including intussusception and death were collected throughout the entire study periods. Potential imbalances were defined as the 95% confidence interval (CI) for the relative risk (RR) stratified by trials excluding “1.”

Results: Solicited AEs were evaluated in 3286 RIX4414 vaccinees and 2015 placebo recipients. Among solicited AEs, no imbalance was noted between groups. SAEs, including death and intussusception, were evaluated in 36755 RIX4414 and 34454 placebo recipients. Within 31 days after each dose, no imbalances were noted between the groups for all SAEs (RR = 0.9; 95% CI: 0.81, 1.01), deaths (RR = 1.64; 95% CI: 0.92, 3.02), and intussusception (RR 1.23; 95% CI: 0.41, 3.90). SAEs because of gastrointestinal diseases including diarrhea, gastroenteritis (all cause and due to rotavirus), dehydration, and intestinal ileus occurred significantly less often in RIX4414 than placebo recipients.

Conclusions: Across the phase II and III clinical trials, the reactogenicity and safety profile between RIX4414 and placebo was similar, in particular with no increased risk of intussusception.

From the *GlaxoSmithKline Biologicals, Rixensart, Belgium; and †GlaxoSmithKline Biologicals, King of Prussia, PA.

Accepted for publication December 1, 2008.

GlaxoSmithKline Biologicals provided financial support and was involved in all stages of the conduct and analysis of the studies. GlaxoSmithKline Biologicals also funded all costs associated with the development and the publishing of the present manuscript.

Clinical trials registration: All clinical trials described in this review have been registered at www.clinicaltrials.gov.

Address for correspondence: Brigitte Cheuvart, PhD, GlaxoSmithKline Biologicals, Rue de l'institut 89, Rixensart, B-1330 Belgium. E-mail: brigitte.cheuvart@gskbio.com.

© 2009 Lippincott Williams & Wilkins, Inc.