Updates: Janssen Announces Phase 2b Data Demonstrating its Investigational RSV Adult Vaccine Provided

The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that its investigational respiratory syncytial virus (RSV) vaccine candidate was highly effective in protecting against lower respiratory tract disease (LRTD) caused by RSV, demonstrating vaccine efficacy of 80 percent (CI, 52.2-92.9%) in adults aged 65 and older. The study results were presented as a late-breaking abstract at the virtual IDWeek 2021 conference on October 2.

“The findings from our CYPRESS study are very encouraging as we seek to deliver a long-awaited preventive vaccine to stave off the severe complications associated with RSV in adults,” said Penny Heaton, M.D., Global Therapeutic Area Head, Vaccines, Janssen Research & Development, LLC. “Respiratory syncytial virus is a leading cause of bronchitis and pneumonia and one of the most common infections in the world. As older adults are at high risk of developing serious, potentially life-threatening illness from RSV, there is an urgent need for a vaccine to prevent the significant morbidity and mortality caused by the virus.”

The CYPRESS study met its primary and secondary endpoints, with the investigational RSV adult vaccine demonstrating efficacy of 80 percent (CI, 52.2-92.9%) against confirmed RSV-associated LRTD. The investigational RSV adult vaccine also demonstrated efficacy of 70 percent (CI, 42.7-85.1%) against any symptomatic RSV-associated acute respiratory infection (ARI).

The investigational RSV adult vaccine candidate elicited robust humoral and cellular immune responses in adults aged 65 and older, with participants in the immunogenicity subset showing a substantial increase in RSV neutralizing antibodies 14 days after vaccination. The investigational RSV vaccine candidate was generally well-tolerated in all vaccinated participants.

“RSV remains a major global public health concern and a cause of serious respiratory illness in all age groups,” said Ann R. Falsey, M.D., Professor of Medicine, University of Rochester School of Medicine and presenting author*. “The positive efficacy results from the CYPRESS study reinforce the potential of this investigational RSV vaccine in preventing serious disease resulting from RSV in older adults.”

Following an initial proof-of-concept study with Janssen’s investigational RSV adult vaccine (Ad26.RSV.preF component only) in a human challenge study,1 Janssen combined Ad26.RSV.preF with a prefusion F (preF) protein for induction of a more optimal immune response. This combination single-dose regimen was evaluated in the Phase 2b CYPRESS study, which enrolled 5,782 participants across 40 sites in the United States followed through a single RSV season.

Based on the positive results from the Phase 2b CYPRESS study, which is the first large study evaluating the efficacy and safety of Janssen’s investigational RSV vaccine against RSV-associated LRTD in vaccinated adults aged 65 and older in the United States, Janssen initiated the global Phase 3 EVERGREEN study. The Phase 3 study will evaluate the efficacy, safety and immunogenicity of Janssen’s investigational adult vaccine against LRTD caused by RSV, when compared with placebo in approximately 23,000 adults aged 60 years and older throughout North America and a selection of countries across Europe, Asia and the Southern Hemisphere.

Currently there is no preventive vaccine or broadly available antiviral treatment for RSV, a highly contagious, potentially life-threatening respiratory virus affecting more than 64 million people worldwide in a typical year, across all age groups.2 With the most severe complications seen in older adults and young children, RSV remains a major global public health and economic concern.

In September 2019, the U.S. Food and Drug Administration granted Breakthrough Therapy Designation for Janssen’s investigational RSV adult vaccine for the prevention of LRTD caused by RSV in adults aged 60 years or older. This was based on clinical data indicating the potential for substantial improvement compared to available standard of care on a clinically significant endpoint(s). In November 2020, the European Medicines Agency’s Committee for Medicinal Products for Human Use designated Janssen’s investigational RSV adult vaccine as eligible for the priority medicines (PRIME) scheme based on promising clinical data and an unmet need for a prophylactic option to prevent RSV in older adults.

About Respiratory Syncytial Virus (RSV)
Respiratory syncytial virus (RSV) is a prevalent, highly contagious respiratory virus and a leading cause of bronchitis, bronchiolitis and pneumonia, affecting more than 64 million people worldwide in a typical year. Because the symptoms of RSV can be difficult to distinguish from influenza or other respiratory infections, such as COVID-19, many who are infected with RSV remain undiagnosed.

Older adults, young children and those with underlying health conditions are most at risk. RSV disproportionately impacts adults over 60 years and high-risk adults over 18 years who are more likely to develop a lower respiratory tract disease (LRTD). Between 3-7 percent of older adults (age 60 and older) and 4-10 percent of high-risk adults (age 18 and older) experience RSV in a typical year.

With no preventive vaccine or effective antiviral treatment available, RSV remains a major global public health concern and is a substantial health and economic burden globally.

About CYPRESS (NCT03982199)
CYPRESS (NCT03982199) is a randomized, double-blind, placebo-controlled Phase 2b trial. The trial enrolled 5,782 participants (2,891 in each study arm) aged 65 years and older. The participants were randomized 1:1 prior to the RSV season to receive Janssen’s investigational RSV adult vaccine or placebo. Immunogenicity and safety assessments were performed in a subset of approximately 200 and 695 participants, respectively. Disease symptoms were collected through a questionnaire and/or by a clinician’s assessment.

The primary endpoint was the first occurrence of reverse transcription polymerase chain reaction (RT-PCR) confirmed lower respiratory tract disease (LRTD) caused by RSV according to any of 3 case definitions: (1) three or more symptoms of lower respiratory tract infection (LRTI), (2) two or more symptoms of LRTI, or (3) two or more symptoms of LRTI or one or more symptom of LRTI with one or more systemic symptom. The secondary efficacy endpoint was the first occurrence of any RT–PCR-confirmed RSV-associated acute respiratory infection (ARI).

For further information, please see:
About EVERGREEN (NCT04908683)

 

 

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