Immunogenic superiority and safety of Biological E CORBEVAX vaccine compared to COVISHIELD (ChAdOx1 nCoV-19) vaccine studied in a phase III, single blind, multicenter, randomized clinical trial
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Abstract
Background: Optimum formulation of Biological Es CORBEVAX vaccine that contains protein sub unit of Receptor Binding Domain (RBD) from the spike protein of SARS-COV-2 formulated with aluminum hydroxide (Al3+) and CpG1018 as adjuvants was selected in phase-1 and 2 studies and proven to be safe, well tolerated and immunogenic in healthy adult population. In the current study, additional data was generated to determine immunogenic superiority of CORBEVAX vaccine over COVISHIELD vaccine and safety in larger and older population. Methods: This is a phase III prospective, single blinded, randomized, active controlled study (CTRI/2021/08/036074) conducted at 18 sites across India in healthy adults aged between 18-80 years. This study has two arms; immunogenicity arm and safety arm. Participants in immunogenicity arm were randomized equally to either CORBEVAX or COVISHIELD vaccination groups to determine the immunogenic superiority. Healthy adults without a history of Covid-19 vaccination or SARS-CoV-2 infection, were enrolled. Findings: The safety profile of CORBEVAX vaccine was comparable to the comparator vaccine COVISHIELD in terms of overall AE rates, related AE rates and medically attended AEs. Majority of reported AEs were mild in nature, and overall CORBEVAX appeared to cause fewer local and systemic adverse reactions/events. Overall, two grade-3 serious AEs (Dengue fever and femur fracture) were reported and they are unrelated to study vaccine. Neutralizing Antibody titers, against both Ancestral and Delta strain, induced post two-dose vaccination regimen were higher in the CORBEVAX arm as compared to COVISHIELD and the analysis of GMT ratios demonstrated immunogenic superiority of CORBEVAX in comparison with COVISHIELD. Both CORBEVAX and COVISHIELD vaccines showed comparable seroconversion post vaccination when assessed against anti-RBD IgG response. The subjects in CORBEVAX cohort also exhibited higher Interferon-gamma secreting PBMCs post stimulation with SARS-COV-2 RBD peptides than the subjects in COVISHIELD cohort. Interpretations: Neutralizing antibody titers induced by CORBEVAX vaccine against Delta and Ancestral strains were protective, indicative of vaccine effectiveness of >90% for prevention of symptomatic infections based on the Correlates of Protection assessment performed during Moderna and Astra-Zeneca vaccine Phase III studies. Safety findings revealed that CORBEVAX vaccine has excellent safety profile when tested in larger and older population.
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SciScore for 10.1101/2022.03.20.22271891: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The Investigational Review Board or Ethics Committee at each study site approved the protocol.
Consent: All participants provided written informed consent before enrollment into the study.
Field Sample Permit: Serious adverse events (SAEs), medically attended adverse events (MAAEs) and adverse events of special interest (AESIs) if any, were collected during the entire study duration.Sex as a biological variable not detected. Randomization Study Design and Study Population: This is an ongoing phase III prospective, single blinded, randomized, active controlled study conducted at 18 sites across India in accordance with the principles defined in the Declaration of Helsinki, International … SciScore for 10.1101/2022.03.20.22271891: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The Investigational Review Board or Ethics Committee at each study site approved the protocol.
Consent: All participants provided written informed consent before enrollment into the study.
Field Sample Permit: Serious adverse events (SAEs), medically attended adverse events (MAAEs) and adverse events of special interest (AESIs) if any, were collected during the entire study duration.Sex as a biological variable not detected. Randomization Study Design and Study Population: This is an ongoing phase III prospective, single blinded, randomized, active controlled study conducted at 18 sites across India in accordance with the principles defined in the Declaration of Helsinki, International Conference on Harmonization guidelines (Good Clinical Practices), and the local regulatory guidelines. Blinding Study Design and Study Population: This is an ongoing phase III prospective, single blinded, randomized, active controlled study conducted at 18 sites across India in accordance with the principles defined in the Declaration of Helsinki, International Conference on Harmonization guidelines (Good Clinical Practices), and the local regulatory guidelines. Power Analysis not detected. Cell Line Authentication Authentication: A randomization scheme was generated by using a validated system. Table 2: Resources
Antibodies Sentences Resources Participants were seronegative to anti-SARS-CoV-2 IgG antibody prior to randomization into immunogenicity arm, whereas in safety arm subjects were randomized irrespective of their serostatus for SARS-CoV-2. anti-SARS-CoV-2 IgGsuggested: None6 Participants who were negative for both Anti-SARS CoV-2 human S1/S2 IgG antibodies and SARS CoV-2 infection were enrolled to study immune responses (immunogenicity arm). Anti-SARSsuggested: Nonehuman S1/S2 IgGsuggested: NoneOutcomes: The primary outcome of the study was demonstration of immunogenic superiority of BE’s CORBEVAX™ vaccine against COVISHIELD™ vaccine in terms of GMTs of anti-SARS-CoV-2 virus neutralizing antibodies at day 42 (14 days after 2nd dose). anti-SARS-CoV-2suggested: NoneAnti-RBD antibody concentration in terms of GMC’s and to descriptively assess the safety, tolerability and reactogenicity of CORBEVAX™ vaccine during the study period. Anti-RBDsuggested: NoneExperimental Models: Cell Lines Sentences Resources This vaccine is based on recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS-CoV-2 Spike (S) glycoprotein, produced in genetically modified human embryonic kidney (HEK) 293 cells (CDSCO.gov). HEKsuggested: None293suggested: NCI-DTP Cat# NCI-293TT, RRID:CVCL_1D85)Software and Algorithms Sentences Resources This is also a single-blind study where study participants randomized into immunogenicity arm are kept blinded of the vaccination group to which they have been assigned, but the investigator and study staff are aware of the assigned group (CORBEVAX™ or COVISHIELD™). Procedure: Biological E’s CORBEVAX™ vaccine is based on recombinant RBD protein, which is produced in Pichia Pastoris culture as secretory protein and purified via multiple chromatography and ultrafiltration/normal-filtration steps. Procedure: Biologicalsuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Study limitations: This study has several limitations like efficacy of the vaccine against Covid-19 infection was not studied and long-term safety was not established as interim results are available only until day 56. However, it is worth noting that in a small set of patients (n=360) safety was established until 12 months and significantly higher neutralizing antibody titres (nAbs) persisted at least 6 months after second dose of the vaccination when compared to human convalescent serum (HCS).5 Overall, we conclude that CORBEVAX™ is safe, well tolerated and elicited excellent antibody and cellular immune responses that can offer significant protection against symptomatic infection from SARS-CoV-2 virus.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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