Meningococcal

Bexsero by GlaxoSmithKline (Meningococcal B)

Captured 2022-12-06
Document Highlights

Initial U.S. Approval: 2015

BEXSERO is a vaccine indicated for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroup B… for use in individuals aged 10 through 25 years.

[S]evere myalgiawas reported by 3% to 7% of subjects. Severe pain was reported by 8% of university students

2.1% reported serious adverse events.

Postmarketing Experience
– Lymphadenopathy.
– Injection site reactions (including extensive swelling of the vaccinated limb, blisters at or around the injection site, and injection site nodule which may persist for more than 1 month).
– Allergic reactions (including anaphylactic reactions), rash, eye swelling.
– Syncope, vasovagal responses to injection.

Each 0.5-mL dose of BEXSERO is formulated to contain 50 micrograms each of recombinant proteins Neisserial adhesin A (NadA), Neisserial Heparin Binding Antigen (NHBA), and factor H binding protein (fHbp), 25 micrograms of Outer Membrane Vesicles (OMV), 1.5 mg aluminum hydroxide (0.519 mg of Al3+ [aluminum]), 3.125 mg sodium chloride, 0.776 mg histidine, and 10 mg sucrose at pH 6.4 – 6.7.

3 recombinant proteins are individually produced in Escherichia coli [E.coli]…

BEXSERO has not been evaluated for carcinogenic or mutagenic potential or impairment of male fertility in animals.

Comments

Two of the three controlled studies utilized a placebo containing aluminum. A small control group of less than 100 participants received saline placebo, then Menveo (Meningococcal ACWY) two months later. Receiving an active comparator vaccine two months post-placebo obscures the data regarding safety of Bexsero and limits the validity of the data for comparing adverse events.

"In a randomized controlled study... 120 participants... received at least 1 dose of BEXSERO, including 112 participants who received 2 doses of BEXSERO 2 months apart; 97 participants received saline placebo followed by MENVEO..."

"In a second randomized controlled study... subjects (N = 1,622)... received at least 1 dose of BEXSERO. This study included a subset of 810 subjects who received 2 doses of BEXSERO 1 or 2 months apart. A control group of 128 subjects received at least 1 dose of placebo containing aluminum hydroxide."

"In a third randomized controlled study... university students... received at least 1 dose of BEXSERO, including 932 subjects who received 2 doses of BEXSERO 1 month apart. Comparator groups received 1 dose of MENVEO followed by 1 dose of placebo containing aluminum hydroxide..."

Why placebo controlled trials are necessary.