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European agency endorses Baxter's bird flu vaccine

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
European agency endorses Baxter's bird flu vaccine

By Bruce Japsen | Tribune staff reporter

December 18, 2008

Baxter International Inc.'s vaccine to combat the bird flu today won an endorsement from European health officials.

It's a dose of good news for the Deerfield-based medical product giant and countries around the world that have been stockpiling the product without a government-approved clearance about the vaccine's safety or effectiveness.

Baxter this afternoon said the Committee for Medicinal Products for Human Use of the European Medicines Agency issued a "positive opinion" for Baxter's Celvapan, a vaccine against H5N1 strains of avian influenza, also known as bird flu. The committee's endorsement is generally a precursor to approval by the European Union.

An eventual clearance by European health officials should help win approval in the U.S. as well. Such approvals allow for the products to be marketed broadly as being safe and effective.

Although the spread of the bird flu has slowed, cases continue to emerge around the world. Since 2003, there have been 391 cases of Avian flu in humans and 247 deaths, largely in Asia along the Pacific Rim, according to the World Health Organization's Web site.

Because of limited manufacturing capacity for vaccines, several countries, including the U.S., have stockpiled Baxter's vaccine along with bird flu vaccines made by other companies in the event of a pandemic outbreak. In Europe, the United Kingdom and Austria signed contracts to stockpile Baxter's vaccine and that made of other companies.

"This is another step toward our goal of supplying a safe and effective vaccine to protect the population against a possible influenza pandemic," said Dr. Hartmut Ehrlich, vice president of Baxter's Bioscience global research and development.

Celvapan has other benefits. Unlike the traditional decades-old, egg-based production used by other flu vaccine-makers, Baxter uses a cell-based technology that can produce vaccines quicker and in large quantities. The method could enable Baxter to produce dosages faster in the event of a flu pandemic, the company has said.

Baxter is also in final stage clinical trials for a vaccine to prevent seasonal influenza that uses the company's cell-based technology, which could help boost production and prevent flu vaccine shortages that have arisen in recent years.

Baxter has not disclosed specific amounts of revenue generated but its third quarter financial report lumped vaccine sales in a line item called "other" that contributed $89 million to the company's $1.35 billion in bioscience sales. Total Baxter sales in the third quarter were about $3.2 billion.

http://www.chicagotribune.com/business/chi-biz-baxter-bird-flu-vaccine-dec18,0,567144.story
 
Re: European agency endorses Baxter's bird flu vaccine

Baxter Receives EMEA Positive Opinion for CELVAPAN, The First Cell Culture-Based Pandemic Flu Vaccine

December 18, 2008

Baxter International Inc. BAX today announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA) has issued a positive opinion for the marketing authorization of CELVAPAN, the first cell culture-based H5N1 (avian flu) pandemic vaccine, in the European Union.

The positive opinion precedes the licensure of the ?mock-up? vaccine, which allows CELVAPAN to be used if the World Health Organization (WHO) officially declares a pandemic. The positive opinion was based on results from a comprehensive clinical development program, including a Phase III clinical trial that demonstrated vaccines for two different H5N1 virus strains were well tolerated and generated a functional immune response.

?We are very pleased to receive the EMEA?s positive opinion for CELVAPAN,? said Hartmut Ehrlich, M.D., vice president, BioScience global research and development. ?This is another step towards our goal of supplying a safe and effective vaccine to protect the population against a possible influenza pandemic.?

A ?mock up? vaccine is identical to the future pandemic vaccine in composition and manufacturing; however, since the actual pandemic strain is not known, the vaccine contains another influenza strain not yet exposed to the general population. Once a pandemic is declared, this licensure allows for a fast track approval of the vaccine containing the actual pandemic strain.

CELVAPAN is made using Baxter?s proprietary Vero cell technology, which offers advantages against conventional egg-based vaccine technology. Baxter?s Vero cell manufacturing process is more rapid due to its ability to use the ?native? virus that does not need to be modified in order to grow in chicken eggs. The shorter time for vaccine production is critical in accelerating vaccine supply in response to an influenza pandemic.

CELVAPAN is produced in Bohumil, Czech Republic, at one of the largest cell culture vaccine production facilities in the world. Vero cell technology uses a well-established continuous mammalian cell line to produce the pandemic vaccine.

Baxter?s candidate avian flu vaccine is derived from the H5N1 strain A/Vietnam/1203/2004. Its antigen composition and structure are identical to the actual virus circulating in nature. This vaccine formulation alleviates the need to enhance the immune response by including adjuvants (additives) that may cause side effects. In the Phase III study, CELVAPAN induced an immune response that is similar to the body?s defense against a natural influenza virus infection.

Phase III Clinical Trial Results

The purpose of the randomized Phase III study was to evaluate safety and immune responses to 7.5 ?g of the Vietnam strain vaccine in two age groups (adults 18-59 and elderly, i.e., older than 60). The antibody persistence and immune response to a booster with either the same or a different strain was also measured. The study also investigated the ability of the vaccine to induce cross-immunity against divergent H5N1 strains.

Overall, the vaccine was well tolerated after the first and second vaccination as well as after the booster, with a safety profile similar to currently licensed seasonal influenza vaccines. The most common side effects were injection site pain and headache, fatigue or malaise.

A positive immune response was induced even after only one immunization as determined by measurement of functional antibodies using a microneutralization assay (50.7 percent in the adult group; 54.4 percent in the elderly group). Following the second immunization, 73 percent of subjects in the adult and 74 percent in the elderly age group demonstrated seroneutralizing levels of antibody, meaning the vaccine was found to be at least equally immunogenic in the elderly as in the adult age group.

A six-month booster vaccination with either A/Vietnam/1203/2004 or A/Indonesia/05/2005 strain vaccines induced a substantial booster response. A booster vaccination using a different strain resulted in high levels of antibodies against the initial and the booster strain, which is indicative of cross-protective immunological memory.

Last June, The New England Journal of Medicine published data demonstrating CELVAPAN met Phase I/II trial endpoints for safety and immunogenicity (generating a functional immune response). This was the first peer-reviewed publication of study results for CELVAPAN, the first cell culture-derived avian influenza vaccine to undergo clinical evaluation.




http://news.moneycentral.msn.com/provider/providerarticle.aspx?feed=BW&date=20081218&id=9463945
 
Re: European agency endorses Baxter's bird flu vaccine

Source: http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/dec2208eurovax-jw.html

EU panel supports innovative pandemic, seasonal flu vaccines

Robert Roos * News Editor

Dec 22, 2008 (CIDRAP News) ? An H5N1 influenza vaccine made by Baxter International could become the first cell culture?based H5N1 influenza vaccine to be approved for marketing, following its endorsement by a committee of the European Medicines Agency (EMEA) last week.

Recommendations of the Committee for Medicinal Products for Human Use (CHMP) are usually followed by the EMEA within a few months.

Most flu vaccines, including the two H5N1 prepandemic vaccines now licensed, are grown in chicken eggs, a process that takes about 4 to 6 months. Baxter's H5N1 vaccine, called Celvapan, is grown in Vero (monkey kidney) cells. Cell culture production is regarded as somewhat faster and much more flexible than the egg-based method.

Also last week, the CHMP recommended EMEA approval of a Sanofi Pasteur seasonal flu vaccine that is injected intradermally (ID)?just beneath the skin surface?instead of into muscle. "This represents the first key step toward recognition of the ID route as a promising option for vaccine administration," the company said in a news release.

Baxter vaccine called mock-up
Baxter said its cell-based production technology is faster than the egg-based method because the virus used in the vaccine does not need to be modified to grow in chicken eggs.

The company said EMEA approval of Celvapan would permit the vaccine to be used if the World Health Organization declared a pandemic. The vaccine is derived from an H5N1 strain isolated in Vietnam in 2004.

The company described Celvapan as a mock-up vaccine?one that is identical to the future pandemic vaccine in composition and manufacturing but contains an existing flu strain, since the actual pandemic strain has not emerged.

"Once a pandemic strain is declared, this licensure allows for a fast track approval of the vaccine containing the actual pandemic strain," the company said in a news release. Health officials hope that vaccines based on existing H5N1 viruses will provide some protection if H5N1 evolves into a pandemic strain.

In May 2007 the EMEA approved a mock-up flu vaccine made by Novartis, called Focetria, to permit a faster start on production in case of a pandemic. The company said that vaccine would not be manufactured until a pandemic is declared.

Baxter said the antigen composition and structure of Celvapan "are identical to the actual virus circulating in nature," which eliminates the need to use adjuvants (immune-boosting chemicals) and the resulting potential for side effects.

Clinical trial results
In a phase 3 trial, Celvapan was tested in two groups of adults, aged 18 to 59 and aged 60 and older. Two doses produced an immune response in 73% of the younger group and 74% of the older group, the company reported. Six months after the second dose, a booster vaccination with either the vaccine strain or a 2005 H5N1 strain from Indonesia induced a "substantial booster response," the company said.

The vaccine had a side-effect profile similar to that of licensed seasonal flu vaccines, Baxter reported. Celvapan is produced in Bohumil, Czech Republic, the company said.

Human H5N1 vaccines licensed to date include one in the United States and one in Europe. In April 2007 the US Food and Drug Administration approved a vaccine made by Sanofi Pasteur, and the government has been stockpiling it. In May of this year, the EMEA approved GlaxoSmithKline's H5N1 vaccine, called Prepandrix. Both are egg-based vaccines.

Though no cell-based prepandemic vaccines have been licensed yet, at least one cell-based seasonal flu vaccine has been approved. Novartis announced the European approval of Optaflu in June 2007.

Intradermal vaccine supported
The CHMP approval of Sanofi Pasteur's ID seasonal flu vaccine, called Intanza/IDflu, was announced Dec 18.

"Vaccination via the ID route involves the administration of the antigen into the dermal layer of the skin," Sanofi said in a news release. "Due to the high concentration of specialized immune cells in the skin layer and their ability to effectively stimulate an immune response, ID vaccination provides direct and efficient access to the immune system."

The vaccine is administered with the Micro Injection System made by Becton Dickinson (BD), which permits consistent and reliable ID vaccination, according to Sanofi.

The BD product consists of a prefilled syringe with a needle and a shield that allows the needle to penetrate only 1.5 millimeters into the skin, according to a 2007 report in Vaccine. Previously, ID injections were done with the Mantoux technique, developed for tuberculosis skin tests, the report said. It said the Mantoux technique is not commonly used for vaccination, because it is hard to apply reliably and efficiently.

The US flu vaccine shortage in the 2004-05 flu season stimulated interest in using ID vaccination as a way to stretch the vaccine supply, the report said.

In preparation for seeking European approval, Sanofi said it conducted clinical trials of Intanza/IDflu involving more than 7,000 adult and elderly volunteers. In a phase 3 trial involving more than 3,000 volunteers over age 60, Intanza was well tolerated and induced a stronger immune response when given intradermally than intramuscularly, according to Susan Watkins, a Sanofi spokeswoman in Swiftwater, Pa. The trial used the same dose as in licensed seasonal flu vaccines: 15 micrograms for each of three strains.

Sanofi is also developing an ID version of its US-licensed seasonal flu vaccine, Fluzone, Watkins told CIDRAP News. She said the vaccine is in "end-term" clinical development, but she was not sure when the company would apply for FDA approval.

See also:

EMEA news release about Dec 15-18 meeting
http://www.emea.europa.eu/pdfs/human/press/pr/67072408en.pdf

Dec 18 Baxter news release about Celvapan
http://www.baxter.com/about_baxter/news_room/news_releases/2008/12_18_08_celvapan.html

Sanofi Pasteur home page with link to press release on Intanza/IDlu
http://www.sanofipasteur.com/sanofi-pasteur2/front/index.jsp?siteCode=SP_CORP

International Federation of Pharmaceutical Manufacturers and Associations table of clinical trials of prepandemic vaccines
http://www.ifpma.org/influenza/content/pdfs/Table_H5N1_Pandemic_Influenza_RnD_26May08.pdf

May 9, 2007, CIDRAP News story on EU approval of Novartis's mock-up pandemic vaccine
http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/may0907novartis.html

Jun 13, 2007, CIDRAP News story on European approval of Novartis's cell-based seasonal flu vaccine
http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/jun1307novartis.html

December 2007 Vaccine report on BD's system for ID vaccination
http://dx.doi.org/10.1016/j.vaccine.2007.10
 
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