Menveo

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Menveo Generic Name & Formulations

General Description

Neisseria meningitidis oligosaccharide conjugate vaccine (Corynebacterium diphtheriae CRM197 protein); 10mcg of Group A + 5mcg each of Group C, Y, and W-135 + 32.7–64.1mcg of diphtheria CRM197 protein; per 0.5mL; lyophilized pwd for IM inj after reconstitution (two-vial presentation); soln for IM inj (one-vial presentation); preservative-free.

How Supplied

Carton (two-vial presentation)—5 doses (5 vials of lyophilized MenA conjugate component + 5 vials of liquid MenCYW-135 conjugate component); Carton (one-vial presentation)—10 doses

Storage

Storage Before Reconstitution

  • Store refrigerated, away from the freezer compartment, at 36°F to 46°F (2°C to 8°C). Protect from light. Vaccine must be maintained at 36°F to 46°F (2°C to 8°C) during transport. Do not use after the expiration date.

  • Do not freeze. Frozen/previously frozen product should be discarded.

Storage after Reconstitution

  • Use the reconstituted vaccine immediately but it may be held at 36°F to 77°F (2°C to 25°C) for up to 8 hours. Do not freeze. Discard reconstituted vaccine if it has been frozen or not used within 8 hours.

Manufacturer

Mechanism of Action

Globally, 5 serogroups, A, B, C, Y, and W-135 cause almost all invasive meningococcal infections. Vaccination with Menveo leads to the production of bactericidal antibodies directed against the capsular polysaccharides of serogroups A, C, Y, and W-135.

Menveo Indications

Indications

Meningitis immunization.

Menveo Dosage and Administration

Adults and Children

<2mos: not established. Use two-vial presentation in individuals 2mos–55yrs. Use one-vial presentation in individuals 10–55yrs. Give by IM inj only. Infants: give in anterolateral thigh; toddlers, adolescents and adults: in deltoid muscle. Primary vaccination (2mos): as a four-dose series at 2, 4, 6, and 12mos of age; (7–23mos): as a two-dose series with the 2nd dose given in the 2nd year of life and at least 3mos after the 1st dose; (2–55yrs): 0.5mL once. For children 2–5yrs: if continued high risk, may give a 2nd dose 2mos after the 1st dose. Booster vaccination (15–55yrs): may give a single dose (0.5mL) to individuals at continued risk, if at least 4yrs elapsed since a prior dose. All: observe for 15mins post-dose.

Menveo Contraindications

Contraindications

Life-threatening reaction to any previous CRM197 or other diphtheria toxoid or meningococcal-containing vaccine.

Menveo Boxed Warnings

Not Applicable

Menveo Warnings/Precautions

Warnings/Precautions

Immunodeficiency. Have epinephrine inj (1:1000) available. Known history of Guillain-Barre Syndrome. Complement deficiency, eculizumab recipients; increased risk of invasive meningococcal disease despite vaccination with Menveo. Pregnancy. Nursing mothers.

Warnings/Precautions

Management of Acute Allergic Reactions

  • Have medical treatment readily available in case of an acute allergic reaction, including an anaphylactic event, following administration.

Syncope

  • Syncope may occur. Procedures should be in place to avoid injury from fainting.

Altered Immunocompetence

  • May reduce immune responses in some individuals with altered immunocompetence, including those receiving immunosuppressant therapy.

  • Increased risk for invasive disease caused by N meningitidis, including invasive disease caused by serogroups A, C, Y and W-135, in persons with certain complement deficiencies and those receiving treatment that inhibits terminal complement activation (eg, eculizumab) even if they develop antibodies following vaccination with Menveo.

Guillain-Barré Syndrome

  • Consider the potential benefits and risks of administering Menveo in persons with a history of Guillain-Barré Syndrome (GBS).

  • Temporal relationship has been reported with GBS following administration of another US-licensed meningococcal quadrivalent polysaccharide conjugate vaccine.

Apnea in Premature Infants

  • In some infants born prematurely, apnea has been observed following IM administration.

  • Consider the infant’s medical status and the potential benefits and risks of vaccination when deciding to administer Menveo to an infant born prematurely.

Pregnancy Considerations

Risk Summary

  • No adequate and well-controlled studies of Menveo in pregnant women in the US.

  • Available data do not suggest an increased risk of major birth defects and miscarriage in women who received Menveo within 28 days prior to conception or during pregnancy. 

Nursing Mother Considerations

Risk Summary

  • Unknown whether Menveo is excreted in human milk.

  • Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for Menveo and any potential adverse effects on the breastfed child from Menveo.

Pediatric Considerations

  • Safety and efficacy of Menveo in children aged younger than 2 months have not been established.

  • The safety and efficacy of the one-vial presentation has not been established in children younger than 10 years of age. The two-vial presentation is approved for use in children 2–9 years of age.

Geriatric Considerations

  • Safety and efficacy of Menveo in adults 65 years of age and older have not been established.

Menveo Pharmacokinetics

See Literature

Menveo Interactions

Interactions

Immunosuppressants (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, high-dose steroids) may get suboptimal response. Concomitant vaccines: see full labeling.

Interactions

Concomitant Administration with Other Vaccines

  • Do not mix Menveo or any of its components with any other vaccine or diluent in the same syringe or vial.

  • In clinical trials of infants and toddlers, there was no immune interference observed when Menveo was concomitantly administered with routine vaccines (diphtheria toxoid; acellular pertussis; tetanus toxoid; inactivated polio types 1, 2, and 3; hepatitis B; Haemophilus influenzae type b antigens; pentavalent rotavirus; 7-valent pneumococcal conjugate vaccine; MMRV or MMR+V).

  • In clinical trials of adolescents, there was no immune interference observed when Menveo was concomitantly administered with the following vaccines: Tdap and HPV. When Menveo was administered concomitantly with Tdap and HPV, lower GMCs for antibodies to the pertussis antigens filamentous hemagglutinin and pertactin were observed compared with Tdap alone.

Immunosuppressive Treatments

  • Immunosuppressants (eg, irradiation, antimetabolites, alkylating agents, cytotoxic drugs, high-dose steroids) may reduce the immune response to Menveo.

  • The immunogenicity of Menveo has not been evaluated in persons receiving such therapies.

Menveo Adverse Reactions

Adverse Reactions

Inj site pain, tenderness, erythema, induration; irritability, sleepiness, headache, malaise, nausea, myalgia, arthralgia; syncope (seizure-like movements possible post-dose), apnea in premature infants.

Adverse Reactions

Common solicited adverse reactions (≥10%) among children initiating vaccination at 2 months of age and receiving the 4-dose series

  • Tenderness (24% to 41%) and erythema at injection site (11% to 15%), irritability (42% to 57%), sleepiness (29% to 50%), persistent crying (21% to 41%), change in eating habits (17% to 23%), vomiting (5% to 11%), diarrhea (8% to 16%). 

Common solicited adverse reactions (≥10%) among children initiating vaccination at 7 months through 23 months of age and receiving the 2- dose series:

  • Tenderness (10% to 16%) and erythema at injection site (12% to 15%), irritability (27% to 40%), sleepiness (17% to 29%), persistent crying (12-21%), change in eating habits (12% to 20%), diarrhea (10% to 16%). 

Common solicited adverse reactions (≥10%) among children aged 2 through 10 years who received Menveo

  • Injection site pain (31%), erythema (23%), irritability (18%), induration (16%), sleepiness (14%), malaise (12%), headache (11%). 

Common solicited adverse reactions (≥10%) among adolescents and adults who received a single dose of Menveo:

  • Pain at the injection site (41%), headache (30%), myalgia (18%), malaise (16%), and nausea (10%). 

  • Similar rates of solicited adverse reactions were observed following a single booster dose. 

Menveo Clinical Trials

Clinical Trials

Primary Vaccination Studies

Immunogenicity in Infants/Toddlers Aged 2 Months through 12 Months

  • A randomized, controlled, multicenter study (NCT01000311) evaluated the efficacy of Menveo in infants (mean age at enrollment was 65 days). The predefined criteria for immunogenicity were met for all 4 serogroups A, C, W-135, and Y at 1 month following completion of a 4-dose series at 2, 4, 6, and 12 months of age. The percentage of subjects with hSBA ≥1:8 at 7 months was 94% to 98% for serogroups C, W-135, and Y and 76% for serogroup A.

  • A randomized, controlled, multicenter clinical trial (NCT00626327) evaluated the efficacy of 2 doses of Menveo administered at 7–9 months and 12 months of age in 386 participants (mean age at enrollment was 8.5 months). The study also evaluated Menveo concomitantly administered with MMRV. Among the per-protocol population, after Menveo administered at 7-9 and at 12 months, the proportions of subjects with hSBA ≥1:8 for serogroups A, C, W-135, and Y were respectively: 88% (84-91), 100% (98-100), 98% (96-100), 96% (93-99).

Immunogenicity in Children Aged 2 Years through 10 Years

  • A randomized, multicenter, active-controlled clinical study (NCT00616421) compared hSBA response after 1 dose of Menveo or Menactra in participants aged 2 to 10 years of age. Participants were randomly assigned to receive a single dose of Menveo (n=1170) or Menactra (n=1161), and included serological results for 89% to 95% of participants.

  • In a separate group of children aged 2 to 5 years who received 2 doses of Menveo administered 2 months apart, the serologic results included 96% to 99% of participants.

  • Menveo achieved noninferiority to Menactra in participants aged 2 to 5 years and 6 to 10 years for seroresponse rates for serogroups C, W-135, and Y, but not for serogroup A.

  • In 297 per-protocol participants aged 2 to 5 years who were observed 1 month after the second dose of Menveo, the proportions of participants with seroresponse (95% CI) were: 91% (87-94), 98% (95-99), 89% (85-92), and 95% (91-97) for serogroups A, C, W-135, and Y, respectively. The proportion of participants with hSBA ≥1:8 (95% CI) were 91% (88-94), 99% (97-100), 99% (98-100), and 98% (95-99) for serogroups A, C, W-135, and Y, respectively. The hSBA GMTs (95% CI) for this group were 64 (51-81), 144 (118-177), 132 (111-157), and 102 (82-126) for serogroups A, C, W-135, and Y, respectively.

Immunogenicity in Adolescents Aged 11 Years through 18 Years

  • A randomized, multicenter, active-controlled clinical study (NCT00450437) compared the hSBA responses after 1 dose of Menveo or Menactra in 3539 participants aged 11 to 55 years. Participants were randomly assigned to receive Menveo (n=2663) or Menactra (n=876).

  • In participants 11 to 18 years of age, Menvo achieved noninferiority to Menactra for all 4 serogroups.

Immunogenicity in Adults Aged 19 Years through 55 Years

  • The study described above for participants 11 through 18 years of age was stratified by age to include participants aged 11 through 55 years of age. Menveo achieved noninferiority to Menactra for all 4 serogroups.

Immunogenicity of Menveo One-Vial Presentation in Individuals Aged 10 Years through 40 Years

  • An observer-blind randomized, multicenter, controlled clinical trial (NCT03433482) compared the immune response of Menveo one-vial presentation to the two-vial presentation in individuals 10 to 40 years of age.

  • The one-vial presentation achieved noninferiority to the two-vial presentation for MenA serogroup hSBA GMTs at 28 days post-vaccination. In secondary analyses, comparable immune responses were observed against N. meningitidis serogroups C, W-135 and Y as measured by hSBA GMTs. Additional secondary analyses demonstrated comparable percentages of subjects with hSBA titers ≥8, and percentages of subjects with a ≥4-fold rise in titers compared to baseline for serogroups A, C, W-135 and Y.

 

Booster Vaccination Study

Immunogenicity in Adolescents and Adults Aged 15 Years through 55 Years

  • In a multicenter, open-label trial (NCT02986854) conducted in the US, 601 participants aged 15 to 51 years received a single booster dose of Menveo 4 to 6 years after prior vaccination with Menveo (n = 301; median age: 16 years) or Menactra (n = 300; median age: 16 years). 

  • The co-primary immunogenicity endpoints were hSBA seroresponse to each serogroup 29 days a) following a booster vaccination with Menveo given to subjects who received a prior dose of Menveo, and b) following a booster vaccination with Menveo given to subjects who received a prior dose of Menactra.

  • Seroresponse rates at Day 29 following a booster vaccination with Menveo were 97% for serogroup A, 95% for serogroup C, 96% for serogroup W-135, and 97% for serogroup Y, in subjects who had received a prior dose of Menveo. At Day 6, following a booster vaccination, seroresponse rates were 39%, 51%, 50%, and 49% for serogroups A, C, W-135, and Y, respectively, in subjects who had received a prior dose of Menveo.

  • The hSBA GMTs were 13, 92, 112, and 63 for serogroups A, C, W-135, and Y at Day 6, and 210, 1160, 1395, and 1067, respectively, for the 4 serogroups at Day 29 following a booster dose of Menveo.

  • Booster vaccinations with Menveo following a prior dose of Menactra achieved similar seroresponse rates and GMTs.

Menveo Note

Not Applicable

Menveo Patient Counseling

Patient Counseling

Provide the following information to the vaccine recipient, parent, or guardian: 

  • Potential benefits and risks of immunization with Menveo. 

  • The importance of completing the immunization series. 

  • Potential for adverse reactions that have been temporally associated with administration of Menveo or other vaccines containing similar components. 

  • Reporting any adverse reactions to their healthcare provider.

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