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NCT00294047

Study to Evaluate the Efficacy of the Human Papillomavirus Vaccine in Healthy Adult Women of 26 Years of Age and Older

Completed Phase 3 Results posted Last updated 2 January 2020
What this trial tests

Phase 3 trial testing Cervarix in Infections, Papillomavirus in 5,752 participants. Completed in 29 January 2014.

Timeline
16 February 2006
Primary endpoint
29 January 2014
29 January 2014

Quick facts

Lead sponsorGlaxoSmithKline
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposeprevention
Enrollment5,752
Start date16 February 2006
Primary completion29 January 2014
Estimated completion29 January 2014
Sites75 locations across Netherlands, Russia, Peru, United Kingdom, Mexico, Philippines, Canada, Thailand

Drugs / interventions tested

Conditions studied

Sponsor

GlaxoSmithKline — full company profile →

Who can join

26 and older, female only, with Infections, Papillomavirus or Papillomavirus Vaccines. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Subjects With Persistent Infection (6-month Definition) With Human Papillomavirus (HPV)-16 or HPV-18 and/or With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)1+ Associated With HPV-16 and/or -18 Cervical Infection. Primary · Up to Month 48

CIN1+ = CIN grades 1, 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Persistent HPV infection = detection of the same HPV type(s) by polymerase chain reaction (PCR) in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. * DNA- and sero-/+: subjects HPV deoxyribonucleic acid (DNA) negative (DNA-) at Month 0 and 6 and seronegative/positive (sero-/+) at Month 0 for the corresponding HPV-type by Enzyme-linked Immunosorbent Assay (ELISA) * Overall: subjects DNA- at Month 0 and 6 for the corresponding HPV-type, regardless of initial serostatus

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group36
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group27
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group10
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group14
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group9
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group5
HPV-16/18, overall
GroupValue95% CI
Cervarix Group9
Aluminium Hydroxide Group51
HPV-16, overall
GroupValue95% CI
Cervarix Group6
Aluminium Hydroxide Group36
Number of Subjects With Persistent Infection (6-month Definition) With HPV-16 or HPV-18 and/or With Histopathologically-CIN1+ Associated With HPV-16 and/or -18 Cervical Infection Detected Using the HPV Type Assignment Algorithm (TAA). Primary · Up to Month 48

CIN1+ = CIN grades 1, 2 and 3, AIS and invasive cervical cancer. Persistent cervical HPV infection (6-month definition) = detection of the same HPV type(s) by PCR in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. * DNA- and sero-/+: subjects HPV DNA negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative/positive (sero-/+) for HPV-16 and/or HPV-18 by ELISA at baseline (Month 0). * Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group36
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group27
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group10
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group12
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group8
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group4
HPV-16/18, overall
GroupValue95% CI
Cervarix Group9
Aluminium Hydroxide Group49
HPV-16, overall
GroupValue95% CI
Cervarix Group6
Aluminium Hydroxide Group35
Number of Subjects With Persistent Infection (6-month Definition) With Human Papillomavirus (HPV)-16 or HPV-18 and/or With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)1+ Associated With HPV-16 and/or -18 Cervical Infection. Primary · Up to Month 84

CIN1+ = CIN grades 1, 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Persistent HPV infection = detection of the same HPV type(s) by polymerase chain reaction (PCR) in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. - DNA- and sero-/+: subjects HPV deoxyribonucleic acid (DNA) negative (DNA-) at Month 0 and 6 and seronegative/positive (sero-/+) at Month 0 for the corresponding HPV-type by Enzyme-linked Immunosorbent Assay (ELISA) - Overall: subjects DNA- at Month 0 and 6 for the corresponding HPV-type, regardless of initial serostatus

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group71
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group53
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group3
Aluminium Hydroxide Group20
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group3
Aluminium Hydroxide Group16
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group10
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group6
HPV-16/18, overall
GroupValue95% CI
Cervarix Group10
Aluminium Hydroxide Group90
HPV-16, overall
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group63
Number of Subjects With Persistent Infection (6-month Definition) With HPV-16 or HPV-18 and/or With Histopathologically-CIN1+ Associated With HPV-16 and/or -18 Cervical Infection Detected Using the HPV Type Assignment Algorithm (TAA). Primary · Up to Month 84

CIN1+ = CIN grades 1, 2 and 3, AIS and invasive cervical cancer. Persistent cervical HPV infection (6-month definition) = detection of the same HPV type(s) by PCR in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. - DNA- and sero-/+: subjects HPV DNA negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative/positive (sero-/+) for HPV-16 and/or HPV-18 by ELISA at baseline (Month 0). - Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group71
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group53
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group20
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group3
Aluminium Hydroxide Group14
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group9
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group5
HPV-16/18, overall
GroupValue95% CI
Cervarix Group10
Aluminium Hydroxide Group88
HPV-16, overall
GroupValue95% CI
Cervarix Group7
Aluminium Hydroxide Group62
Number of Subjects With Persistent Infection (6-month Definition) With Human Papillomavirus (HPV)-16 or HPV-18 Secondary · Up to Month 48

Persistent cervical HPV infection (6-month definition) was defined as the detection of the same HPV type(s) by PCR in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. Detection was done in: * DNA- and sero-/+: subjects HPV DNA negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative/positive (sero-/+) for HPV-16 and/or HPV-18 by ELISA at baseline (Month 0). * Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group6
Aluminium Hydroxide Group34
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group26
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group8
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group11
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group8
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group3
HPV-16/18, overall
GroupValue95% CI
Cervarix Group8
Aluminium Hydroxide Group45
HPV-16, overall
GroupValue95% CI
Cervarix Group6
Aluminium Hydroxide Group34
Number of Subjects With Persistent Infection (12-month Definition) With Human Papillomavirus (HPV)-16 or HPV-18 Secondary · Up to Month 48

Persistent cervical HPV infection (12-month definition) was defined as the detection of the same HPV type(s) PCR in cervical samples at all available time points over approximately a 12-month interval (evaluations are planned at approximately 6-month intervals). * DNA- and sero-/+: subjects HPV DNA negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative/positive (sero-/+) for HPV-16 and/or HPV-18 by ELISA at baseline (Month 0). * Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group18
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group12
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group6
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group3
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group2
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group1
HPV-16/18, overall
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group21
HPV-16, overall
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group14
Number of Subjects With Persistent Infection (6-month Definition) With Oncogenic HPV Types Individually or in Combinations. Secondary · Up to Month 48

Persistent cervical HPV infection (6-month definition) = detection of the same HPV type(s) by PCR in cervical samples at 2 consecutive evaluations over approximately a 6-month interval. Oncogenic HPV types included HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68. Detection was done in subjects HPV DNA- for the corresponding HPV type at baseline (at month 0 and Month 6) regardless of initial serostatus. HPV-HRW=All high-risk (oncogenic) HPV types excluding HPV-16 and HPV-18. HPV-HR=High-risk (oncogenic) HPV types: HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68.

HPV-16
GroupValue95% CI
Cervarix Group6
Aluminium Hydroxide Group34
HPV-18
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group11
HPV-31
GroupValue95% CI
Cervarix Group4
Aluminium Hydroxide Group19
HPV-33
GroupValue95% CI
Cervarix Group8
Aluminium Hydroxide Group6
HPV-35
GroupValue95% CI
Cervarix Group8
Aluminium Hydroxide Group13
HPV-39
GroupValue95% CI
Cervarix Group20
Aluminium Hydroxide Group11
HPV-45
GroupValue95% CI
Cervarix Group4
Aluminium Hydroxide Group17
HPV-51
GroupValue95% CI
Cervarix Group27
Aluminium Hydroxide Group26
Number of Subjects With Persistent Infection (12-month Definition) With Oncogenic HPV Types Individually or in Combinations. Secondary · Up to Month 48

Persistent HPV infection (12-month definition) = detection of the same HPV type(s) by PCR in cervical samples at available time points over approximately a 12-month interval (evaluations are planned at approximately 6-month intervals). Oncogenic HPV types included HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68. subjects HPV DNA- for the corresponding HPV type at Month 0 6, regardless of initial serostatus. HPV-HRW=All high-risk (oncogenic) HPV types excluding HPV-16 and HPV-18 HPV-HR=High-risk (oncogenic) HPV types: HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 , 68

HPV-16
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group14
HPV-18
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group7
HPV-31
GroupValue95% CI
Cervarix Group2
Aluminium Hydroxide Group10
HPV-33
GroupValue95% CI
Cervarix Group5
Aluminium Hydroxide Group5
HPV-35
GroupValue95% CI
Cervarix Group3
Aluminium Hydroxide Group8
HPV-39
GroupValue95% CI
Cervarix Group12
Aluminium Hydroxide Group5
HPV-45
GroupValue95% CI
Cervarix Group4
Aluminium Hydroxide Group8
HPV-51
GroupValue95% CI
Cervarix Group11
Aluminium Hydroxide Group14
Number of Subjects With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)2+ Associated With HPV-16 and/or -18 Cervical Infection Detected Within the Lesional Component of the Cervical Tissue Specimen Secondary · Up to Month 48

CIN2+ was defined as CIN grades 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Detection was done in: * DNA- and sero-: subjects HPV deoxyribonucleic acid (DNA) negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative (sero-) for HPV-16 and/or HPV-18 by Enzyme-linked Immunosorbent Assay (ELISA) at baseline (Month 0). * Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline. Note: Results for seropositive status were not analysed.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group4
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group3
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group2
HPV-16/18, overall
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group6
HPV-16, overall
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group3
HPV-18, overall
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group4
Number of Subjects With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)1+ Associated With HPV-16 and/or -18 Cervical Infection Detected Within the Lesional Component of the Cervical Tissue Specimen Secondary · Up to Month 48

CIN1+ was defined as CIN grades 1, 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Detection was done in: * DNA- and sero-/+: subjects HPV deoxyribonucleic acid (DNA) negative (DNA-) at Month 0 and Month 6 for the corresponding HPV-type and seronegative/positive (sero-/+) for HPV-16 and/or HPV-18 by Enzyme-linked Immunosorbent Assay (ELISA) at baseline (Month 0). * Overall: subjects DNA- at Month 0 and Month 6 for the corresponding HPV-type and regardless of initial serostatus at baseline.

HPV-16/18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group7
HPV-16, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group5
HPV-18, DNA- and sero- subjects
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group3
HPV-16/18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group3
HPV-16, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group1
HPV-18, DNA- and sero+ subjects
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group2
HPV-16/18, overall
GroupValue95% CI
Cervarix Group1
Aluminium Hydroxide Group11
HPV-16, overall
GroupValue95% CI
Cervarix Group0
Aluminium Hydroxide Group6
Number of Subjects With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)1+ Associated With HPV-16 and/or -18 Cervical Infection Detected Within the Lesional Component of the Cervical Tissue Specimen Secondary · Up to Month 48

CIN1+ was defined as CIN grades 1, 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Detection was done on all subjects irrespective of their baseline HPV DNA and serostatus.

HPV-16/18
GroupValue95% CI
Cervarix Group35
Aluminium Hydroxide Group56
HPV-16
GroupValue95% CI
Cervarix Group24
Aluminium Hydroxide Group42
HPV-18
GroupValue95% CI
Cervarix Group13
Aluminium Hydroxide Group20
Number of Subjects With Histopathologically-confirmed Cervical Intraepithelial Neoplasia (CIN)1+ Irrespective of HPV Cervical Infection and Irrespective of Baseline HPV DNA Status Secondary · Up to Month 48

CIN1+ was defined as CIN grades 1, 2 and 3, adenocarcinoma in situ (AIS) and invasive cervical cancer. Detection was done on all subjects irrespective of their baseline HPV DNA status.

GroupValue95% CI
Cervarix Group152
Aluminium Hydroxide Group178

Adverse events — posted to ClinicalTrials.gov

Time frame: SAEs: from the beginning of the study up to Month 84. Unsolicited AEs: within 30 days (Days 0-29) post-vaccination period). Solicited AEs: During the 7-day (Days 0-6) post-vaccination period.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Cervarix Group
Serious: 291/2881 (10%)
Deaths:
Aluminium Hydroxide Group
Serious: 269/2871 (9%)
Deaths:

Serious adverse events (327 terms)

ReactionSystemCervarix GroupAluminium Hydroxide Group
Abortion spontaneous completePregnancy, puerperium and perinatal conditions
Abortion spontaneous incompletePregnancy, puerperium and perinatal conditions
AppendicitisInfections and infestations
Abortion spontaneousPregnancy, puerperium and perinatal conditions
Uterine leiomyomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Abortion missedPregnancy, puerperium and perinatal conditions
CholelithiasisHepatobiliary disorders
Dengue feverInfections and infestations
Blighted ovumPregnancy, puerperium and perinatal conditions
Abortion threatenedPregnancy, puerperium and perinatal conditions
Pre-eclampsiaPregnancy, puerperium and perinatal conditions
Ovarian cystReproductive system and breast disorders
PyelonephritisInfections and infestations
Ectopic pregnancyPregnancy, puerperium and perinatal conditions
GastroenteritisInfections and infestations
Urinary tract infectionInfections and infestations
Suicide attemptPsychiatric disorders
MigraineNervous system disorders
HypertensionVascular disorders
MenorrhagiaReproductive system and breast disorders
ConvulsionNervous system disorders
Breast cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Uterine polypReproductive system and breast disorders
Abdominal painGastrointestinal disorders
CholecystitisHepatobiliary disorders
Other adverse events (12 terms — click to expand)

ReactionSystemCervarix GroupAluminium Hydroxide Group
PainGeneral disorders
HeadacheGeneral disorders
FatigueGeneral disorders
SwellingGeneral disorders
RednessGeneral disorders
MyalgiaGeneral disorders
GastrointestinalGeneral disorders
ArthralgiaGeneral disorders
FeverGeneral disorders
UrticariaGeneral disorders
HeadacheNervous system disorders
RashGeneral disorders

Most-reported serious reactions: Abortion spontaneous complete, Abortion spontaneous incomplete, Appendicitis, Abortion spontaneous, Uterine leiomyoma, Abortion missed, Cholelithiasis, Dengue fever.

Data from ClinicalTrials.gov NCT00294047 adverse events section.

Sponsor's own description

This is a multicentre study in which women were planned to receive either the Human Papillomavirus Vaccine (HPV) vaccine or control. Under Protocol Amendment 3, study participation will last approximately 48 months and involves a total of eleven scheduled visits. Under Protocol Amendment 4, study participation will last up to 84 months and involves a maximum of seventeen scheduled visits.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors.
    Arbyn M, Xu L, Simoens C, Martin-Hirsch PP. · · 2018 · cited 289× · PMID 29740819 · DOI 10.1002/14651858.cd009069.pub3
  2. Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 7-year follow-up of the phase 3, double-blind, randomised controlled VIVIANE study.
    Wheeler CM, Skinner SR, Del Rosario-Raymundo MR, Garland SM, et al · · 2016 · cited 142× · PMID 27373900 · DOI 10.1016/s1473-3099(16)30120-7
  3. Efficacy, safety, and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 4-year interim follow-up of the phase 3, double-blind, randomised controlled VIVIANE study.
    Skinner SR, Szarewski A, Romanowski B, Garland SM, et al · · 2014 · cited 126× · PMID 25189358 · DOI 10.1016/s0140-6736(14)60920-x
  4. Human Papillomavirus Vaccines.
    Markowitz LE, Schiller JT. · · 2021 · cited 105× · PMID 34590141 · DOI 10.1093/infdis/jiaa621
  5. Comparison of different human papillomavirus (HPV) vaccine types and dose schedules for prevention of HPV-related disease in females and males.
    Bergman H, Buckley BS, Villanueva G, Petkovic J, et al · · 2019 · cited 90× · PMID 31755549 · DOI 10.1002/14651858.cd013479
  6. Progression of HPV infection to detectable cervical lesions or clearance in adult women: Analysis of the control arm of the VIVIANE study.
    Skinner SR, Wheeler CM, Romanowski B, Castellsagué X, et al · · 2016 · cited 73× · PMID 26685704 · DOI 10.1002/ijc.29971
  7. Pooled analysis of large and long-term safety data from the human papillomavirus-16/18-AS04-adjuvanted vaccine clinical trial programme.
    Angelo MG, David MP, Zima J, Baril L, et al · · 2014 · cited 72× · PMID 24644063 · DOI 10.1002/pds.3554
  8. Ten-year immune persistence and safety of the HPV-16/18 AS04-adjuvanted vaccine in females vaccinated at 15-55 years of age.
    Schwarz TF, Galaj A, Spaczynski M, Wysocki J, et al · · 2017 · cited 53× · PMID 28984053 · DOI 10.1002/cam4.1155

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