Trial Outcomes & Findings for Hepatitis B Vaccine Predialysis/Dialysis Study (V232-060) (NCT NCT00440297)

NCT ID: NCT00440297

Last Updated: 2017-04-13

Results Overview

The number of participants as measured by the seroprotection rate (anti-hepatitis B surface antibodies greater than or equal to 10 mIU/mL). Anti-HBs (Antibodies against hepatitis B surface antigen) titers were measured from blood samples taken at Day 1 (prior to the first dose) and at Month 7 (1 month after the third dose).

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

277 participants

Primary outcome timeframe

7 months (1 month after the third dose)

Results posted on

2017-04-13

Participant Flow

22-Dec-2006 (First Patient Enrolled in Study) to 05-May-2008 (Last Participant had their Last Visit). This study was conducted at 23 sites: 7 in Canada, 8 in the United Kingdom, 5 in Italy, and 3 in Spain. In the Modified Process group, one participant was randomized by mistake, and therefore was not vaccinated.

A screening serum sample was obtained prior to study entry and assayed for hepatitis B serologic markers. Only patients that were seronegative were considered for enrollment.

Participant milestones

Participant milestones
Measure
Modified Process Hepatitis B Vaccine
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
ENGERIX-B™, 2 x 20 µg(micrograms)
Overall Study
STARTED
139
138
Overall Study
Vaccination Visit 1
138
138
Overall Study
Vaccination Visit 2
136
134
Overall Study
Vaccination Visit 3
124
125
Overall Study
Vaccination Visit 4
116
122
Overall Study
COMPLETED
116
120
Overall Study
NOT COMPLETED
23
18

Reasons for withdrawal

Reasons for withdrawal
Measure
Modified Process Hepatitis B Vaccine
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
ENGERIX-B™, 2 x 20 µg(micrograms)
Overall Study
Adverse Event
8
5
Overall Study
Lost to Follow-up
1
0
Overall Study
Physician Decision
1
0
Overall Study
Protocol Violation
11
7
Overall Study
Withdrawal by Subject
1
6
Overall Study
Randomized by mistake
1
0

Baseline Characteristics

Hepatitis B Vaccine Predialysis/Dialysis Study (V232-060)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Modified Process Hepatitis B Vaccine
n=138 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=138 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
Total
n=276 Participants
Total of all reporting groups
Age, Continuous
69.7 Years
STANDARD_DEVIATION 13.4 • n=5 Participants
69.2 Years
STANDARD_DEVIATION 12.7 • n=7 Participants
69.5 Years
STANDARD_DEVIATION 13.0 • n=5 Participants
Sex: Female, Male
Female
53 Participants
n=5 Participants
56 Participants
n=7 Participants
109 Participants
n=5 Participants
Sex: Female, Male
Male
85 Participants
n=5 Participants
82 Participants
n=7 Participants
167 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 7 months (1 month after the third dose)

Population: Per-Protocol Population: The Per-Protocol Population is defined as the participants that were able to complete the study as defined by the protocol.

The number of participants as measured by the seroprotection rate (anti-hepatitis B surface antibodies greater than or equal to 10 mIU/mL). Anti-HBs (Antibodies against hepatitis B surface antigen) titers were measured from blood samples taken at Day 1 (prior to the first dose) and at Month 7 (1 month after the third dose).

Outcome measures

Outcome measures
Measure
Modified Process Hepatitis B Vaccine
n=101 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=111 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
The Number of Seroprotected Participants to the Modified Process Hepatitis B Vaccine and ENGERIX-B™ (Currently Licensed Vaccine) at Month 7
49 Participants
64 Participants

PRIMARY outcome

Timeframe: 9 months (1 month after the fourth dose)

Population: Per-Protocol Population: The Per- Protocol Population is defined as the participants that were able to complete the study as defined by the protocol.

The number of participants as measured by the seroprotection rate (anti-hepatitis B surface antibodies greater than or equal to 10 mIU/mL). Anti-HBs (Antibodies against hepatitis B surface antigen) titers were measured from blood samples taken at Day 1 (prior to the first dose) and at Month 9 (1 month after the fourth dose).

Outcome measures

Outcome measures
Measure
Modified Process Hepatitis B Vaccine
n=99 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=104 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
The Number of Seroprotected Participants to the Modified Process Hepatitis B Vaccine and ENGERIX-B™ (Currently Licensed Vaccine) at Month 9
66 Participants
72 Participants

PRIMARY outcome

Timeframe: Days 1-15 After Any Vaccination

Population: Safety Analysis Set: The Safety Analysis Set is defined as all participants who receive at least one injection of vaccine and who had a safety follow-up

Outcome measures

Outcome measures
Measure
Modified Process Hepatitis B Vaccine
n=138 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=135 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
The Total Number of Participants With One or More Injection-Site Adverse Experiences
43 Participants
48 Participants

PRIMARY outcome

Timeframe: Days 1-5 After Any Vaccination

Population: Safety Analysis Set: The Safety Analysis Set is defined as all participants who receive at least one injection of vaccine and who had a safety follow-up

Outcome measures

Outcome measures
Measure
Modified Process Hepatitis B Vaccine
n=138 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=135 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
The Total Number of Participants With a Maximum Temperature >= 100.0F / 37.8C
5 Participants
6 Participants

PRIMARY outcome

Timeframe: 0-9 months (recorded from first dose until the participant completes or discontinues the study)

Population: Safety Analysis Set: The Safety Analysis Set is defined as all participants who receive at least one injection of vaccine and who had a safety follow-up

Participants with adverse experiences considered possibly, probably, or definitely related to study vaccines and considered serious (death, persistent disability, life threatening, hospitalization, birth defects, cancer, or overdose).

Outcome measures

Outcome measures
Measure
Modified Process Hepatitis B Vaccine
n=138 Participants
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
n=135 Participants
ENGERIX-B™, 2 x 20 µg(micrograms)
The Total Number of Participants With Serious Vaccine-Related Clinical Adverse Experiences
0 Participants
0 Participants

Adverse Events

Modified Process Hepatitis B Vaccine

Serious events: 11 serious events
Other events: 56 other events
Deaths: 0 deaths

ENGERIX-B™

Serious events: 11 serious events
Other events: 73 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Modified Process Hepatitis B Vaccine
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
ENGERIX-B™, 2 x 20 µg(micrograms)
Infections and infestations
Pneumonia
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Cardiac disorders
Myocardial Infarction
2.9%
4/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Injury, poisoning and procedural complications
Hip fracture
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Blood and lymphatic system disorders
Anaemia
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Acute pulmonary oedema
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Nervous system disorders
Cerebral ischaemia
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Renal and urinary disorders
Renal failure
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Renal neoplasm
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Gastrointestinal disorders
Pancreatitis acute
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Emphysema
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Hepatobiliary disorders
Hepatitis
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastases to liver
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Liver function test abnormal
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Cardiac disorders
Cardiac failure congestive
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Cardiac disorders
Cardiac arrest
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Gastrointestinal disorders
Gastric ulcer
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Cardiac disorders
Cardio-respiratory arrest
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Renal and urinary disorders
Renal failure chronic
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Musculoskeletal and connective tissue disorders
Muscular weakness
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Injury, poisoning and procedural complications
Renal haematoma
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Vascular disorders
Circulatory collapse
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Infections and infestations
Sepsis
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Injury, poisoning and procedural complications
Arteriovenous fistula site complication
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Metabolism and nutrition disorders
Hypoglycaemia
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months

Other adverse events

Other adverse events
Measure
Modified Process Hepatitis B Vaccine
Modified Process Hepatitis B Vaccine, 40 µg(micrograms)
ENGERIX-B™
ENGERIX-B™, 2 x 20 µg(micrograms)
Gastrointestinal disorders
Constipation
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Gastrointestinal disorders
Diarrhea
3.6%
5/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
4.4%
6/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Gastrointestinal disorders
Nausea
2.2%
3/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Gastrointestinal disorders
Vomiting
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Asthenia
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Fatigue
2.9%
4/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Edema peripheral
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
2.2%
3/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Pyrexia
2.9%
4/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
4.4%
6/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Infections and infestations
Cystitis
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Infections and infestations
Lower respiratory tract infection
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Infections and infestations
Nasopharyngitis
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
2.2%
3/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Infections and infestations
Urinary tract infection
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
2.2%
3/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Musculoskeletal and connective tissue disorders
Athralgia
2.2%
3/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
3.0%
4/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Musculoskeletal and connective tissue disorders
Muscle spasms
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Musculoskeletal and connective tissue disorders
Pain in extremity
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.74%
1/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Nervous system disorders
Dizziness
2.9%
4/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
3.7%
5/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Nervous system disorders
Headache
5.8%
8/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
5.9%
8/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Psychiatric disorders
Insomnia
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
3.0%
4/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Cough
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain
1.4%
2/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
0.00%
0/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Respiratory, thoracic and mediastinal disorders
Rhinorrhea
0.00%
0/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
Skin and subcutaneous tissue disorders
Pruritis
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Injection site Erythema
5.1%
7/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
14.1%
19/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Injection site Edema
0.72%
1/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
1.5%
2/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Injection site Pain
23.2%
32/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
28.9%
39/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
General disorders
Injection site Swelling
8.7%
12/138 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months
10.4%
14/135 • All adverse events: Days 1-15 after any vaccination; Deaths and vaccine-related serious adverse events: up to 9 months

Additional Information

Vice President, Late Stage Development Group Leader

Merck Sharp & Dohme Corp

Phone: 1-800-672-6372

Results disclosure agreements

  • Principal investigator is a sponsor employee Merck agreements may vary with individual investigators, but will not prohibit any investigator from publishing. Merck supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.
  • Publication restrictions are in place

Restriction type: OTHER