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EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-immune Adults

Primary Purpose

Plasmodium Falciparum Malaria

Status
Completed
Phase
Phase 1
Locations
Ghana
Study Type
Interventional
Intervention
Placebo
EBA-175 RII-NG Malaria Vaccine
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Plasmodium Falciparum Malaria focused on measuring Ghana, malaria, vaccine, Plasmodium falciparum

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy males and healthy non-pregnant and non breastfeeding females between the ages of 18 and 40 years.
  • Females of childbearing potential must agree to practice adequate contraception through out the study and for 3 months after the third vaccination (including abstinence; hormonal contraception; condoms with spermicidal agents); males with female partners of childbearing age must agree to use condoms or other birth control.
  • Good health as determined by screening medical history, physical examination (PE), and routine laboratory assessments.
  • Willingness to comply with protocol requirements.
  • Ability to provide informed consent before any protocol procedures are performed.
  • Availability for follow-up for 12 months after the first immunization dose.

Exclusion Criteria:

  • Regular use of medications other than vitamins and contraceptives.
  • Current or recent (within the last 4 weeks prior to vaccination) treatment with parenteral, inhaled, or oral corticosteroids (intranasal steroids are acceptable), or other immunosuppressive agents, or chemotherapy.
  • History of splenectomy.
  • Abnormal screening laboratory values. Any abnormal screening value for any screening test, will exclude the subject from the study. An exception to this rule is the glucose measurement. Random plasma glucose will be measured on all subjects during the screening visit. Values higher than 110 mg/dl will be confirmed by a repeat fasting glucose measurement.
  • History of or current medical, occupational, social or family problems as a result of alcohol or illicit drug use by the volunteer.
  • History of moderate to severe mental illness, as defined by symptoms interfering with social or occupational function or suicidal thoughts/attempts.
  • History of receiving blood or blood products (such as blood transfusion, platelet transfusion, immunoglobulins, hyperimmune serum) in the previous 6 months.
  • Vaccination with a live vaccine within the past 30 days or with a non-replicating, inactivated, or subunit vaccine within the last 14 days.
  • Known hypersensitivity to components of the vaccine [Erythrocyte-Binding Antigen 175 kDa Region II-Nonglycosylated (EBA-175 RII-NG), sucrose, or aluminum adjuvant].
  • History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, or nervous system, or other metabolic and autoimmune/inflammatory conditions, sickle cell disease.
  • History of anaphylaxis or severe hypersensitivity reaction.
  • Severe asthma, as defined by an emergency room visit or hospitalization within the last 12 months.
  • Pregnant or breastfeeding women, or women unwilling to use effective contraception during the study period.
  • Acute illness, including temperature > 37.8 degrees Celsius within one week prior to vaccination.
  • Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg).
  • Concurrent participation in other investigational protocols or receipt of an investigational product within the previous 30 days.
  • Identification of any condition that, in the opinion of the investigator, would affect the ability of the subject to understand or comply with the study protocol or would jeopardize the safety or rights of a subject participating in the study.
  • History of malignancy, including hematologic and skin cancers, or known immunodeficiency syndrome.
  • Pre-medication with analgesic or antipyretic in the 6 hours prior to vaccination, or planned medication with analgesic or antipyretic in the 24 hours following vaccination. This criterion should not preclude subjects receiving such medication after vaccination if the need arises.

Sites / Locations

  • Noguchi Memorial Institute for Medical Research - Immunology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Group B: 20 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant

Group A: 5 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant

Group C: 80 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant

Arm Description

18 subjects to receive 20 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.

18 subjects to receive 5 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.

18 subjects to receive 80 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.

Outcomes

Primary Outcome Measures

Number of subjects experiencing severe (Grade 3) solicited injection site reactions.
Number of subjects experiencing severe solicited systemic reactions (Grade 3).
Number of subjects experiencing severe (Grade 3) clinical laboratory values.
Number of subjects spontaneously reporting adverse events considered associated with the vaccination that are severe (Grade 3).
Serious adverse events considered associated with the vaccination.

Secondary Outcome Measures

Number of subjects experiencing a 4-fold increase in Anti-EBA-175 RII-NG antibody level (ELISA).
Relative binding inhibition of recombinant EBA-175 RII-NG to human red blood cells in vitro in the presence of serum from immunized individuals.
Anti-EBA-175 RII-NG antibody level by enzyme-linked immunosorbent assay (ELISA).
Relative growth inhibition of Plasmodium falciparum in human red blood cells cultured in vitro in the presence of serum from immunized individuals.

Full Information

First Posted
December 3, 2009
Last Updated
March 28, 2013
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT01026246
Brief Title
EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-immune Adults
Official Title
Phase I, Double-Blinded, Placebo-Controlled Dosage-Escalation Study of the Safety and Immunogenicity of EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-immune Adults
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
June 2010 (undefined)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

5. Study Description

Brief Summary
Malaria is caused by a germ that people get from the bites of some mosquitoes. It kills over 2 million people each year. Many of the drugs used to treat malaria do not work as well as they used to and researchers are exploring other vaccines to prevent malaria. The purpose of this study is to learn if the vaccine, called EBA-175 RII-NG, is safe and if it strengthens the body's defenses against malaria. Participants will include 60 healthy adults, ages 18-40, recruited from Accra, Ghana. Several dosages of the vaccine will be tested for safety. The lowest dosages of the vaccine will be tested before the next higher dose is tested. There will be two groups for each dose, one group will receive the vaccine and the other group will receive a placebo (salt water solution). Participants may be involved in study related procedures for up to 398 days.
Detailed Description
Malaria accounts for 500 million febrile illnesses and more than a million deaths annually. The disease burden is heaviest in economically developing countries where it is estimated that up to 5 percent of the gross domestic product of sub-Saharan countries is consumed by the direct and indirect health costs of malaria. Researchers propose to conduct a Phase I dosage-escalating study to assess the safety and immunogenicity of 3 different dosages of erythrocyte-binding antigen 175 kDA region II-nonglycosylated (EBA-175 RII-NG) recombinant Plasmodium falciparum (Pf) vaccine adjuvanted with Adju-Phos (aluminum phosphate adjuvant): 5, 20, and 80 micrograms (mcg), given in 3 doses at 0, 1, and 6 months by intramuscular (IM) injection to healthy young adults in a malaria endemic area (semi-immune adults). One dose of vaccine will be given at each time point. The primary objective is to assess the safety and reactogenicity (tolerability) of ascending dosages of EBA-175 RII-NG vaccine among healthy subjects given in 3 IM doses at 0, 1 and 6 months. The secondary objective is to evaluate the immunogenicity of the EBA-175 RII-NG vaccine by measuring anti-EBA-175 RII-NG antibodies using enzyme-linked immunosorbent assay (ELISA), inhibition of Plasmodium falciparum growth in vitro, and inhibition of binding of EBA-175 RII-NG to red blood cells (RBCs). Participants will include 60 malaria semi-immune healthy subjects between the ages of 18 and 40 years, males and females, recruited from Accra, Ghana. Subjects will be randomized to receive 3 doses of the vaccine or saline placebo by the intramuscular route in a 9:1 ratio at 0, 1 and 6 months. The safety and immunogenicity of ascending dosages of the vaccine will be assessed. Eighteen subjects will receive vaccine at each of the following dosage levels: 5, 20, and 80 mcg. Two subjects will receive placebo for each dosage level. Dosage escalation will proceed only after review of the 2-week safety data of the 2 initial doses of the prior dosage level.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Falciparum Malaria
Keywords
Ghana, malaria, vaccine, Plasmodium falciparum

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group B: 20 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant
Arm Type
Experimental
Arm Description
18 subjects to receive 20 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.
Arm Title
Group A: 5 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant
Arm Type
Experimental
Arm Description
18 subjects to receive 5 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.
Arm Title
Group C: 80 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant
Arm Type
Experimental
Arm Description
18 subjects to receive 80 mcg EBA-175 + 500 mcg aluminum phosphate adjuvant; 2 subjects to receive placebo.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The placebo used will be normal saline (0.9 percent NaCl).
Intervention Type
Biological
Intervention Name(s)
EBA-175 RII-NG Malaria Vaccine
Intervention Description
EBA-175 RII-NG malaria vaccine is supplied as a white, translucent, cloudy, nonparticulate liquid suspension in single-dose clear glass vials pre-mixed with Adju-Phos aluminum phosphate adjuvant. Each 2-mL vial of EBA-175 RII-NG vaccine contains: 0.7 mL (0.5 mL per dose) EBA-175 RII-NG, at the required dose concentration, 5 percent sucrose, 1.0 mg/mL (0.5 mg/0.5 mL per dose) aluminum as aluminum phosphate adjuvant, sodium phosphate buffer (10 mM sodium phosphate and 150 mM sodium chloride), and no preservative.
Primary Outcome Measure Information:
Title
Number of subjects experiencing severe (Grade 3) solicited injection site reactions.
Time Frame
Within 14 days following vaccination.
Title
Number of subjects experiencing severe solicited systemic reactions (Grade 3).
Time Frame
Within 14 days following vaccination.
Title
Number of subjects experiencing severe (Grade 3) clinical laboratory values.
Time Frame
Within 14 days following vaccination.
Title
Number of subjects spontaneously reporting adverse events considered associated with the vaccination that are severe (Grade 3).
Time Frame
Duration of study.
Title
Serious adverse events considered associated with the vaccination.
Time Frame
Duration of study.
Secondary Outcome Measure Information:
Title
Number of subjects experiencing a 4-fold increase in Anti-EBA-175 RII-NG antibody level (ELISA).
Time Frame
Days 14, 28, 42, 180 and 194 relative to baseline.
Title
Relative binding inhibition of recombinant EBA-175 RII-NG to human red blood cells in vitro in the presence of serum from immunized individuals.
Time Frame
Days 0, 14, 28, 42, 180 and 194.
Title
Anti-EBA-175 RII-NG antibody level by enzyme-linked immunosorbent assay (ELISA).
Time Frame
Days 0, 14, 28, 42, 180 and 194.
Title
Relative growth inhibition of Plasmodium falciparum in human red blood cells cultured in vitro in the presence of serum from immunized individuals.
Time Frame
Days 0, 14, 28, 42, 180 and 194.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy males and healthy non-pregnant and non breastfeeding females between the ages of 18 and 40 years. Females of childbearing potential must agree to practice adequate contraception through out the study and for 3 months after the third vaccination (including abstinence; hormonal contraception; condoms with spermicidal agents); males with female partners of childbearing age must agree to use condoms or other birth control. Good health as determined by screening medical history, physical examination (PE), and routine laboratory assessments. Willingness to comply with protocol requirements. Ability to provide informed consent before any protocol procedures are performed. Availability for follow-up for 12 months after the first immunization dose. Exclusion Criteria: Regular use of medications other than vitamins and contraceptives. Current or recent (within the last 4 weeks prior to vaccination) treatment with parenteral, inhaled, or oral corticosteroids (intranasal steroids are acceptable), or other immunosuppressive agents, or chemotherapy. History of splenectomy. Abnormal screening laboratory values. Any abnormal screening value for any screening test, will exclude the subject from the study. An exception to this rule is the glucose measurement. Random plasma glucose will be measured on all subjects during the screening visit. Values higher than 110 mg/dl will be confirmed by a repeat fasting glucose measurement. History of or current medical, occupational, social or family problems as a result of alcohol or illicit drug use by the volunteer. History of moderate to severe mental illness, as defined by symptoms interfering with social or occupational function or suicidal thoughts/attempts. History of receiving blood or blood products (such as blood transfusion, platelet transfusion, immunoglobulins, hyperimmune serum) in the previous 6 months. Vaccination with a live vaccine within the past 30 days or with a non-replicating, inactivated, or subunit vaccine within the last 14 days. Known hypersensitivity to components of the vaccine [Erythrocyte-Binding Antigen 175 kDa Region II-Nonglycosylated (EBA-175 RII-NG), sucrose, or aluminum adjuvant]. History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, or nervous system, or other metabolic and autoimmune/inflammatory conditions, sickle cell disease. History of anaphylaxis or severe hypersensitivity reaction. Severe asthma, as defined by an emergency room visit or hospitalization within the last 12 months. Pregnant or breastfeeding women, or women unwilling to use effective contraception during the study period. Acute illness, including temperature > 37.8 degrees Celsius within one week prior to vaccination. Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg). Concurrent participation in other investigational protocols or receipt of an investigational product within the previous 30 days. Identification of any condition that, in the opinion of the investigator, would affect the ability of the subject to understand or comply with the study protocol or would jeopardize the safety or rights of a subject participating in the study. History of malignancy, including hematologic and skin cancers, or known immunodeficiency syndrome. Pre-medication with analgesic or antipyretic in the 6 hours prior to vaccination, or planned medication with analgesic or antipyretic in the 24 hours following vaccination. This criterion should not preclude subjects receiving such medication after vaccination if the need arises.
Facility Information:
Facility Name
Noguchi Memorial Institute for Medical Research - Immunology
City
Legon
State/Province
Greater Accra
Country
Ghana

12. IPD Sharing Statement

Citations:
PubMed Identifier
27644034
Citation
Koram KA, Adu B, Ocran J, Karikari YS, Adu-Amankwah S, Ntiri M, Abuaku B, Dodoo D, Gyan B, Kronmann KC, Nkrumah F. Safety and Immunogenicity of EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-Immune Adults: A Phase 1, Double-Blinded Placebo Controlled Dosage Escalation Study. PLoS One. 2016 Sep 19;11(9):e0163066. doi: 10.1371/journal.pone.0163066. eCollection 2016.
Results Reference
derived

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EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-immune Adults

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