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Safety and Efficacy Study of WRSS1, a Shigella Sonnei Vaccine Candidate

Primary Purpose

Dysentery, Shigella, Diarrhea

Status
Completed
Phase
Phase 1
Locations
Thailand
Study Type
Interventional
Intervention
Part 1/Arm 1 of Study: WRSS1 vaccine
Part 1/Arm 2 of Study: Placebo vaccine
Part 2/Arm 1 of Study: S. sonnei 53G
Part 2/Arm 2 of Study: S. sonnei 53G
Sponsored by
U.S. Army Medical Research and Development Command
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Dysentery

Eligibility Criteria

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

Inclusion Criteria:

  1. 20-40 years old; male or female;
  2. General good health as determined by a screening evaluation no greater than 30 days before admission;
  3. Normal bowel habits (grade 1-2 stools - no more than one to two stools per day with at least one stool per 2 days;
  4. Sexually active females willing to use birth control (birth control pills, injection hormonal contraceptive, implant hormonal contraceptive, hormonal patch, IUD, sterilization for effective contraceptive methods, spermicidal products and barrier methods are considered acceptable)during the entire study (starting from study day -30) and for 3 months after completion of the study (approximately a total of 6 months) or sexually inactive females (no sexual contact). Volunteers who take birth control pills will be required to use additional contraceptive methods for the remaining days of the cycle after discharge from the VTC (alteration of gastrointestinal functions from the oral vaccine or challenge strain may lead to unpredictable efficacy of pills);
  5. Will be available and willing to continue participation in the second part of the study if he/she has been randomly selected;
  6. Pass the Assessment of Understanding of the consent form.

Exclusion Criteria:

  1. An acute or chronic medical condition or a clinically significant abnormality on physical exam that, in the opinion of the investigator, would render vaccination or challenge as unsafe;
  2. Current use of iron or zinc supplements within the past 7 days; current use of antacids (H2 blockers, omeprazole, OTC agents) or immunosuppressive drug;
  3. Unwillingness to follow the study procedures
  4. Currently breastfeeding, pregnant (βHCG +) or planning to become pregnant within 3 months after the completion of the study;
  5. Allergy to quinolone, sulfa, and penicillin classes of antibiotics;
  6. History of any of the following conditions within the past 10 years:

    • Arthritis (two or more episodes of joint pain and swelling),
    • Gastrointestinal disease (diagnosed by a doctor as having irritable bowel disease, Crohn's disease, ulcerative colitis (biopsy confirmed), celiac disease, stomach or intestinal ulcers), or
    • Dyspepsia (digestion or heartburn requiring medication more than once per week);
  7. Lifetime previous history of known/suspected Shigella diarrhea (except for volunteers who receive vaccines from Part 1) ;
  8. Lifetime history of, or active gallbladder disease;
  9. HLA B27 Ag (+); Anti-HIV (+); HBsAg(+); Anti HCV IgG Ab(+); abnormal screening tests judged to be clinically significant as judged by PI or sub-PI (Values are out of the acceptable abnormal range from the table in the protocol) other than mild anemia in females (Hct = 0.33-0.36);
  10. Lifetime history of participation in Shigella study (except for volunteers who receive vaccines from Part 1);
  11. Concurrent participation in another experimental vaccine or drug study within the past 30 days(except for volunteers who receive vaccines from part1);
  12. Serological positive for Shigella sonnei: anti-Shigella sonnei LPS IgG antibody titer in serum >800 (except for volunteers who receive vaccines from Part 1);
  13. Receipt of antimicrobial drugs for any reason or acute illness or fever >=38 oC within 7 days before vaccination or challenge;
  14. Individuals with household contacts that are immunocompromised;
  15. History of major abdominal surgery or laparotomy for any reason in the past 3 years, or abdominal scar of unclear origin;
  16. Presence of significant ova or parasite or Shigella bacteria in the stool;
  17. Receipt of any of the following (does not include the WRSS1 vaccine):

    • a licensed live, attenuated vaccine within the 30 days of challenge
    • a licensed subunit or killed vaccine within the 14 days of the challenge
    • a blood product, including immunoglobulin, in the 90 days before the challenge

Sites / Locations

  • Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Active Comparator

Arm Label

Part 1/Arm 1 of Study: WRSS1 vaccine

Part 1/Arm 2 of Study: Placebo vaccine

Part 2/Arm 1 of Study: S. sonnei 53G

Part 2/Arm 2 of Study: S sonnei 53G

Arm Description

WRSS1 is a live attenuated S. sonnei vaccine candidate derived from the Mosely strain of S.sonnei

Placebo

10 volunteers from Study Arm 1/Part 1 (WRSS1 vaccine) plus 4 alternates from Arm 1/Part 1 are given 53G S. sonnei

10 subjects (naïve controls) plus 4 alternates are give 53G S sonnei

Outcomes

Primary Outcome Measures

Number of Participants With Adverse Events
Overview of AEs highlighting all AEs, withdrawals and deaths related to AEs
Number of Participants With Shigella Induced Clinical Disease in Part 2
Study Part 2-Frequency of Shigella induced clinical disease defined as one or more of diarrhea, dysentery or fever in vaccinees and controls following challenge with S. sonnei 53G. Transmissibility of disease will be evaluated by the presence of fecal shedding in control subjects.

Secondary Outcome Measures

Count of Subjects With Normal and Abnormal Clinical Laboratory Values During Parts 1 and 2 of Study
Count of subjects in Parts 1 and 2 with normal and abnormal clinical laboratory values after samples taken on days 1, 7, 14, and 28. Abnormal lab values are determined clinically significant by the PI

Full Information

First Posted
December 23, 2009
Last Updated
October 10, 2018
Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Mahidol University, National Institutes of Health (NIH)
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1. Study Identification

Unique Protocol Identification Number
NCT01080716
Brief Title
Safety and Efficacy Study of WRSS1, a Shigella Sonnei Vaccine Candidate
Official Title
Safety, Immunogenicity, and Efficacy Studies of WRSS1, a Live Attenuated Shigella Sonnei Vaccine Candidate, in Healthy Thai Adults
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
May 2010 (undefined)
Primary Completion Date
September 2010 (Actual)
Study Completion Date
December 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Mahidol University, National Institutes of Health (NIH)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is an inpatient trial to determine the safety, immunogenicity and efficacy of the WRSS1 candidate vaccine in healthy Thai adult volunteers.
Detailed Description
This study is designed as 2 parts. Part 1 is a blinded, placebo-controlled inpatient trial in a total of 20 volunteers (14 vaccinees and 6 controls) to determine the safety and immunogenicity. Volunteers will be vaccinated with a single oral dose of 104 colony forming unit (cfu) of WRSS1 or placebo given with bicarbonate buffer. Part 2 will be started approximately 60 days after WRSS1 vaccination. This part is an inpatient phase II efficacy trial involving a challenge with the S.sonnei 53G of 10 vaccinees from the first part and 10 naïve controls.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dysentery, Shigella, Diarrhea

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1/Arm 1 of Study: WRSS1 vaccine
Arm Type
Experimental
Arm Description
WRSS1 is a live attenuated S. sonnei vaccine candidate derived from the Mosely strain of S.sonnei
Arm Title
Part 1/Arm 2 of Study: Placebo vaccine
Arm Type
Placebo Comparator
Arm Description
Placebo
Arm Title
Part 2/Arm 1 of Study: S. sonnei 53G
Arm Type
Experimental
Arm Description
10 volunteers from Study Arm 1/Part 1 (WRSS1 vaccine) plus 4 alternates from Arm 1/Part 1 are given 53G S. sonnei
Arm Title
Part 2/Arm 2 of Study: S sonnei 53G
Arm Type
Active Comparator
Arm Description
10 subjects (naïve controls) plus 4 alternates are give 53G S sonnei
Intervention Type
Biological
Intervention Name(s)
Part 1/Arm 1 of Study: WRSS1 vaccine
Intervention Description
Single, oral dose of WRSS1
Intervention Type
Biological
Intervention Name(s)
Part 1/Arm 2 of Study: Placebo vaccine
Intervention Description
Placebo vaccine
Intervention Type
Biological
Intervention Name(s)
Part 2/Arm 1 of Study: S. sonnei 53G
Intervention Description
Subject from Part 1/Arm 1 of Study are given 53G S. sonnei
Intervention Type
Biological
Intervention Name(s)
Part 2/Arm 2 of Study: S. sonnei 53G
Intervention Description
10 naïve controls are given S. sonnei 53G
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Events
Description
Overview of AEs highlighting all AEs, withdrawals and deaths related to AEs
Time Frame
Up to 12 months
Title
Number of Participants With Shigella Induced Clinical Disease in Part 2
Description
Study Part 2-Frequency of Shigella induced clinical disease defined as one or more of diarrhea, dysentery or fever in vaccinees and controls following challenge with S. sonnei 53G. Transmissibility of disease will be evaluated by the presence of fecal shedding in control subjects.
Time Frame
0-5 days
Secondary Outcome Measure Information:
Title
Count of Subjects With Normal and Abnormal Clinical Laboratory Values During Parts 1 and 2 of Study
Description
Count of subjects in Parts 1 and 2 with normal and abnormal clinical laboratory values after samples taken on days 1, 7, 14, and 28. Abnormal lab values are determined clinically significant by the PI
Time Frame
Days 1, 7, 14, and 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 20-40 years old; male or female; General good health as determined by a screening evaluation no greater than 30 days before admission; Normal bowel habits (grade 1-2 stools - no more than one to two stools per day with at least one stool per 2 days; Sexually active females willing to use birth control (birth control pills, injection hormonal contraceptive, implant hormonal contraceptive, hormonal patch, IUD, sterilization for effective contraceptive methods, spermicidal products and barrier methods are considered acceptable)during the entire study (starting from study day -30) and for 3 months after completion of the study (approximately a total of 6 months) or sexually inactive females (no sexual contact). Volunteers who take birth control pills will be required to use additional contraceptive methods for the remaining days of the cycle after discharge from the VTC (alteration of gastrointestinal functions from the oral vaccine or challenge strain may lead to unpredictable efficacy of pills); Will be available and willing to continue participation in the second part of the study if he/she has been randomly selected; Pass the Assessment of Understanding of the consent form. Exclusion Criteria: An acute or chronic medical condition or a clinically significant abnormality on physical exam that, in the opinion of the investigator, would render vaccination or challenge as unsafe; Current use of iron or zinc supplements within the past 7 days; current use of antacids (H2 blockers, omeprazole, OTC agents) or immunosuppressive drug; Unwillingness to follow the study procedures Currently breastfeeding, pregnant (βHCG +) or planning to become pregnant within 3 months after the completion of the study; Allergy to quinolone, sulfa, and penicillin classes of antibiotics; History of any of the following conditions within the past 10 years: Arthritis (two or more episodes of joint pain and swelling), Gastrointestinal disease (diagnosed by a doctor as having irritable bowel disease, Crohn's disease, ulcerative colitis (biopsy confirmed), celiac disease, stomach or intestinal ulcers), or Dyspepsia (digestion or heartburn requiring medication more than once per week); Lifetime previous history of known/suspected Shigella diarrhea (except for volunteers who receive vaccines from Part 1) ; Lifetime history of, or active gallbladder disease; HLA B27 Ag (+); Anti-HIV (+); HBsAg(+); Anti HCV IgG Ab(+); abnormal screening tests judged to be clinically significant as judged by PI or sub-PI (Values are out of the acceptable abnormal range from the table in the protocol) other than mild anemia in females (Hct = 0.33-0.36); Lifetime history of participation in Shigella study (except for volunteers who receive vaccines from Part 1); Concurrent participation in another experimental vaccine or drug study within the past 30 days(except for volunteers who receive vaccines from part1); Serological positive for Shigella sonnei: anti-Shigella sonnei LPS IgG antibody titer in serum >800 (except for volunteers who receive vaccines from Part 1); Receipt of antimicrobial drugs for any reason or acute illness or fever >=38 oC within 7 days before vaccination or challenge; Individuals with household contacts that are immunocompromised; History of major abdominal surgery or laparotomy for any reason in the past 3 years, or abdominal scar of unclear origin; Presence of significant ova or parasite or Shigella bacteria in the stool; Receipt of any of the following (does not include the WRSS1 vaccine): a licensed live, attenuated vaccine within the 30 days of challenge a licensed subunit or killed vaccine within the 14 days of the challenge a blood product, including immunoglobulin, in the 90 days before the challenge
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ladaporn Bodhidatta, MD
Organizational Affiliation
Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Punnee Pitisuttithum, MBBS
Organizational Affiliation
Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Carl Mason, MD
Organizational Affiliation
Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Mahidol University and National Institutes of Health will have access to study data.
Citations:
PubMed Identifier
27146000
Citation
Pitisuttithum P, Islam D, Chamnanchanunt S, Ruamsap N, Khantapura P, Kaewkungwal J, Kittitrakul C, Luvira V, Dhitavat J, Venkatesan MM, Mason CJ, Bodhidatta L. Clinical Trial of an Oral Live Shigella sonnei Vaccine Candidate, WRSS1, in Thai Adults. Clin Vaccine Immunol. 2016 Jul 5;23(7):564-75. doi: 10.1128/CVI.00665-15. Print 2016 Jul.
Results Reference
derived

Learn more about this trial

Safety and Efficacy Study of WRSS1, a Shigella Sonnei Vaccine Candidate

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