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A Safety and Immunogenicity Study of 3 Doses of Opal Immunotherapy in HIV Infected People

Primary Purpose

HIV Infections

Status
Terminated
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Opal-HIV-Gag(c) Low Dose
Opal-HIV-Gag(c) Medium dose
Opal-HIV-Gag(c) High dose
Dimethyl Sulfoxide
Sponsored by
Medicines Development for Global Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HIV Infections focused on measuring HIV, Therapeutic, Immunotherapy, Acquired Immunodeficiency Syndrome, Virus Diseases, Lentivirus Infections, Human Immunodeficiency Virus

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provision of written informed consent
  • Documented laboratory diagnosis of HIV 1 infection
  • Documented HIV clade of infection
  • 18 - 60 years of age, inclusive
  • Stable antiretroviral therapy (ART) regimen containing at least 3 active ART agents for at least 2 months prior to Baseline
  • Plasma HIV-Ribonucelc acid (RNA) <400 copies/millilitre (mL) for 6 months up to and including Screening. Subjects on stable ART with a single value ≥400 copies/mL (i.e. the result is unconfirmed by subsequent testing) within this timeframe may be included at the discretion of the Investigator
  • CD4+ T-cell count ≥350 cells/cubic millimetres (mm3) at Screening (with nadir ≥100 cells/mm3)
  • A positive immunogenic response when stimulated with HIV-1 Gag clade C peptides at Screening
  • Male or female. Women of child-bearing potential must be using two effective methods of contraception and agree to continue to do so from Screening, throughout study medication dosing and for 28 days after the last dose of study medication

Exclusion Criteria:

  • Any serious or active medical or psychiatric illness which, in the opinion of the Investigator, would interfere with treatment, assessment, compliance with the protocol, or subject safety. This would include any active clinically significant renal, cardiac, pulmonary, vascular, or metabolic (thyroid disorders, adrenal disease) illness, or malignancy
  • Hepatitis B virus surface antigen, or Hepatitis C virus (HCV) antibody and HCV-RNA positive at Screening
  • Female subjects who are lactating and those of reproductive potential with a positive urine pregnancy test at either Screening or Baseline
  • A new AIDS-defining condition diagnosed within 42 days prior to Baseline visit
  • Known or suspected allergy to Dimethyl Sulfoxide
  • History of allergy or reaction to medications (including peptide or protein containing agents) or history of severe allergy that, in the opinion of the Investigator, might compromise the subject's participation in any way
  • Moderate or severe asthma, defined as at least chronic moderate symptoms which frequently interfere with daily activities and require anti-asthma/anti-inflammatory agents
  • Have received immunomodulating agents (including immunosuppressive agents, interferon or other immune or cytokine-based therapies), immunisation, and/or systemic chemotherapeutic agents within 60 days of Screening or expected to receive these agents during the course of the study
  • Recipient of live attenuated vaccines within 60 days of Screening
  • Recipient of whole killed, toxoid or sub-unit vaccines (e.g. influenza, pneumococcus, tetanus, hepatitis B) within 42 days prior to Baseline
  • Ever received an HIV prophylactic or immunotherapeutic vaccine (does not apply to subjects who have written documentation of receiving placebo or adjuvant only)
  • Recreational and/or therapeutic drug or alcohol use that, in the opinion of the Investigator, might compromise the subject's participation in any way.
  • Medical or psychiatric condition or occupational responsibilities that may preclude compliance with the protocol
  • Laboratory blood values:

    • Haemoglobin <11.0 grams/decilitre (g/dL) for men and <10.0 g/dL for women
    • Neutrophil count <800/mm3
    • Platelet count <50,000/mm3
    • Aspartate aminotransferase or Alanine transaminase >2.5 times Upper Limit of Normal (ULN)
    • Lipase >2.5 times ULN
    • Amylase >1.5 times ULN (unless serum lipase is ≤1.5 times ULN)
    • Subjects with an estimated creatinine clearance of <80 mL/minute
  • Recipients of blood products or immunoglobulins within 6 months prior to Screening or loss of 450 mL or more of blood during the three months prior to Screening
  • Recipients of experimental or investigational agents within 30 days prior to Screening
  • Previous participation in this study

Sites / Locations

  • St Stephen's Centre, Chelsea and Westminster Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Opal-HIV-Gag(c)

Diluent

Arm Description

Opal-HIV-Gag(c) administered ex vivo to separated white blood cells on 4 occasions at 4 weekly intervals.

Administered ex vivo to separated white blood cells on 4 occasions at 4 weekly intervals.

Outcomes

Primary Outcome Measures

Safety
Examined through treatment-emergent adverse events, vital signs and routine laboratory screening.

Secondary Outcome Measures

Immunogenicity
Immunogenicity will be assessed by ELISpot and other markers of immune response
Impact on HIV infection
Assessed by HIV-1 viral load and CD4 T-cell counts.

Full Information

First Posted
May 13, 2010
Last Updated
March 20, 2018
Sponsor
Medicines Development for Global Health
Collaborators
Phillip T. and Susan M. Ragon Foundation, Imperial College London
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1. Study Identification

Unique Protocol Identification Number
NCT01123915
Brief Title
A Safety and Immunogenicity Study of 3 Doses of Opal Immunotherapy in HIV Infected People
Official Title
A Phase 1, Dose Escalating, Single Centre, Double Blind Study of the Safety and Immunogenicity of Opal-HIV-Gag Clade C in HIV Positive Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Terminated
Study Start Date
May 2010 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
December 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medicines Development for Global Health
Collaborators
Phillip T. and Susan M. Ragon Foundation, Imperial College London

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I study is the first step to determine if Opal immunotherapy may have potential utility as a treatment for HIV. Although effective treatments for HIV infection exist, they are limited by the requirement for life-long daily treatment, cost, side effects, and the development of resistance. There is a need for therapeutic approaches that induce or enhance T-cell immunity to control HIV disease. Overlapping Peptide-pulsed Autologous Cells (Opal) is a technique where autologous peripheral blood mononuclear cells (PBMC) or whole blood is pulsed with sets of overlapping peptides spanning whole proteins of HIV.
Detailed Description
Opal-HIV-Gag(c) is not for direct injection and is administered by ex vivo incubation of whole blood or separated blood components (such as white blood cells or peripheral blood mononuclear cells) and reinfusion. As a practical alternative to PBMC separation and to optimise vaccine presentation during the ex vivo incubation, a blood cell separation device will be used to separate the whole blood and enrich the white blood cell component. The device processes whole blood in a closed, single use disposable kit. Reconstituted Opal-HIV-Gag(c)or matching placebo will be added to the white blood cells, incubated for one hour and reinfused into the subject. Subjects will receive 4 administrations at 4 weekly intervals. Subjects are followed for 12 weeks after the final administration. Each dose group will be enrolled sequentially, with a sentinel group for each dose group. Satisfactory safety data from each cohort, reviewed by a Data Safety Monitoring Board, will permit dose escalation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HIV Infections
Keywords
HIV, Therapeutic, Immunotherapy, Acquired Immunodeficiency Syndrome, Virus Diseases, Lentivirus Infections, Human Immunodeficiency Virus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Opal-HIV-Gag(c)
Arm Type
Experimental
Arm Description
Opal-HIV-Gag(c) administered ex vivo to separated white blood cells on 4 occasions at 4 weekly intervals.
Arm Title
Diluent
Arm Type
Placebo Comparator
Arm Description
Administered ex vivo to separated white blood cells on 4 occasions at 4 weekly intervals.
Intervention Type
Biological
Intervention Name(s)
Opal-HIV-Gag(c) Low Dose
Intervention Type
Biological
Intervention Name(s)
Opal-HIV-Gag(c) Medium dose
Intervention Type
Biological
Intervention Name(s)
Opal-HIV-Gag(c) High dose
Intervention Type
Other
Intervention Name(s)
Dimethyl Sulfoxide
Primary Outcome Measure Information:
Title
Safety
Description
Examined through treatment-emergent adverse events, vital signs and routine laboratory screening.
Time Frame
Several points throughout the 12 week active phase and 12 week and follow up period
Secondary Outcome Measure Information:
Title
Immunogenicity
Description
Immunogenicity will be assessed by ELISpot and other markers of immune response
Time Frame
Several points throughout the 12 week active phase and 12 week and follow up period
Title
Impact on HIV infection
Description
Assessed by HIV-1 viral load and CD4 T-cell counts.
Time Frame
Several points throughout the 12 week active phase and 12 week and follow up period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of written informed consent Documented laboratory diagnosis of HIV 1 infection Documented HIV clade of infection 18 - 60 years of age, inclusive Stable antiretroviral therapy (ART) regimen containing at least 3 active ART agents for at least 2 months prior to Baseline Plasma HIV-Ribonucelc acid (RNA) <400 copies/millilitre (mL) for 6 months up to and including Screening. Subjects on stable ART with a single value ≥400 copies/mL (i.e. the result is unconfirmed by subsequent testing) within this timeframe may be included at the discretion of the Investigator CD4+ T-cell count ≥350 cells/cubic millimetres (mm3) at Screening (with nadir ≥100 cells/mm3) A positive immunogenic response when stimulated with HIV-1 Gag clade C peptides at Screening Male or female. Women of child-bearing potential must be using two effective methods of contraception and agree to continue to do so from Screening, throughout study medication dosing and for 28 days after the last dose of study medication Exclusion Criteria: Any serious or active medical or psychiatric illness which, in the opinion of the Investigator, would interfere with treatment, assessment, compliance with the protocol, or subject safety. This would include any active clinically significant renal, cardiac, pulmonary, vascular, or metabolic (thyroid disorders, adrenal disease) illness, or malignancy Hepatitis B virus surface antigen, or Hepatitis C virus (HCV) antibody and HCV-RNA positive at Screening Female subjects who are lactating and those of reproductive potential with a positive urine pregnancy test at either Screening or Baseline A new AIDS-defining condition diagnosed within 42 days prior to Baseline visit Known or suspected allergy to Dimethyl Sulfoxide History of allergy or reaction to medications (including peptide or protein containing agents) or history of severe allergy that, in the opinion of the Investigator, might compromise the subject's participation in any way Moderate or severe asthma, defined as at least chronic moderate symptoms which frequently interfere with daily activities and require anti-asthma/anti-inflammatory agents Have received immunomodulating agents (including immunosuppressive agents, interferon or other immune or cytokine-based therapies), immunisation, and/or systemic chemotherapeutic agents within 60 days of Screening or expected to receive these agents during the course of the study Recipient of live attenuated vaccines within 60 days of Screening Recipient of whole killed, toxoid or sub-unit vaccines (e.g. influenza, pneumococcus, tetanus, hepatitis B) within 42 days prior to Baseline Ever received an HIV prophylactic or immunotherapeutic vaccine (does not apply to subjects who have written documentation of receiving placebo or adjuvant only) Recreational and/or therapeutic drug or alcohol use that, in the opinion of the Investigator, might compromise the subject's participation in any way. Medical or psychiatric condition or occupational responsibilities that may preclude compliance with the protocol Laboratory blood values: Haemoglobin <11.0 grams/decilitre (g/dL) for men and <10.0 g/dL for women Neutrophil count <800/mm3 Platelet count <50,000/mm3 Aspartate aminotransferase or Alanine transaminase >2.5 times Upper Limit of Normal (ULN) Lipase >2.5 times ULN Amylase >1.5 times ULN (unless serum lipase is ≤1.5 times ULN) Subjects with an estimated creatinine clearance of <80 mL/minute Recipients of blood products or immunoglobulins within 6 months prior to Screening or loss of 450 mL or more of blood during the three months prior to Screening Recipients of experimental or investigational agents within 30 days prior to Screening Previous participation in this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marta Boffito, MD PhD
Organizational Affiliation
St Stephen's AIDS Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
St Stephen's Centre, Chelsea and Westminster Foundation Trust
City
London
ZIP/Postal Code
SW10 9NH
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
24124451
Citation
Kloverpris HN, Jackson A, Handley A, Hayes P, Gilmour J, Riddell L, Chen F, Atkins M, Boffito M, Walker BD, Ackland J, Sullivan M, Goulder P. Non-immunogenicity of overlapping gag peptides pulsed on autologous cells after vaccination of HIV infected individuals. PLoS One. 2013 Oct 4;8(10):e74389. doi: 10.1371/journal.pone.0074389. eCollection 2013.
Results Reference
derived
PubMed Identifier
24069230
Citation
Jackson A, Kloverpris HN, Boffito M, Handley A, Atkins M, Hayes P, Gilmour J, Riddel L, Chen F, Bailey-Tippets M, Walker B, Ackland J, Sullivan M, Goulder P. A randomised, placebo-controlled, first-in-human study of a novel clade C therapeutic peptide vaccine administered ex vivo to autologous white blood cells in HIV infected individuals. PLoS One. 2013 Sep 17;8(9):e73765. doi: 10.1371/journal.pone.0073765. eCollection 2013.
Results Reference
derived

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A Safety and Immunogenicity Study of 3 Doses of Opal Immunotherapy in HIV Infected People

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