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Immunogenicity and Safety of Verorab® in a "One-week" Intradermal Post-exposure Prophylaxis Regimen

Primary Purpose

Rabies

Status
Completed
Phase
Phase 3
Locations
Philippines
Study Type
Interventional
Intervention
PVRV
PVRV and pERIG Favirab®
PVRV and pERIG Favirab®
Sponsored by
Sanofi Pasteur, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rabies focused on measuring Rabies, Verorab®, Favirab®

Eligibility Criteria

undefined - 50 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

For all patients:

  • Patient aged ≤50 years, with WHO category II or III contacts happened within 48 hours before appearance at site.

For adults:

  • Informed consent form has been signed and dated.
  • Able to attend all scheduled visits and to comply with all trial procedures.

For children:

  • For children under 18 years of age, informed consent form has been signed and dated by the parent(s) or another legally acceptable representative.
  • For children under 18 years, assent form or informed consent form has been signed and dated by the appropriate age-range patient, according to country specific institution requirement as detailed in each country specific assent form or informed consent form.
  • Patient and parent/guardian are able to attend all scheduled visits and to comply with all trial procedures.

Exclusion Criteria:

For all patients:

  • Receipt of chloroquine or other medications used for malaria chemoprophylaxis, with or without other anti-malarial treatment, for more than 4 weeks (duration of anti-malarial course) and part of the treatment received within the 2 weeks before vaccination.
  • Participation in another clinical trial investigating a vaccine, drug, medical device, or medical procedure in the 4 weeks preceding the first trial immunization
  • Planned participation in another clinical trial during the present trial period
  • Receipt of any vaccine in the 4 weeks preceding the first trial vaccination, except for influenza vaccination and tetanus immunization (related only to current animal bite exposure
  • Planned receipt of any vaccine in the 4 weeks following the trial primary and booster vaccination
  • Previous immunization against rabies at any time in the past with either the trial vaccine and immunoglobulin or another rabies immunobiological product (in pre-or post-exposure regimen)
  • Receipt of blood or blood-derived products in the past 3 months, which might interfere with assessment of the immune response
  • Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months)
  • Self-reported seropositivity for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus
  • Patient with clinical signs of encephalitis
  • Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to the vaccine(s) used in the trial or to a vaccine containing any of the same substances
  • Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily
  • Current alcohol abuse or drug addiction that might interfere with the ability to comply with trial procedures
  • Chronic illness that, in the opinion of the investigator, is at a stage where it might interfere with trial conduct or completion
  • Identified as employees of the Investigator or study center, with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as family members (i.e., immediate, husband, wife and their children, adopted or natural) of the employees or the Investigator
  • Febrile illness (temperature ≥38.0°C) or moderate or severe acute illness/infection (according to investigator judgment) on the day of vaccination
  • Prior history of mammal animal bite within the past 5 years.

For infants or toddlers :

  • Known personal or maternal seropositivity for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus, as reported by the parent/guardian
  • Prior history of seizures .

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Group 1

Group 2

Group 3

Arm Description

Patients with WHO Category II exposure receive PEP with PVRV using "one-week, 4-site" (4-4-4-0-0) ID vaccination regimen, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later

Patients with WHO Category III exposure receive PEP with PVRV using "one-week, 4-site" (4-4-4-0-0) ID vaccination regimen and pERIG Favirab®, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later

Patients with WHO Category III exposure receive PEP with PVRV using the updated 2-site TRC (2-2-2-0-2) ID vaccination regimen and pERIG Favirab®, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later

Outcomes

Primary Outcome Measures

Percentage of participants with seroconversion on Day 14
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL

Secondary Outcome Measures

Percentage of participants with seroconversion before and after primary vaccination
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Percentage of participants with seroconversion after primary vaccination (antibody persistence)
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Percentage of participants with seroconversion after booster vaccination
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Geometric mean titers (GMTs) before and after primary vaccination
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
GMTs after primary vaccination (antibody persistence)
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
GMTs after booster vaccination
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
Number of participants reporting solicited injection site reactions following primary and booster vaccination
Solicited injection site reactions are tenderness (for participants aged ≤ 23 months), pain (for participants aged ≥ 2 years), redness and swelling (for all participants)
Number of participants reporting solicited systemic reactions following primary and booster vaccination
Solicited systemic reactions are Fever, Vomiting, Crying abnormal, Drowsiness, Appetite lost, and Irritability for participants aged ≤ 23 months and Fever (Temperature), Headache, Malaise, and Myalgia for participants aged ≥ 2 years

Full Information

First Posted
June 14, 2012
Last Updated
April 22, 2022
Sponsor
Sanofi Pasteur, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT01622062
Brief Title
Immunogenicity and Safety of Verorab® in a "One-week" Intradermal Post-exposure Prophylaxis Regimen
Official Title
Verorab® Immunogenicity and Safety After a One-week, 4-site, Intradermal (ID) Post-exposure Prophylaxis Regimen (4-4-4-0-0) Followed by a One-visit, 4-site, ID Booster at Five Years
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
June 29, 2012 (Actual)
Primary Completion Date
November 14, 2018 (Actual)
Study Completion Date
November 14, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi Pasteur, a Sanofi Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the 4-site "one-week" post-exposure prophylaxis (PEP) regimen as a possible alternative to the 2-site updated Thai Red Cross (TRC) PEP regimen. Primary objective: To demonstrate that PEP using the new "one-week, 4-site" (4-4-4-0-0) intradermal (ID) vaccination regimen is non-inferior to PEP using the updated TRC (2-2-2-0-2) ID vaccination regimen. Secondary objectives: Primary immunization: To describe the immune response in each group at Day 0, Day 14 and Day 90. Antibody persistence: To describe rabies virus-neutralizing antibody persistence during the 5 years after completion of PEP in each group. Booster vaccination: To describe the immune response induced by a single-visit 4-site intradermal booster vaccination in each group at Year 5. Safety: To describe the safety profile of each group after the primary and booster vaccinations.
Detailed Description
Participants with WHO Category II exposure will receive PEP, using "one-week, 4-site" ID vaccination regimen. Participants with WHO Category III exposure will receive PEP, using "one-week, 4-site" (4-4-4-0-0) ID vaccination regimen and pERIG Favirab® or using the updated 2-site TRC (2-2-2-0-2) ID vaccination regimen and pERIG Favirab®. All participants will receive a "single-visit, 4-site" booster vaccination five years later.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rabies
Keywords
Rabies, Verorab®, Favirab®

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
600 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Patients with WHO Category II exposure receive PEP with PVRV using "one-week, 4-site" (4-4-4-0-0) ID vaccination regimen, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Patients with WHO Category III exposure receive PEP with PVRV using "one-week, 4-site" (4-4-4-0-0) ID vaccination regimen and pERIG Favirab®, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later
Arm Title
Group 3
Arm Type
Active Comparator
Arm Description
Patients with WHO Category III exposure receive PEP with PVRV using the updated 2-site TRC (2-2-2-0-2) ID vaccination regimen and pERIG Favirab®, and a "single-visit, 4-site" booster vaccination with PVRV 5 years later
Intervention Type
Biological
Intervention Name(s)
PVRV
Other Intervention Name(s)
VERORAB®
Intervention Description
0.1 mL, 4 site 'one week' (4-4-4-0-0) administered intradermally
Intervention Type
Biological
Intervention Name(s)
PVRV and pERIG Favirab®
Other Intervention Name(s)
VERORAB®; pERIG Favirab®
Intervention Description
0.1 mL of vaccine administered intradermally in 4 site 'one week' (4-4-4-0-0) regimen, and pERIG Favirab® (volume to be calculated according to the patient' body weight) infiltrated into and around wound(s)
Intervention Type
Biological
Intervention Name(s)
PVRV and pERIG Favirab®
Other Intervention Name(s)
VERORAB®; pERIG Favirab®
Intervention Description
0.1 mL of vaccine administered intradermally in 2-site TRC (2-2-2-0-2) regimen, and pERIG Favirab® (volume to be calculated according to the patient' body weight) infiltrated into and around wound(s)
Primary Outcome Measure Information:
Title
Percentage of participants with seroconversion on Day 14
Description
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Time Frame
Day 14 post vaccination
Secondary Outcome Measure Information:
Title
Percentage of participants with seroconversion before and after primary vaccination
Description
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Time Frame
Day 0, Day 14, Day 90
Title
Percentage of participants with seroconversion after primary vaccination (antibody persistence)
Description
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Time Frame
Year 1 to Year 5
Title
Percentage of participants with seroconversion after booster vaccination
Description
Seroconversion is defined as rabies virus neutralizing antibody titers ≥ 0.5 IU/mL
Time Frame
Year 5 + 11 days
Title
Geometric mean titers (GMTs) before and after primary vaccination
Description
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
Time Frame
Day 0, Day 14, Day 90
Title
GMTs after primary vaccination (antibody persistence)
Description
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
Time Frame
Year 1 to Year 5
Title
GMTs after booster vaccination
Description
Titers of rabies virus-neutralizing antibodies were assessed by the rapid fluorescent focus inhibition test
Time Frame
Year 5 + 11 days
Title
Number of participants reporting solicited injection site reactions following primary and booster vaccination
Description
Solicited injection site reactions are tenderness (for participants aged ≤ 23 months), pain (for participants aged ≥ 2 years), redness and swelling (for all participants)
Time Frame
7 days after each and any injection
Title
Number of participants reporting solicited systemic reactions following primary and booster vaccination
Description
Solicited systemic reactions are Fever, Vomiting, Crying abnormal, Drowsiness, Appetite lost, and Irritability for participants aged ≤ 23 months and Fever (Temperature), Headache, Malaise, and Myalgia for participants aged ≥ 2 years
Time Frame
From Day 0 up to 7 days after injection 3, and 7 days after subsequent injections

10. Eligibility

Sex
All
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: For all patients: Patient aged ≤50 years, with WHO category II or III contacts happened within 48 hours before appearance at site. For adults: Informed consent form has been signed and dated. Able to attend all scheduled visits and to comply with all trial procedures. For children: For children under 18 years of age, informed consent form has been signed and dated by the parent(s) or another legally acceptable representative. For children under 18 years, assent form or informed consent form has been signed and dated by the appropriate age-range patient, according to country specific institution requirement as detailed in each country specific assent form or informed consent form. Patient and parent/guardian are able to attend all scheduled visits and to comply with all trial procedures. Exclusion Criteria: For all patients: Receipt of chloroquine or other medications used for malaria chemoprophylaxis, with or without other anti-malarial treatment, for more than 4 weeks (duration of anti-malarial course) and part of the treatment received within the 2 weeks before vaccination. Participation in another clinical trial investigating a vaccine, drug, medical device, or medical procedure in the 4 weeks preceding the first trial immunization Planned participation in another clinical trial during the present trial period Receipt of any vaccine in the 4 weeks preceding the first trial vaccination, except for influenza vaccination and tetanus immunization (related only to current animal bite exposure Planned receipt of any vaccine in the 4 weeks following the trial primary and booster vaccination Previous immunization against rabies at any time in the past with either the trial vaccine and immunoglobulin or another rabies immunobiological product (in pre-or post-exposure regimen) Receipt of blood or blood-derived products in the past 3 months, which might interfere with assessment of the immune response Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months) Self-reported seropositivity for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus Patient with clinical signs of encephalitis Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to the vaccine(s) used in the trial or to a vaccine containing any of the same substances Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily Current alcohol abuse or drug addiction that might interfere with the ability to comply with trial procedures Chronic illness that, in the opinion of the investigator, is at a stage where it might interfere with trial conduct or completion Identified as employees of the Investigator or study center, with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as family members (i.e., immediate, husband, wife and their children, adopted or natural) of the employees or the Investigator Febrile illness (temperature ≥38.0°C) or moderate or severe acute illness/infection (according to investigator judgment) on the day of vaccination Prior history of mammal animal bite within the past 5 years. For infants or toddlers : Known personal or maternal seropositivity for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus, as reported by the parent/guardian Prior history of seizures .
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Sanofi Pasteur SA
Official's Role
Study Director
Facility Information:
City
Muntinlupa
ZIP/Postal Code
1781
Country
Philippines

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
Citations:
PubMed Identifier
30890382
Citation
Quiambao BP, Ambas C, Diego S, Bosch Castells V, Korejwo J, Petit C, Houillon G. Intradermal post-exposure rabies vaccination with purified Vero cell rabies vaccine: Comparison of a one-week, 4-site regimen versus updated Thai Red Cross regimen in a randomized non-inferiority trial in the Philippines. Vaccine. 2019 Apr 10;37(16):2268-2277. doi: 10.1016/j.vaccine.2019.02.083. Epub 2019 Mar 16.
Results Reference
derived
Links:
URL
http://www.sanofipasteur.com
Description
Related Info

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Immunogenicity and Safety of Verorab® in a "One-week" Intradermal Post-exposure Prophylaxis Regimen

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