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Safety, Tolerability, and Immunogenicity Study of Investigational Recombinant Botulinum Vaccine A/B (rBV A/B) in Volunteers Previously Immunized With Investigational Pentavalent Botulinum Toxoid

Primary Purpose

Botulism

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
rBV A/B
Sponsored by
California Department of Public Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Botulism focused on measuring Botulism Vaccine

Eligibility Criteria

18 Years - 69 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • The volunteer has received pentavalent botulinum toxoid for occupational protection under BB IND 0161, with the previous pentavalent botulinum toxoid dose at least 6 months prior to the planned rBV A/B dose.
  • The volunteer is between the ages of 18 and 69 years at the time of consent.
  • The volunteer is healthy and has an acceptable medical history.
  • The volunteer meets the subject suitability requirements and recommendations for source plasma donors (for Part 2 subjects only).
  • The volunteer, if female and of childbearing potential, is not pregnant or lactating, and agrees to use an acceptable form of FDA-approved contraception for the duration of the study.
  • The volunteer has the ability to understand the requirements of the study and provide informed consent.
  • The volunteer agrees to complete the subject diary on a daily basis for 7 days post-vaccination and to report concomitant medication and adverse events during the study period.
  • The volunteer provides written authorization for use and disclosure of protected health information.
  • The volunteer agrees not to donate blood or blood products (outside of study procedures) during the course of the study.
  • The volunteer has personal health insurance.

Exclusion Criteria:

  • Be pregnant or nursing
  • The volunteer has a history of laboratory evidence of syphilis, acquired immunodeficiency syndrome, Creutzfeldt-Jakob disease, or infection with human immunodeficiency viruses 1 or 2, human T cell lymphotropic virus 1, hepatitis B virus, or hepatitis C virus.
  • The volunteer had prior severe local or severe systemic reaction to last immunization with pentavalent botulinum toxoid.
  • The volunteer has a known allergy to aluminum compounds, yeast, or other components of the vaccine.
  • The volunteer has donated one or more units of blood or undergone plasmapheresis within 28 days before screening.
  • The volunteer has received a blood product or immunoglobulin within 6 months of screening or plans to receive such products during the study.
  • The volunteer has received licensed nonliving vaccine within 14 days before study entry or licensed live vaccine within 60 days before study entry.
  • The volunteer has received investigational products (drugs, biologics, vaccines, or implantable devices) 60 days prior to study entry or plans to receive experimental products at any time during the study.
  • The volunteer has received prescription immunosuppressive or immunomodulatory agents, including parenteral, inhaled, or oral corticosteroids within 3 months before screening or plans on receiving such therapy at any time during the study with the exceptions (Subjects who have used prescription topical steroids may be enrolled 2 weeks after the therapy is completed; Intra-articular, bursal, or tendon injectable steroids are permitted; Any over-the-counter topical steroid use is permitted; Ophthalmic and intranasal steroids are permitted).
  • The volunteer has received cytotoxic therapy at any time in the previous 5 years to study entry.
  • The volunteer has an active systemic or recurrent disease that would place the subject at unacceptable risk of injury, require hospitalization, or require surgical intervention.
  • The volunteer has a history of alcohol or drug abuse within 12 months before screening.
  • The volunteer has past, present, or suspected illicit injection drug use.
  • The volunteer has inflammatory, vasculitic, or rheumatic disease, including systemic lupus erythematosus, polymyalgia rheumatica, rheumatoid arthritis, or scleroderma.
  • The volunteer has clinically recognized hepatic or renal insufficiency.
  • The volunteer has uncontrolled hypertension.
  • The volunteer has moderate to severe asthma, chronic obstructive pulmonary disease, or other significant pulmonary disease.
  • The volunteer has a seizure disorder.
  • The volunteer has moderate or severe illness or oral temperature of 100.4°F or greater within 3 days prior to immunization.
  • The volunteer is determined by the investigator to be unsuitable for participation in this trial for any reason.

Sites / Locations

  • California Department of Public Health
  • Battelle Biomedical Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Vaccine

Arm Description

Outcomes

Primary Outcome Measures

Four-Fold Increase in Neutralizing Antibody Concentration (NAC)
Proportion of participants achieving a four-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success).

Secondary Outcome Measures

Three-Fold Increase in Neutralizing Antibody Concentration (NAC)
Proportion of participants achieving a three-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success)
Two-Fold Increase in the Area Under the Neutralizing Antibody Concentration (NAC) Curve
Proportion of participants achieving a two-fold increase in the area under the plasma NAC-time curve between Week 0 and Week 12 in comparison with a straight-line extension of the Week 0 NAC to Week 12 for both botulinum toxin A and toxin B. A proportion ≥ 0.50 was considered a success.

Full Information

First Posted
October 3, 2012
Last Updated
April 19, 2017
Sponsor
California Department of Public Health
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1. Study Identification

Unique Protocol Identification Number
NCT01701999
Brief Title
Safety, Tolerability, and Immunogenicity Study of Investigational Recombinant Botulinum Vaccine A/B (rBV A/B) in Volunteers Previously Immunized With Investigational Pentavalent Botulinum Toxoid
Official Title
Phase 2b, Two-part, Open-label, Uncontrolled Study to Evaluate Safety, Tolerability, and Immunogenicity of a Single 40-µg Dose of Recombinant Botulinum Vaccine A/B (rBV A/B) for the Production of BabyBIG® in Volunteers Previously Immunized With Pentavalent Botulinum Toxoid for Occupational Protection
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
February 2013 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
California Department of Public Health

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Study rBV A/B-CL-001 is a Phase 2b, 2-part, open-label, uncontrolled study to evaluate safety, tolerability, and immunogenicity of a single dose of recombinant botulinum vaccine A/B (rBV A/B) for the production of BabyBIG in volunteers previously immunized with the pentavalent botulinum (PBT) toxoid. This study is designed to determine neutralizing antibody levels for botulinum toxin types A and B in healthy subjects who were previously immunized with the PBT for occupational protection and who receive the rBV A/B. Subjects with titers of the neutralizing antibodies against the toxins would be candidates for plasma donation for BabyBIG production.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Botulism
Keywords
Botulism Vaccine

7. Study Design

Primary Purpose
Other
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Vaccine
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
rBV A/B
Intervention Description
rBV A/B injections will consist of a single 40 µg injection of total antigen (20 µg of Antigen A and 20 µg of Antigen B) adsorbed to 0.2% (wt/vol) Alhydrogel™, in a total dose volume of 0.5 mL. The vaccine will be administered by intramuscular injection in the deltoid muscle, preferably in the nondominant arm.
Primary Outcome Measure Information:
Title
Four-Fold Increase in Neutralizing Antibody Concentration (NAC)
Description
Proportion of participants achieving a four-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success).
Time Frame
Week 0 to Week 4
Secondary Outcome Measure Information:
Title
Three-Fold Increase in Neutralizing Antibody Concentration (NAC)
Description
Proportion of participants achieving a three-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success)
Time Frame
Week 0 to Week 4
Title
Two-Fold Increase in the Area Under the Neutralizing Antibody Concentration (NAC) Curve
Description
Proportion of participants achieving a two-fold increase in the area under the plasma NAC-time curve between Week 0 and Week 12 in comparison with a straight-line extension of the Week 0 NAC to Week 12 for both botulinum toxin A and toxin B. A proportion ≥ 0.50 was considered a success.
Time Frame
Week 0 to Week 12
Other Pre-specified Outcome Measures:
Title
Collected Plasma Volume
Description
Measurement of the volume of source plasma containing neutralizing antibodies against botulinum toxin type A and type B collected by plasmapheresis in Part 2.
Time Frame
Week 1 to Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: The volunteer has received pentavalent botulinum toxoid for occupational protection under BB IND 0161, with the previous pentavalent botulinum toxoid dose at least 6 months prior to the planned rBV A/B dose. The volunteer is between the ages of 18 and 69 years at the time of consent. The volunteer is healthy and has an acceptable medical history. The volunteer meets the subject suitability requirements and recommendations for source plasma donors (for Part 2 subjects only). The volunteer, if female and of childbearing potential, is not pregnant or lactating, and agrees to use an acceptable form of FDA-approved contraception for the duration of the study. The volunteer has the ability to understand the requirements of the study and provide informed consent. The volunteer agrees to complete the subject diary on a daily basis for 7 days post-vaccination and to report concomitant medication and adverse events during the study period. The volunteer provides written authorization for use and disclosure of protected health information. The volunteer agrees not to donate blood or blood products (outside of study procedures) during the course of the study. The volunteer has personal health insurance. Exclusion Criteria: Be pregnant or nursing The volunteer has a history of laboratory evidence of syphilis, acquired immunodeficiency syndrome, Creutzfeldt-Jakob disease, or infection with human immunodeficiency viruses 1 or 2, human T cell lymphotropic virus 1, hepatitis B virus, or hepatitis C virus. The volunteer had prior severe local or severe systemic reaction to last immunization with pentavalent botulinum toxoid. The volunteer has a known allergy to aluminum compounds, yeast, or other components of the vaccine. The volunteer has donated one or more units of blood or undergone plasmapheresis within 28 days before screening. The volunteer has received a blood product or immunoglobulin within 6 months of screening or plans to receive such products during the study. The volunteer has received licensed nonliving vaccine within 14 days before study entry or licensed live vaccine within 60 days before study entry. The volunteer has received investigational products (drugs, biologics, vaccines, or implantable devices) 60 days prior to study entry or plans to receive experimental products at any time during the study. The volunteer has received prescription immunosuppressive or immunomodulatory agents, including parenteral, inhaled, or oral corticosteroids within 3 months before screening or plans on receiving such therapy at any time during the study with the exceptions (Subjects who have used prescription topical steroids may be enrolled 2 weeks after the therapy is completed; Intra-articular, bursal, or tendon injectable steroids are permitted; Any over-the-counter topical steroid use is permitted; Ophthalmic and intranasal steroids are permitted). The volunteer has received cytotoxic therapy at any time in the previous 5 years to study entry. The volunteer has an active systemic or recurrent disease that would place the subject at unacceptable risk of injury, require hospitalization, or require surgical intervention. The volunteer has a history of alcohol or drug abuse within 12 months before screening. The volunteer has past, present, or suspected illicit injection drug use. The volunteer has inflammatory, vasculitic, or rheumatic disease, including systemic lupus erythematosus, polymyalgia rheumatica, rheumatoid arthritis, or scleroderma. The volunteer has clinically recognized hepatic or renal insufficiency. The volunteer has uncontrolled hypertension. The volunteer has moderate to severe asthma, chronic obstructive pulmonary disease, or other significant pulmonary disease. The volunteer has a seizure disorder. The volunteer has moderate or severe illness or oral temperature of 100.4°F or greater within 3 days prior to immunization. The volunteer is determined by the investigator to be unsuitable for participation in this trial for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen S. Arnon, M.D.
Organizational Affiliation
California Department of Public Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
California Department of Public Health
City
Richmond
State/Province
California
ZIP/Postal Code
94804
Country
United States
Facility Name
Battelle Biomedical Research Center
City
West Jefferson
State/Province
Ohio
ZIP/Postal Code
43162
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29475762
Citation
Khouri JM, Motter RN, Arnon SS. Safety and immunogenicity of investigational recombinant botulinum vaccine, rBV A/B, in volunteers with pre-existing botulinum toxoid immunity. Vaccine. 2018 Apr 5;36(15):2041-2048. doi: 10.1016/j.vaccine.2018.02.042. Epub 2018 Feb 21.
Results Reference
derived
Links:
URL
http://www.infantbotulism.org/
Description
Related Info

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Safety, Tolerability, and Immunogenicity Study of Investigational Recombinant Botulinum Vaccine A/B (rBV A/B) in Volunteers Previously Immunized With Investigational Pentavalent Botulinum Toxoid

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