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Challenge Study of an ETEC Vaccine

Primary Purpose

Enteritis; Escherichia Coli, Enterotoxigenic

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
LTR192G with dscCfaE
No Intervention
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 Enteritis; Escherichia Coli, Enterotoxigenic

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Male or female age 18 through 50 years (inclusive).
  • General good health, without clinically significant medical history, physical examination findings or clinical laboratory abnormalities per clinical judgment of PI.
  • Negative pregnancy test. Pregnancy at any time will result in not receiving any or additional investigational product. Females of childbearing potential must agree to use an efficacious hormonal or barrier method of birth control during the study. Abstinence is acceptable. Female subjects unable to bear children must have this documented (eg, tubal ligation or hysterectomy) or must have negative pregnancy tests.
  • Willingness to participate in the study after all aspects of the protocol have been explained and written informed consent obtained.
  • Completion of a training session and demonstrated comprehension of the protocol procedures, knowledge of ETEC-associated illness, and by passing a written examination (70% passing score).
  • Availability for the study duration, including all planned follow-up visits.

Exclusion Criteria:

General

  • Presence of a significant medical or psychiatric condition which in the opinion of the investigator precludes participation in the study. Some medical conditions which are adequately treated and stable would not preclude entry into the study. These conditions might include stable asthma controlled with inhalers or mild hypertension stably controlled with a single agent.
  • Significant abnormalities in screening hematology, or serum chemistry as determined by PI or PI in consultation with the research monitor and sponsor.
  • Presence in the serum of HIV antibody, HBsAg, or HCV antibody.
  • Evidence of IgA deficiency (serum IgA < 7 mg/dL or below the limit of detection of assay).
  • Evidence of current excessive alcohol consumption or drug dependence (a targeted drug screen may be used to evaluate at the clinician's discretion).
  • Evidence of impaired immune function.
  • Recent vaccination or receipt of an investigational product (within 30 days before vaccination).
  • Any other criteria which, in the investigator's opinion, would compromise the ability of the subject to participate in the study, the safety of the study, or the results of the study

Research Related Exclusions Applicable to Vaccination and Challenge Participation

  • History of microbiologically confirmed ETEC or cholera infection in last 3 years.
  • Occupation involving handling of ETEC or Vibrio cholerae currently, or in the past 3 years.
  • Symptoms consistent with Travelers' Diarrhea concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study.
  • Vaccination for or ingestion of ETEC, cholera, or E coli heat labile toxin within 3 years prior to dosing.

Research Related Exclusions Not Applicable to Challenge-Only Participants

  • Exclusionary skin history/findings that would confound assessment or prevent appropriate local monitoring of AEs, or possibly increase the risk of an AE.
  • History of chronic skin disease (clinician judgment).- History of atopy such as active eczema.
  • Acute skin infection/eruptions on the upper arms including fungal infections, severe acne, or active contact dermatitis.
  • History of significant allergic reactions to any vaccines and allergies that may increase the risk of AEs (Well-controlled seasonal allergies responsive to antihistamine medication or intranasal steroids are not exclusionary per clinician determination).

Study-specific Exclusion Criteria

  • Abnormal stool pattern (fewer than 3 per week or more than 3 per day).
  • Regular use of laxatives, antacids, or other agents to lower stomach acidity.
  • Use of any medication known to affect the immune function (eg, systemic corticosteroids and others) within 30 days preceding the first vaccination or planned use during the active study period.
  • Known allergy to two of the following antibiotics: ciprofloxacin, trimethoprim-sulfamethoxazole, and penicillin.

Sites / Locations

  • Johns Hopkins Center for Immunization Research
  • Naval Medical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Challenge (Vaccinated)

Challenge (Unvaccinated)

Arm Description

The vaccine will be administered via the ID route to alternating upper arms on days 0, 21, and 42. On the morning of challenge, subjects will drink 120 mL of bicarbonate buffer. Approximately 1 minute later, subjects will drink a solution of virulent H10407 bacteria suspended in the remaining 30 mL of bicarbonate buffer (2 x 10P7P cfu).

On the morning of challenge, subjects will drink 120 mL of bicarbonate buffer. Approximately 1 minute later, subjects will drink a solution of virulent H10407 bacteria suspended in the remaining 30 mL of bicarbonate buffer (2 x 10P7P cfu).

Outcomes

Primary Outcome Measures

Number of adverse events associated with vaccine
Number of prevented diarrhea episodes

Secondary Outcome Measures

Full Information

First Posted
August 12, 2013
Last Updated
July 5, 2017
Sponsor
U.S. Army Medical Research and Development Command
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1. Study Identification

Unique Protocol Identification Number
NCT01922856
Brief Title
Challenge Study of an ETEC Vaccine
Official Title
A Phase 2b Controlled Efficacy Study of Intradermally Delivered ETEC Fimbrial Tip Adhesin Vaccine Against Experimental Challenge With ETEC H10407 in Healthy Adult Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
September 19, 2013 (Actual)
Primary Completion Date
February 6, 2016 (Actual)
Study Completion Date
July 14, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to determine the efficacy of a vaccine against enterotoxigenic E. coli (ETEC)-caused diarrhea.
Detailed Description
The purpose of the study is to establish preliminary efficacy of dscCfaE administered with LTR192G by intradermal (ID) immunization in prevention of disease caused by a challenge with a CFA/I expressing ETEC strain (H10407).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Enteritis; Escherichia Coli, Enterotoxigenic

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Challenge (Vaccinated)
Arm Type
Experimental
Arm Description
The vaccine will be administered via the ID route to alternating upper arms on days 0, 21, and 42. On the morning of challenge, subjects will drink 120 mL of bicarbonate buffer. Approximately 1 minute later, subjects will drink a solution of virulent H10407 bacteria suspended in the remaining 30 mL of bicarbonate buffer (2 x 10P7P cfu).
Arm Title
Challenge (Unvaccinated)
Arm Type
Experimental
Arm Description
On the morning of challenge, subjects will drink 120 mL of bicarbonate buffer. Approximately 1 minute later, subjects will drink a solution of virulent H10407 bacteria suspended in the remaining 30 mL of bicarbonate buffer (2 x 10P7P cfu).
Intervention Type
Biological
Intervention Name(s)
LTR192G with dscCfaE
Intervention Description
Recombinant fimbrial adhesin (dscCfaE) with Modified Escherichia coli (E coli) heat labile enterotoxin (LTR192G)
Intervention Type
Other
Intervention Name(s)
No Intervention
Intervention Description
Controls only receive challenge
Primary Outcome Measure Information:
Title
Number of adverse events associated with vaccine
Time Frame
Up to 1 year
Title
Number of prevented diarrhea episodes
Time Frame
24 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female age 18 through 50 years (inclusive). General good health, without clinically significant medical history, physical examination findings or clinical laboratory abnormalities per clinical judgment of PI. Negative pregnancy test. Pregnancy at any time will result in not receiving any or additional investigational product. Females of childbearing potential must agree to use an efficacious hormonal or barrier method of birth control during the study. Abstinence is acceptable. Female subjects unable to bear children must have this documented (eg, tubal ligation or hysterectomy) or must have negative pregnancy tests. Willingness to participate in the study after all aspects of the protocol have been explained and written informed consent obtained. Completion of a training session and demonstrated comprehension of the protocol procedures, knowledge of ETEC-associated illness, and by passing a written examination (70% passing score). Availability for the study duration, including all planned follow-up visits. Exclusion Criteria: General Presence of a significant medical or psychiatric condition which in the opinion of the investigator precludes participation in the study. Some medical conditions which are adequately treated and stable would not preclude entry into the study. These conditions might include stable asthma controlled with inhalers or mild hypertension stably controlled with a single agent. Significant abnormalities in screening hematology, or serum chemistry as determined by PI or PI in consultation with the research monitor and sponsor. Presence in the serum of HIV antibody, HBsAg, or HCV antibody. Evidence of IgA deficiency (serum IgA < 7 mg/dL or below the limit of detection of assay). Evidence of current excessive alcohol consumption or drug dependence (a targeted drug screen may be used to evaluate at the clinician's discretion). Evidence of impaired immune function. Recent vaccination or receipt of an investigational product (within 30 days before vaccination). Any other criteria which, in the investigator's opinion, would compromise the ability of the subject to participate in the study, the safety of the study, or the results of the study Research Related Exclusions Applicable to Vaccination and Challenge Participation History of microbiologically confirmed ETEC or cholera infection in last 3 years. Occupation involving handling of ETEC or Vibrio cholerae currently, or in the past 3 years. Symptoms consistent with Travelers' Diarrhea concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study. Vaccination for or ingestion of ETEC, cholera, or E coli heat labile toxin within 3 years prior to dosing. Research Related Exclusions Not Applicable to Challenge-Only Participants Exclusionary skin history/findings that would confound assessment or prevent appropriate local monitoring of AEs, or possibly increase the risk of an AE. History of chronic skin disease (clinician judgment).- History of atopy such as active eczema. Acute skin infection/eruptions on the upper arms including fungal infections, severe acne, or active contact dermatitis. History of significant allergic reactions to any vaccines and allergies that may increase the risk of AEs (Well-controlled seasonal allergies responsive to antihistamine medication or intranasal steroids are not exclusionary per clinician determination). Study-specific Exclusion Criteria Abnormal stool pattern (fewer than 3 per week or more than 3 per day). Regular use of laxatives, antacids, or other agents to lower stomach acidity. Use of any medication known to affect the immune function (eg, systemic corticosteroids and others) within 30 days preceding the first vaccination or planned use during the active study period. Known allergy to two of the following antibiotics: ciprofloxacin, trimethoprim-sulfamethoxazole, and penicillin.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kawsar Talaat, MD
Organizational Affiliation
Johns Hopkins Center for Immunization Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johns Hopkins Center for Immunization Research
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Naval Medical Research Center
City
Silver Spring
State/Province
Maryland
ZIP/Postal Code
20910
Country
United States

12. IPD Sharing Statement

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Challenge Study of an ETEC Vaccine

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