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Safety and Immunogenicity of Co-Administered Hookworm Vaccine Candidates Na-GST-1 and Na-APR-1 in Gabonese Adults

Primary Purpose

Hookworm Infection, Hookworm Disease

Status
Completed
Phase
Phase 1
Locations
Gabon
Study Type
Interventional
Intervention
Na-APR-1 (M74)/Alhydrogel®
Na-GST-1/Alhydrogel®
Hepatitis B vaccine
Sponsored by
Baylor College of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hookworm Infection focused on measuring Human Hookworm, Necator americanus, Hookworm, Hookworm Disease, Iron-deficiency anemia, Soil-transmitted helminth infection, Neglected Tropical Disease, Na-APR-1, Na-GST-1

Eligibility Criteria

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

Inclusion Criteria:

  • Males or females between 18 and 50 years, inclusive, who are long-term residents of Gabon.
  • Good general health as determined by means of the screening procedure.
  • Assumed availability for the duration of the trial (12 months).
  • Willingness to participate in the study as evidenced by signing the informed consent document.
  • Negative for hookworm during screening, or if found to be infected with hookworm, has completed a course of three doses of albendazole.

Exclusion Criteria:

  • Pregnancy as determined by a positive urine hCG (if female).
  • Participant unwilling to use reliable contraception up until one month following the third immunization (if female and not surgically sterile, abstinent or at least 2 years post-menopausal).
  • Currently lactating and breast-feeding (if female).
  • Inability to correctly answer all questions on the informed consent comprehension questionnaire.
  • Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, diabetes, or renal disease by history, physical examination, and/or laboratory studies.
  • Known or suspected immunodeficiency.
  • Laboratory evidence of liver disease (alanine aminotransferase [ALT] greater than 1.25-times the upper reference limit).
  • Laboratory evidence of renal disease (serum creatinine greater than 1.25-times the upper reference limit, or more than trace protein or blood on urine dipstick testing).
  • Laboratory evidence of hematologic disease (absolute leukocyte count <3500/mm3; absolute leukocyte count >11.0 x 103/mm3; hemoglobin <10.000 g/dl [females] or <12.0 g/dl [males]; or, platelet count <140,000/mm3).
  • Other condition that in the opinion of the investigator would jeopardize the safety or rights of a volunteer participating in the trial or would render the subject unable to comply with the protocol.
  • Participation in another investigational vaccine or drug trial within 30 days of starting this study or for the duration of the study.
  • Volunteer has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
  • History of a severe allergic reaction or anaphylaxis.
  • Severe asthma as defined by the need for daily use of inhalers or emergency room/clinic visit or hospitalization within 6 months of the volunteer's planned first vaccination in the study.
  • Positive for HCV
  • Positive ELISA for HBsAg.
  • Positive for HIV infection
  • Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of starting this study or expect to use for the duration of the study.
  • Receipt of a live vaccine within past 4 weeks or a killed vaccine within past 2 weeks prior to entry into the study.
  • History of a surgical splenectomy.
  • Receipt of blood products within the 6 months prior to entry into the study.
  • Previous receipt of a primary series of any hepatitis B vaccine.

Sites / Locations

  • Centre de Recherches Médicales de Lambaréné Albert Schweitzer Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Experimental

Arm Label

30 µg Na-GST-1 + 30 µg Na-APR-1 (M74)

Hepatitis B vaccine

100 µg Na-GST-1 plus 100 µg Na-APR-1 (M74)

Arm Description

30 µg Na-GST-1/Alhydrogel plus 5 µg GLA-AF co-administered with 30 µg Na-APR-1 (M74)/Alhydrogel plus 5 µg GLA-AF

Hepatitis B vaccine co-administered with saline

100 µg Na-GST-1/Alhydrogel plus 5 µg GLA-AF co-administered with 100 µg Na-APR-1 (M74)/Alhydrogel plus 5 µg GLA-AF

Outcomes

Primary Outcome Measures

Vaccine-related Adverse Events
To estimate the frequency of vaccine-related adverse events, graded by severity, for each dose of co-administered Na-GST-1 and Na-APR-1 (M74). The frequency of immediate, systemic, and local injection site adverse events will be summarized. Adverse events will be assessed by study team members at 1 hour post-vaccination as well as 1, 3, 7, 14, and 28 days following each vaccination.

Secondary Outcome Measures

IgG response to Na-GST-1 and Na-APR-1 (M74)
To determine the doses of Na-GST-1 and Na-APR-1 (M74) that generate the highest IgG antibody responses at Day 194, as determined by indirect enzyme-linked immunosorbent assays (ELISA)
Duration of antibody response to Na-GST-1 and Na-APR-1 (M74)
To assess and compare the duration of antibody responses to Na- GST-1 and Na-APR-1 (M74).
Exploratory studies of memory B-cell responses
Exploratory studies of memory B-cell responses against the metabolomics changes before and after Na-GST-1 and NA-APR-1 (M74) vaccine antigens.

Full Information

First Posted
April 28, 2014
Last Updated
May 30, 2017
Sponsor
Baylor College of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT02126462
Brief Title
Safety and Immunogenicity of Co-Administered Hookworm Vaccine Candidates Na-GST-1 and Na-APR-1 in Gabonese Adults
Official Title
Randomized, Controlled, Phase 1 Study to Assess Safety and Immunogenicity of Co-administered Hookworm Vaccine Candidates Na-GST-1 and Na-APR-1 Adjuvanted With Alhydrogel® and Gluco-pyranosylphospho-lipid A in Gabonese Adults
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
November 2014 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Baylor College of Medicine

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Na-GST-1 and Na-APR-1 are proteins expressed during the adult stage of the Necator americanus hookworm life cycle that are thought to play a role in the parasite's degradation of host hemoglobin for use as an energy source. Vaccination with recombinant GST-1 or APR-1 has protected dogs and hamsters from infection in challenge studies. This study will evaluate the safety and immunogenicity of co-administering Na-GST-1 and Na-APR-1 to healthy Gabonese adults living in an area of endemic hookworm infection.
Detailed Description
Double-blind, randomized, controlled dose-escalation Phase 1 clinical trial in hookworm exposed adults. Study site: Centre de Recherches Médicales de Lambaréné Number of participants: 32 in 2 cohorts of 16 Doses of Na-GST-1 to be tested: 30 and 100 μg Doses of Na-APR-1 to be tested: 30 and 100 μg Dose of GLA-AF: 5 μg per antigen Cohort 1: 30 μg of each of the two antigens (Na-GST-1/Alhydrogel® and Na-APR-1 (M74)/Alhydrogel®) or hepatitis B vaccine; Cohort 2: 100 μg of each of the two antigens (Na-GST- 1/Alhydrogel® and Na-APR-1 (M74) /Alhydrogel®) or hepatitis B vaccine. Randomization: Cohort 1: 30 μg Na-GST-1 + 30 μg Na-APR-1 (M74) (n = 12) versus Hepatitis B Vaccine/placebo (n = 4) Cohort 2: 100 μg Na-GST-1 + 100 μg Na-APR-1 (M74) (n = 12) versus Hepatitis B Vaccine + placebo (n = 4) The cohorts will be enrolled in a staggered fashion with safety data assessed prior to the Na-GST-1 and Na-APR-1 dose escalation from 30 to 100 µg. Pre-treatment: Albendazole (400 mg) at least 2 weeks prior to first vaccination Immunization schedule: Study days 0, 28 and 180 Route: Intramuscular in the deltoid muscle Study duration: approximately 20 months; each participant will be followed for a total of 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hookworm Infection, Hookworm Disease
Keywords
Human Hookworm, Necator americanus, Hookworm, Hookworm Disease, Iron-deficiency anemia, Soil-transmitted helminth infection, Neglected Tropical Disease, Na-APR-1, Na-GST-1

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
30 µg Na-GST-1 + 30 µg Na-APR-1 (M74)
Arm Type
Experimental
Arm Description
30 µg Na-GST-1/Alhydrogel plus 5 µg GLA-AF co-administered with 30 µg Na-APR-1 (M74)/Alhydrogel plus 5 µg GLA-AF
Arm Title
Hepatitis B vaccine
Arm Type
Active Comparator
Arm Description
Hepatitis B vaccine co-administered with saline
Arm Title
100 µg Na-GST-1 plus 100 µg Na-APR-1 (M74)
Arm Type
Experimental
Arm Description
100 µg Na-GST-1/Alhydrogel plus 5 µg GLA-AF co-administered with 100 µg Na-APR-1 (M74)/Alhydrogel plus 5 µg GLA-AF
Intervention Type
Biological
Intervention Name(s)
Na-APR-1 (M74)/Alhydrogel®
Intervention Type
Biological
Intervention Name(s)
Na-GST-1/Alhydrogel®
Intervention Type
Biological
Intervention Name(s)
Hepatitis B vaccine
Intervention Description
Hepatitis B vaccine co-administered with saline
Primary Outcome Measure Information:
Title
Vaccine-related Adverse Events
Description
To estimate the frequency of vaccine-related adverse events, graded by severity, for each dose of co-administered Na-GST-1 and Na-APR-1 (M74). The frequency of immediate, systemic, and local injection site adverse events will be summarized. Adverse events will be assessed by study team members at 1 hour post-vaccination as well as 1, 3, 7, 14, and 28 days following each vaccination.
Time Frame
Day 360
Secondary Outcome Measure Information:
Title
IgG response to Na-GST-1 and Na-APR-1 (M74)
Description
To determine the doses of Na-GST-1 and Na-APR-1 (M74) that generate the highest IgG antibody responses at Day 194, as determined by indirect enzyme-linked immunosorbent assays (ELISA)
Time Frame
Day 194
Title
Duration of antibody response to Na-GST-1 and Na-APR-1 (M74)
Description
To assess and compare the duration of antibody responses to Na- GST-1 and Na-APR-1 (M74).
Time Frame
Day 14, 28, 42, 56, 180, 194, 208, 270, 360
Title
Exploratory studies of memory B-cell responses
Description
Exploratory studies of memory B-cell responses against the metabolomics changes before and after Na-GST-1 and NA-APR-1 (M74) vaccine antigens.
Time Frame
Days 14, 28, 42, 56, 180, 194, 208, 270, 360

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: Males or females between 18 and 50 years, inclusive, who are long-term residents of Gabon. Good general health as determined by means of the screening procedure. Assumed availability for the duration of the trial (12 months). Willingness to participate in the study as evidenced by signing the informed consent document. Negative for hookworm during screening, or if found to be infected with hookworm, has completed a course of three doses of albendazole. Exclusion Criteria: Pregnancy as determined by a positive urine hCG (if female). Participant unwilling to use reliable contraception up until one month following the third immunization (if female and not surgically sterile, abstinent or at least 2 years post-menopausal). Currently lactating and breast-feeding (if female). Inability to correctly answer all questions on the informed consent comprehension questionnaire. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, diabetes, or renal disease by history, physical examination, and/or laboratory studies. Known or suspected immunodeficiency. Laboratory evidence of liver disease (alanine aminotransferase [ALT] greater than 1.25-times the upper reference limit). Laboratory evidence of renal disease (serum creatinine greater than 1.25-times the upper reference limit, or more than trace protein or blood on urine dipstick testing). Laboratory evidence of hematologic disease (absolute leukocyte count <3500/mm3; absolute leukocyte count >11.0 x 103/mm3; hemoglobin <10.000 g/dl [females] or <12.0 g/dl [males]; or, platelet count <140,000/mm3). Other condition that in the opinion of the investigator would jeopardize the safety or rights of a volunteer participating in the trial or would render the subject unable to comply with the protocol. Participation in another investigational vaccine or drug trial within 30 days of starting this study or for the duration of the study. Volunteer has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months. History of a severe allergic reaction or anaphylaxis. Severe asthma as defined by the need for daily use of inhalers or emergency room/clinic visit or hospitalization within 6 months of the volunteer's planned first vaccination in the study. Positive for HCV Positive ELISA for HBsAg. Positive for HIV infection Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of starting this study or expect to use for the duration of the study. Receipt of a live vaccine within past 4 weeks or a killed vaccine within past 2 weeks prior to entry into the study. History of a surgical splenectomy. Receipt of blood products within the 6 months prior to entry into the study. Previous receipt of a primary series of any hepatitis B vaccine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ayola Adegnika, MD
Organizational Affiliation
Centre de Recherches Medicales de Lambarené
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre de Recherches Médicales de Lambaréné Albert Schweitzer Hospital
City
Lambaréné
ZIP/Postal Code
BP: 118
Country
Gabon

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34597297
Citation
Mouwenda YD, Betouke Ongwe ME, Sonnet F, Stam KA, Labuda LA, De Vries S, Grobusch MP, Zinsou FJ, Honkpehedji YJ, Dejon Agobe JC, Diemert DJ, van Leeuwen R, Bottazzi ME, Hotez PJ, Kremsner PG, Bethony JM, Jochems SP, Adegnika AA, Massinga Loembe M, Yazdanbakhsh M. Characterization of T cell responses to co-administered hookworm vaccine candidates Na-GST-1 and Na-APR-1 in healthy adults in Gabon. PLoS Negl Trop Dis. 2021 Oct 1;15(10):e0009732. doi: 10.1371/journal.pntd.0009732. eCollection 2021 Oct.
Results Reference
derived
PubMed Identifier
32926834
Citation
Adegnika AA, de Vries SG, Zinsou FJ, Honkepehedji YJ, Dejon Agobe JC, Vodonou KG, Bikangui R, Bouyoukou Hounkpatin A, Bache EB, Massinga Loembe M, van Leeuwen R, Molemans M, Kremsner PG, Yazdanbakhsh M, Hotez PJ, Bottazzi ME, Li G, Bethony JM, Diemert DJ, Grobusch MP; HookVac Consortium. Safety and immunogenicity of co-administered hookworm vaccine candidates Na-GST-1 and Na-APR-1 in Gabonese adults: a randomised, controlled, double-blind, phase 1 dose-escalation trial. Lancet Infect Dis. 2021 Feb;21(2):275-285. doi: 10.1016/S1473-3099(20)30288-7. Epub 2020 Sep 11.
Results Reference
derived

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Safety and Immunogenicity of Co-Administered Hookworm Vaccine Candidates Na-GST-1 and Na-APR-1 in Gabonese Adults

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