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MTBVAC Study in Adults With and Without Latent Tuberculosis Infection in South Africa (A-050)

Primary Purpose

Tuberculosis

Status
Completed
Phase
Phase 1
Locations
South Africa
Study Type
Interventional
Intervention
MTBVAC
BCG
Sponsored by
International AIDS Vaccine Initiative
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Tuberculosis

Eligibility Criteria

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

Inclusion Criteria

  1. Has completed the written informed consent process.
  2. Is male or female aged 18 through 50 years on Study Day 0.
  3. Agrees to stay in contact with the clinical trial site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study.
  4. For female participants: agrees to avoid pregnancy from 21 days prior to Study Day 0 and for the full duration of the study. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, or intrauterine device (IUD).
  5. For male participants: agrees to use barrier contraception with his partner for at least 2 weeks after dosing with MTBVAC or BCG.
  6. Has general good health, confirmed by medical history and physical examination.
  7. Had BCG vaccination, documented through medical history or presence of scar.
  8. Has not shared enclosed living or work space with someone diagnosed with TB during the 3 months prior to Study Day 0.
  9. [Cohorts 1-4] Does not have LTBI, determined by a negative QFT test at screening or [Cohorts 5-8] Has LTBI, determined by a positive QFT test at screening.

Exclusion Criteria

  1. Acute illness on Study Day 0.
  2. Axillary temperature >or= 37.5C on Study Day 0.
  3. Abnormal laboratory values from most recent blood collection prior to Study Day 0 randomization that are equivalent to Grade 2 or more toxicity, per the protocol toxicity table, or if deemed clinically significant.
  4. Severe anemia, defined as <10 g/dL hemoglobin or hematocrit <30%.
  5. Screening thyroid stimulating hormone (TSH) >upper limit of normal per local laboratory range.
  6. Suspicion or evidence (including but not limited to sputum Xpert MTB/RIF positive) of active TB disease at any site. An attempt must be made to obtain sputum from each participant; persons who are sputum unproductive will be assumed to be Xpert MTB/RIF negative.
  7. History of treatment for TB disease.
  8. History of autoimmune disease or immunosuppression.
  9. Used immunosuppressive medication within 42 days before Study Day 0 (inhaled and topical corticosteroids are permitted).
  10. Received immunoglobulin or blood products within 42 days before Study Day 0.
  11. Received any investigational drug or investigational vaccine within 182 days before Study Day 0, or planned participation in any other investigational study during the study period.
  12. Received investigational vaccine against TB at any time prior to Study Day 0.
  13. Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after dosing with investigational product.
  14. History or laboratory evidence of any past, present, or future possible immunodeficiency state including but not limited to any laboratory indication of HIV 1 infection.
  15. History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the investigational product.
  16. Previous medical history that may compromise the safety of the participant in the study, including but not limited to: impairment of pulmonary function from TB infection or other pulmonary disease; chronic illness with signs of cardiac or renal failure; suspected progressive neurological disease; uncontrolled epilepsy or infantile spasms; or diabetes mellitus.
  17. History or evidence on physical examination of any systemic disease or any acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine, including axillary lymphadenopathy.
  18. Female participants: currently pregnant or lactating/nursing; or positive urine pregnancy test during screening or pre-vaccination on Study Day 0.
  19. Any current medical, psychiatric, occupational, or substance abuse problems that, in the opinion of the investigator, could endanger the participant or make it unlikely that the participant will comply with the protocol.

Sites / Locations

  • SATVI: Worcester

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Active Comparator

Arm Label

Cohort 1: MTBVAC 5 x 10^3 CFU

Cohort 2: MTBVAC 5 x 10^4 CFU

Cohort 3: MTBVAC 5 x 10^5 CFU

Cohort 4: MTBVAC 5 x 10^6 CFU

Cohort 5: MTBVAC 5 x 10^3 CFU

Cohort 6: MTBVAC 5 x 10^4 CFU

Cohort 7: MTBVAC 5 x 10^5 CFU

Cohort 8: MTBVAC 5 x 10^6 CFU

BCG 5 x 10^5 CFU

Arm Description

Quantiferon (QFT) negative, 1 dose on Day 0

QFT Negative, 1 dose on Day 0

QFT Negative, 1 dose on Day 0

QFT Negative, 1 dose on Day 0

QFT Positive, 1 dose on Day 0

QFT Positive, 1 dose on Day 0

QFT Positive, 1 dose on Day 0

QFT Positive, 1 dose on Day 0

Both QFT positive and negative, 1 dose on Day 0

Outcomes

Primary Outcome Measures

Safety and reactogenicity of MTBVAC at escalating dose levels compared to BCG vaccine by assessing number of participants with AEs and SAEs
Collection of systemic solicited and unsolicited adverse events; solicited and unsolicited injection site reactions; and serious adverse reactions.

Secondary Outcome Measures

Difference in T cell response between MTBVAC dose levels across all post-immunization time points measured by percentage of MTBVAC-specific CD4 and CD8 T cells that produce any or a combination of relevant cytokines in ICS assay
12 hour whole blood (WB) intracellular cytokine staining (ICS) assay
Qualitative and quantitative results from QuantiFERON® TB (QFT) test summarized using participant count (percentage) summaries conversion and reversion rates in participants receiving escalating dose levels of MTBVAC
QFT Gold Plus assay
Qualitative and quantitative results from QFT test using percentage conversion and reversion rates of participants receiving escalating dose levels of MTBVAC compared to BCG dose levels of MTBVAC in comparison to BCG measured by QFT Gold Plus assay
QFT Gold Plus assay

Full Information

First Posted
October 10, 2016
Last Updated
February 23, 2023
Sponsor
International AIDS Vaccine Initiative
Collaborators
Biofabri, S.L, Universidad de Zaragoza, South African Tuberculosis Vaccine Initiative
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1. Study Identification

Unique Protocol Identification Number
NCT02933281
Brief Title
MTBVAC Study in Adults With and Without Latent Tuberculosis Infection in South Africa
Acronym
A-050
Official Title
MTBVAC Phase 1b/2a Randomized, Double-blind, Active-controlled,Safety, Immunogenicity, and Dose-escalation Study in Adults With and Without Latent Tuberculosis Infection in South Africa
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
May 14, 2018 (Actual)
Primary Completion Date
September 5, 2021 (Actual)
Study Completion Date
September 5, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International AIDS Vaccine Initiative
Collaborators
Biofabri, S.L, Universidad de Zaragoza, South African Tuberculosis Vaccine Initiative

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
MTBVAC at four dose levels: 5 x 10^3 CFU, 5 x 10^4 CFU, 5 x 10^5 CFU, and 5 x 10^6 CFU. The active control is BCG (5 x 10^5 CFU). Participants will receive a single dose of MTBVAC or BCG revaccination administered intradermally on Study Day 0.
Detailed Description
This is a Phase 1b/2a, double-blind, randomized, BCG-controlled, dose-escalation safety and immunogenicity study in 144 healthy adults with and without LTBI. All participants will have received previous BCG vaccination in infancy. The investigational product is MTBVAC at four dose levels: 5 x 10^3 CFU, 5 x 10^4 CFU, 5 x 10^5 CFU, and 5 x 10^6 CFU. The active control is BCG (5 x 10^5 CFU). Participants meeting the inclusion/exclusion criteria will be randomized within a study cohort to receive a single dose of MTBVAC or BCG revaccination administered intradermally on Study Day 0. The study will be conducted at one site in South Africa. Participants will be enrolled into one of eight cohorts and followed for safety and immunogenicity endpoints through Study Day 365. The estimated time to complete enrolment is approximately 12 months. Cohorts 1-8 will include 72 QFT-negative (Cohorts 1-4) and 72 QFT-positive (Cohorts 5-8) participants. Participants will be randomized within each cohort, to receive either MTBVAC (N=96) or BCG (N=48). The cohorts will be enrolled as described in the protocol, as long as no pausing/stopping rules are triggered

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
144 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: MTBVAC 5 x 10^3 CFU
Arm Type
Experimental
Arm Description
Quantiferon (QFT) negative, 1 dose on Day 0
Arm Title
Cohort 2: MTBVAC 5 x 10^4 CFU
Arm Type
Experimental
Arm Description
QFT Negative, 1 dose on Day 0
Arm Title
Cohort 3: MTBVAC 5 x 10^5 CFU
Arm Type
Experimental
Arm Description
QFT Negative, 1 dose on Day 0
Arm Title
Cohort 4: MTBVAC 5 x 10^6 CFU
Arm Type
Experimental
Arm Description
QFT Negative, 1 dose on Day 0
Arm Title
Cohort 5: MTBVAC 5 x 10^3 CFU
Arm Type
Experimental
Arm Description
QFT Positive, 1 dose on Day 0
Arm Title
Cohort 6: MTBVAC 5 x 10^4 CFU
Arm Type
Experimental
Arm Description
QFT Positive, 1 dose on Day 0
Arm Title
Cohort 7: MTBVAC 5 x 10^5 CFU
Arm Type
Experimental
Arm Description
QFT Positive, 1 dose on Day 0
Arm Title
Cohort 8: MTBVAC 5 x 10^6 CFU
Arm Type
Experimental
Arm Description
QFT Positive, 1 dose on Day 0
Arm Title
BCG 5 x 10^5 CFU
Arm Type
Active Comparator
Arm Description
Both QFT positive and negative, 1 dose on Day 0
Intervention Type
Biological
Intervention Name(s)
MTBVAC
Intervention Description
Escalating dose levels (5 x 10^3 CFU, 5 x 10^4 CFU, 5 x 10^5 CFU, and 5 x 10^6 CFU
Intervention Type
Biological
Intervention Name(s)
BCG
Other Intervention Name(s)
BCG 5 x 10^5 CFU
Intervention Description
BCG 5 x 10^5 CFU
Primary Outcome Measure Information:
Title
Safety and reactogenicity of MTBVAC at escalating dose levels compared to BCG vaccine by assessing number of participants with AEs and SAEs
Description
Collection of systemic solicited and unsolicited adverse events; solicited and unsolicited injection site reactions; and serious adverse reactions.
Time Frame
Study Days 0 to Day 365
Secondary Outcome Measure Information:
Title
Difference in T cell response between MTBVAC dose levels across all post-immunization time points measured by percentage of MTBVAC-specific CD4 and CD8 T cells that produce any or a combination of relevant cytokines in ICS assay
Description
12 hour whole blood (WB) intracellular cytokine staining (ICS) assay
Time Frame
Study Days 0, 28, 56, 182, and 365
Title
Qualitative and quantitative results from QuantiFERON® TB (QFT) test summarized using participant count (percentage) summaries conversion and reversion rates in participants receiving escalating dose levels of MTBVAC
Description
QFT Gold Plus assay
Time Frame
Screening and Study Day 365 (all cohorts); and Study Days 28, 56, 84, and 182 (Cohorts 1-4)
Title
Qualitative and quantitative results from QFT test using percentage conversion and reversion rates of participants receiving escalating dose levels of MTBVAC compared to BCG dose levels of MTBVAC in comparison to BCG measured by QFT Gold Plus assay
Description
QFT Gold Plus assay
Time Frame
Screening and Study Day 365 (all cohorts); and Study Days 28, 56, 84, and 182 (Cohorts 1-4)

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 Has completed the written informed consent process. Is male or female aged 18 through 50 years on Study Day 0. Agrees to stay in contact with the clinical trial site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study. For female participants: agrees to avoid pregnancy from 21 days prior to Study Day 0 and for the full duration of the study. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, or intrauterine device (IUD). For male participants: agrees to use barrier contraception with his partner for at least 2 weeks after dosing with MTBVAC or BCG. Has general good health, confirmed by medical history and physical examination. Had BCG vaccination, documented through medical history or presence of scar. Has not shared enclosed living or work space with someone diagnosed with TB during the 3 months prior to Study Day 0. [Cohorts 1-4] Does not have LTBI, determined by a negative QFT test at screening or [Cohorts 5-8] Has LTBI, determined by a positive QFT test at screening. Exclusion Criteria Acute illness on Study Day 0. Axillary temperature >or= 37.5C on Study Day 0. Abnormal laboratory values from most recent blood collection prior to Study Day 0 randomization that are equivalent to Grade 2 or more toxicity, per the protocol toxicity table, or if deemed clinically significant. Severe anemia, defined as <10 g/dL hemoglobin or hematocrit <30%. Screening thyroid stimulating hormone (TSH) >upper limit of normal per local laboratory range. Suspicion or evidence (including but not limited to sputum Xpert MTB/RIF positive) of active TB disease at any site. An attempt must be made to obtain sputum from each participant; persons who are sputum unproductive will be assumed to be Xpert MTB/RIF negative. History of treatment for TB disease. History of autoimmune disease or immunosuppression. Used immunosuppressive medication within 42 days before Study Day 0 (inhaled and topical corticosteroids are permitted). Received immunoglobulin or blood products within 42 days before Study Day 0. Received any investigational drug or investigational vaccine within 182 days before Study Day 0, or planned participation in any other investigational study during the study period. Received investigational vaccine against TB at any time prior to Study Day 0. Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after dosing with investigational product. History or laboratory evidence of any past, present, or future possible immunodeficiency state including but not limited to any laboratory indication of HIV-1 infection. History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the investigational product. Previous medical history that may compromise the safety of the participant in the study, including but not limited to: impairment of pulmonary function from TB infection or other pulmonary disease; chronic illness with signs of cardiac or renal failure; suspected progressive neurological disease; uncontrolled epilepsy or infantile spasms; or diabetes mellitus. History or evidence on physical examination of any systemic disease or any acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine, including axillary lymphadenopathy. Female participants: currently pregnant or lactating/nursing; or positive urine pregnancy test during screening or pre-vaccination on Study Day 0. Any current medical, psychiatric, occupational, or substance abuse problems that, in the opinion of the investigator, could endanger the participant or make it unlikely that the participant will comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Angelique Luabeya, MD
Organizational Affiliation
SATVI
Official's Role
Principal Investigator
Facility Information:
Facility Name
SATVI: Worcester
City
Worcester
ZIP/Postal Code
6850
Country
South Africa

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

MTBVAC Study in Adults With and Without Latent Tuberculosis Infection in South Africa

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