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A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL) (LEISH3)

Primary Purpose

Post-kala-azar Dermal Leishmaniasis

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Vaccine
Placebo
Sponsored by
University of York
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Post-kala-azar Dermal Leishmaniasis

Eligibility Criteria

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

Inclusion Criteria:

The patient volunteer must be:

  • Aged 12 to 50 years on the day of screening
  • Have had VL and have been cured following a standard regimen of SSG / PM
  • Females must be unmarried, single, or widowed
  • Willing and able to give written informed consent
  • For adolescents aged 12 to 17 years on the day of screening written informed consent from a parent must be obtained.

All Participants

  • Uncomplicated VL responsive to SSG / PM treatment
  • Have relatively normal blood values in the setting of VL, defined as hemoglobin >5.0 g/dL, white blood cells >1.0 x10(9)/L, platelets >40 x10(9)/L, liver function tests < x5 normal, Creatinine <1.5 mg/dL
  • Available for the duration of the study
  • Without any other significant health problems as determined by medical history, physical examination, results of screening tests and the clinical judgment of a medically qualified Clinical Investigator
  • Negative for malaria on blood smear
  • Judged, in the opinion of a medically qualified Clinical Investigator, to be able and likely to comply with all study requirements as set out in the protocol
  • Negative for human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C
  • For females only, willing to undergo urinary pregnancy tests on the day of screening, on the day of vaccination (prior to vaccination) and 3, 6, 9 and 12 months after vaccination.

Exclusion Criteria:

The volunteer may not enter the study if any of the following apply:

  • Has HIV/VL coinfection
  • Has had previous treatment for VL with relapse
  • Receipt of a live attenuated vaccine within 60 days or other vaccine within 14 days of screening
  • Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine or a history of severe or multiple allergies to drugs or pharmaceutical agents
  • Any history of severe local or general reaction to vaccination as defined as
  • Local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the major circumference of the arm, not resolving within 72 hours
  • General: fever ≥ 39.5°C within 48 hours, anaphylaxis, bronchospasm, laryngeal oedema, collapse, convulsions or encephalopathy within 48 hours
  • Females - pregnancy, less than 12 weeks postpartum, lactating or willingness/intention to become pregnant during the study and for 3 months following vaccination.
  • Seropositive for hepatitis B surface antigen (HBsAg) or Hepatitis C (antibodies to hepatitis C virus)
  • Significant abnormal finding (in the setting of VL, see definitions in Inclusion criteria) on entry biochemistry or haematology blood tests or urinalysis
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months
  • Tuberculosis, leprosy, or malnutrition (malnutrition in adults defined as a BMI <18.5, and in adolescents (12-17yrs) as a Z score cut-off value of <-2 SD).
  • Any other significant disease, disorder or finding, which, in the opinion of a medically qualified Clinical Investigator, may either put the volunteer at risk because of participation in the study, or may influence the result of the study, or the volunteer's ability to participate in the study
  • Unlikely to comply with the study protocol

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Vaccine arm

    Placebo

    Arm Description

    Vaccine in 1 ml, single dose

    1 ml normal saline , single dose

    Outcomes

    Primary Outcome Measures

    Safety of single dose vaccination with ChAd63-KH
    Treatment-related adverse events as defined in the clinical trial protocol (median no. events)
    Efficacy of single dose vaccination with ChAd63-KH
    Frequency of occurrence of PKDL in patients completing treatment with SSG / PM.

    Secondary Outcome Measures

    Immunological response: T cells
    To compare systemic immune responses in vaccine vs placebo arms by measurement of the frequency (median) of gamma-interferon producing T cells
    Immunological response: transcriptomics
    Comparing transcripts for differential expression in vaccine and placebo arms
    Pathogenesis of PKDL comparing Leishmania parasite load pre-vaccination and at PKDL onset
    Parasite detection using RNAscope / immunocytochemistry
    Immunological response: B cells
    Measurement of frequency in vaccinated and placebo groups of B cells by flow cytometry
    Immunological response: antibody levels
    To compare systemic immune responses in vaccine vs placebo arms by median optical density levels

    Full Information

    First Posted
    September 23, 2019
    Last Updated
    September 29, 2022
    Sponsor
    University of York
    Collaborators
    Wellcome Trust, European and Developing Countries Clinical Trials Partnership (EDCTP), European Vaccine Initiative
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04107961
    Brief Title
    A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL)
    Acronym
    LEISH3
    Official Title
    A Phase II Study to Assess the Safety and Efficacy of the Leishmania Vaccine ChAd63-KH for the Prevention of Post-kala Azar Dermal Leishmaniasis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The trial will be undertaken but the protocol will be substantially revised.
    Study Start Date
    October 1, 2023 (Anticipated)
    Primary Completion Date
    December 2024 (Anticipated)
    Study Completion Date
    July 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of York
    Collaborators
    Wellcome Trust, European and Developing Countries Clinical Trials Partnership (EDCTP), European Vaccine Initiative

    4. Oversight

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

    5. Study Description

    Brief Summary
    The actual format of the anticipated LEISH3 trial is under review.
    Detailed Description
    The leishmaniases are poverty-related neglected diseases with a major impact on health worldwide. They affect the poorest of the poor and present a severe barrier to socio-economic development. Caused by infection with one of several species of Leishmania parasite, these diseases occur in 98 countries worldwide and can be broadly classified as tegumentary leishmaniases (TL; affecting the skin and mucosa) and visceral leishmaniasis (VL; affecting internal organs). Worldwide, over 1 million reported cases of TL and 0.5 million reported cases of VL occur each year. Whereas TL are chronic and non-life-threatening, VL is responsible for over 20,000 deaths per year, second only to malaria amongst parasites with regard to mortality. Collectively, approximately 2.4 million disability-adjusted life years are lost to the leishmaniases. No vaccines are currently licensed for any form of human leishmaniasis and the drug arsenal is limited and increasingly compromised by drug resistance. .

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Post-kala-azar Dermal Leishmaniasis

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    Randomised placebo-controlled double-blind study
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Masking Description
    Double blinded placebo controlled
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Vaccine arm
    Arm Type
    Experimental
    Arm Description
    Vaccine in 1 ml, single dose
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    1 ml normal saline , single dose
    Intervention Type
    Biological
    Intervention Name(s)
    Vaccine
    Other Intervention Name(s)
    ChAd63-KH
    Intervention Description
    Single intramuscular injection into the deltoid region
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Single intramuscular injection into the deltoid region
    Primary Outcome Measure Information:
    Title
    Safety of single dose vaccination with ChAd63-KH
    Description
    Treatment-related adverse events as defined in the clinical trial protocol (median no. events)
    Time Frame
    12 months from vaccination
    Title
    Efficacy of single dose vaccination with ChAd63-KH
    Description
    Frequency of occurrence of PKDL in patients completing treatment with SSG / PM.
    Time Frame
    12 months from vaccination
    Secondary Outcome Measure Information:
    Title
    Immunological response: T cells
    Description
    To compare systemic immune responses in vaccine vs placebo arms by measurement of the frequency (median) of gamma-interferon producing T cells
    Time Frame
    12 months from vaccination
    Title
    Immunological response: transcriptomics
    Description
    Comparing transcripts for differential expression in vaccine and placebo arms
    Time Frame
    12 months from vaccination
    Title
    Pathogenesis of PKDL comparing Leishmania parasite load pre-vaccination and at PKDL onset
    Description
    Parasite detection using RNAscope / immunocytochemistry
    Time Frame
    12 months from vaccination
    Title
    Immunological response: B cells
    Description
    Measurement of frequency in vaccinated and placebo groups of B cells by flow cytometry
    Time Frame
    12 months from vaccination
    Title
    Immunological response: antibody levels
    Description
    To compare systemic immune responses in vaccine vs placebo arms by median optical density levels
    Time Frame
    12 months from vaccination

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    12 Years
    Maximum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: The patient volunteer must be: Aged 12 to 50 years on the day of screening Have had VL and have been cured following a standard regimen of SSG / PM Females must be unmarried, single, or widowed Willing and able to give written informed consent For adolescents aged 12 to 17 years on the day of screening written informed consent from a parent must be obtained. All Participants Uncomplicated VL responsive to SSG / PM treatment Have relatively normal blood values in the setting of VL, defined as hemoglobin >5.0 g/dL, white blood cells >1.0 x10(9)/L, platelets >40 x10(9)/L, liver function tests < x5 normal, Creatinine <1.5 mg/dL Available for the duration of the study Without any other significant health problems as determined by medical history, physical examination, results of screening tests and the clinical judgment of a medically qualified Clinical Investigator Negative for malaria on blood smear Judged, in the opinion of a medically qualified Clinical Investigator, to be able and likely to comply with all study requirements as set out in the protocol Negative for human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C For females only, willing to undergo urinary pregnancy tests on the day of screening, on the day of vaccination (prior to vaccination) and 3, 6, 9 and 12 months after vaccination. Exclusion Criteria: The volunteer may not enter the study if any of the following apply: Has HIV/VL coinfection Has had previous treatment for VL with relapse Receipt of a live attenuated vaccine within 60 days or other vaccine within 14 days of screening Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate History of allergic disease or reactions likely to be exacerbated by any component of the vaccine or a history of severe or multiple allergies to drugs or pharmaceutical agents Any history of severe local or general reaction to vaccination as defined as Local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the major circumference of the arm, not resolving within 72 hours General: fever ≥ 39.5°C within 48 hours, anaphylaxis, bronchospasm, laryngeal oedema, collapse, convulsions or encephalopathy within 48 hours Females - pregnancy, less than 12 weeks postpartum, lactating or willingness/intention to become pregnant during the study and for 3 months following vaccination. Seropositive for hepatitis B surface antigen (HBsAg) or Hepatitis C (antibodies to hepatitis C virus) Significant abnormal finding (in the setting of VL, see definitions in Inclusion criteria) on entry biochemistry or haematology blood tests or urinalysis Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months Tuberculosis, leprosy, or malnutrition (malnutrition in adults defined as a BMI <18.5, and in adolescents (12-17yrs) as a Z score cut-off value of <-2 SD). Any other significant disease, disorder or finding, which, in the opinion of a medically qualified Clinical Investigator, may either put the volunteer at risk because of participation in the study, or may influence the result of the study, or the volunteer's ability to participate in the study Unlikely to comply with the study protocol
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Paul M Kaye, PhD
    Organizational Affiliation
    University of York
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL)

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