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Evaluating the Safety, Tolerability and Immunogenicity of bacTRL-Spike Vaccine for Prevention of COVID-19

Primary Purpose

COVID-19

Status
Completed
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
bacTRL-Spike
Sponsored by
Symvivo Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for COVID-19

Eligibility Criteria

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

INCLUSION CRITERIA

  1. Age 18 years inclusive at time of enrollment and older;
  2. Capable to and does provide written informed consent;
  3. Able to understand and agrees to comply with planned study procedures and be available for all study visits;
  4. Body Mass Index 18-32 kg/square meter, inclusive, at screening;
  5. Male or non-pregnant, non-breastfeeding females who agree to comply with applicable contraceptive requirements of the protocol (see Table 1: Acceptable Contraceptive Methods.) Women of childbearing potential must have a negative urine or serum pregnancy test within 24 hours prior to initiation of vaccination;
  6. Pulse no greater than 100 beats per minute;
  7. Systolic blood pressure (BP) is 85 to 150 mmHg, inclusive;
  8. Clinical screening laboratory evaluations:

    • Absolute neutrophil count (ANC) ≥1500 cells/mm3
    • Hemoglobin ≥12.0 g/dL for men and ≥11.0 g/dL for women
    • Platelet count ≥120,000/mm3
    • Creatinine clearance (CrCl) >80 mL/min ); Refer to the calculator located on the Frontier Science and Technology Research Foundation (FSTRF) website (at https://www.frontierscience.org/): Calculated Creatinine Clearance - Cockcroft-Gault Equation (Adult).
    • Aspartate aminotransferase (AST) <1.25 x upper limit of normal (ULN)
    • Alanine aminotransferase (ALT) <1.25 x ULN
    • Alkaline phosphatase <2.0 x ULN
    • Total bilirubin <1.1 x ULN
    • Lipase <1.1 x ULN
    • Prothrombin time (PT) <1.1 x ULN
    • Partial thromboplastin time (PTT) <1.1 x ULN
    • CRP < 2.0 x ULN
  9. Agree to have samples stored for secondary research related to coronaviruses.

EXCLUSION CRITERIA

  1. Positive pregnancy test either at screening or just prior to vaccine administration.
  2. Female participant who is breastfeeding or plans to breastfeed from the time of the study vaccination through 3 months after the study vaccination.
  3. Has acute or chronic inflammatory condition of the gastrointestinal tract including, but not limited to, Crohn's disease, ulcerative colitis, gastritis, proctitis, or any other inflammatory bowel disorder.
  4. Has any medical disease, history, or behavior that may predispose to more severe COVID-19 infection, including hypertension, diabetes, current vaping and/or smoking, history of chronic smoking within the prior year (average of at least one cigarette per day or more), or body mass index of greater than 32; stable hypertension controlled with a stable dose of medication is permitted.
  5. Has any medical disease or condition that, in the opinion of the site PI or appropriate sub-investigator, precludes study participation (including but not limited to acute, subacute, intermittent or chronic medical disease or condition that would place the participant at an unacceptable risk of injury, render the participant unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the participant's successful completion of this trial.)
  6. Presence of self-reported or medically documented significant medical or psychiatric condition(s).

    Significant medical or psychiatric conditions include but are not limited to:

    • Respiratory disease (e.g., chronic obstructive pulmonary disease, asthma) requiring daily medications currently or any treatment of respiratory disease exacerbations (e.g., asthma exacerbation) in the last 5 years.
    • Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics.
    • Significant cardiovascular disease (e.g., congestive heart failure, cardiomyopathy, ischemic heart disease) or history of myocarditis or pericarditis as an adult.
    • Neurological or neurodevelopmental conditions (e.g., migraines, epilepsy, stroke, seizures in the last 3 years, encephalopathy, focal neurologic deficits, Guillain-Barré syndrome, encephalomyelitis or transverse myelitis).Ongoing malignancy or recent diagnosis of malignancy in the last five years excluding basal cell and squamous cell carcinoma of the skin, which are allowed.
    • An autoimmune disease, including hypothyroidism without a defined non-autoimmune cause, localized or history of psoriasis.
    • An immunodeficiency of any cause or are immune-suppressed.
  7. Has an acute illness, as determined by the site PI or appropriate sub-investigator, with or without fever (oral temperature >38.0 degrees Celsius [100.4 degrees Fahrenheit]) within 72 hours prior to study vaccination administration.
  8. Has a positive test result for hepatitis B surface antigen, hepatitis C virus antibody, or human immunodeficiency virus (HIV) types 1 or 2 antibodies at screening.
  9. Has participated in another investigational study involving any investigational product (study drug, biologic or device) within 60 days, or 5 half-lives, whichever is longer, before study vaccine administration.
  10. Currently enrolled in or plans to participate in another clinical trial with an investigational agent (including licensed or unlicensed vaccine, drug, biologic, device, blood product, or medication) that will be received during the trial period.
  11. Has a history of hypersensitivity or severe allergic reaction (e.g., anaphylaxis, generalized urticaria, angioedema, other significant reaction) to any previous licensed or unlicensed vaccines.
  12. Chronic use (more than 14 continuous days) or anticipated use within the next 6 months of any medications that may be associated with impaired immune responsiveness. Including, but not limited to the following excluded drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1). The use of low dose topical, ophthalmic, inhaled and intranasal steroid preparations will be permitted.
  13. Received immunoglobulins and/or any blood or blood products within the 4 months before study vaccine administration or at any time during the study.
  14. Has any blood dyscrasias or significant disorder of coagulation.
  15. Has any chronic liver disease, including fatty liver.
  16. Has a history of alcohol or drug abuse or tests positive for drugs of abuse at screening.
  17. Received or plans to receive a licensed, live vaccine within 4 weeks before or after each vaccination.
  18. Received or plans to receive a licensed, inactivated vaccine within 2 weeks before or after each vaccination.
  19. Receipt of any other SARS-CoV-2/COVID-19, or other experimental coronavirus vaccine at any time prior to or during the study.
  20. Known current or previous laboratory-confirmed SARS CoV-1 OR SARS-CoV-2/COVID-19 infection as documented by a positive PCR test from a nasal swab.
  21. Known close contact of anyone with laboratory-confirmed SARS-CoV-2/COVID-19 infection within 2 weeks prior to vaccine administration.
  22. Has traveled outside Australia for any duration within 30 days before study vaccination.
  23. Currently working in occupation with high risk of exposure to SARS-CoV-2 (e.g., health care worker, emergency response personnel).
  24. Allergy to BOTH amoxicillin (or any penicillin derivative) AND erythromycin
  25. Household contact, including neonates up to the age of 28 days, with any medical condition or taking medications that may result in immunosuppression.
  26. The participant must agree to refrain from donating blood or plasma during the study.
  27. Excluded medications (summarized): Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics; Excluded immunosuppressive drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1); Excluded other medications - current use of any antibiotics, probiotic supplements, H2 blockers or proton pump inhibitors within 7 days prior to vaccination and any anticipated use for 7 days post vaccination.

Sites / Locations

  • Nucleus Network Pty Ltd Brisbane (QPharm)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

bacTRL-Spike

Arm Description

Group 1 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 1 billion colony forming units (cfu) of Bifidobacterium longum (B. longum); Group 2 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 3 billion cfu of B. longum; Group 3 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 10 billion cfu of B. longum; Group 4 (n=3): Single Data and Safety Monitoring Board (DSMB)-defined dose of bacTRL-Spike among subjects 56 years of age and older. Group 5 (n=12): DSMB-defined prime and boost doses of bacTRL-Spike delivered with a 28-day intervening interval.

Outcomes

Primary Outcome Measures

Frequency of Adverse Events
Adverse events (specifically including incidence of gastrointestinal-associated events) following administration of oral bacTRL-Spike

Secondary Outcome Measures

Immune response against SARS-CoV-2 Spike protein
Antibody against SARS-CoV-2 Spike protein
Incidence of COVID-19 infection
Incidence and clinical phenotype of confirmed and probable COVID-19 infection among vaccinated participants, based on current public health definitions
bacTRL-Spike in stool post-vaccination
Isolation of viable bacTRL-Spike from stool post-vaccination
Immunity against SARS-CoV-2
Collection of biological samples for future studies to understand immunity against SARS-CoV-2.

Full Information

First Posted
March 31, 2020
Last Updated
October 24, 2022
Sponsor
Symvivo Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04334980
Brief Title
Evaluating the Safety, Tolerability and Immunogenicity of bacTRL-Spike Vaccine for Prevention of COVID-19
Official Title
A Phase 1, Randomized, Observer-Blind, Placebo-Controlled Trial to Evaluate the Safety, Tolerability and Immunogenicity of the bacTRL-Spike Oral Candidate Vaccine for the Prevention of COVID-19 in Healthy Adults
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
November 2, 2020 (Actual)
Primary Completion Date
August 31, 2022 (Actual)
Study Completion Date
August 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Symvivo Corporation

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
Protocol bacTRL-Spike-1 will be the first-in-human study of bacTRL-Spike, and the first-in-human use of orally delivered bacTRL. Each oral dose of bacTRL-Spike contains bacterial medium with either 1 billion (Group 1A), 3 billion (Group 2A) or 10 billion (Group 3A) colony-forming-units of live Bifidobacterium longum, which has been engineered to deliver plasmids containing synthetic DNA encoding spike protein from SARS-CoV-2.
Detailed Description
Protocol bacTRL-Spike-1 will be the first-in-human study of bacTRL-Spike, and the first-in-human use of orally delivered bacTRL. The trial is designed to evaluate the safety and tolerability of orally delivered bacTRL-Spike vaccine in healthy adults. Total anticipated enrollment is n=24. The distribution of the sample size will be as follows: Group 1 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 1 billion colony forming units (cfu) of Bifidobacterium longum (B. longum); Group 2 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 3 billion cfu of B. longum; Group 3 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 10 billion cfu of B. longum; Group 4 (n=3): Single Data and Safety Monitoring Board (DSMB)-defined dose of bacTRL-Spike among subjects 56 years of age and older. Group 5 (n=12): DSMB-defined prime and boost doses of bacTRL-Spike delivered with a 28-day intervening interval. The planned trial duration is 18 months. Each participant will remain in the trial for 12-13 months, including a screening phase of up to 28 days, intervention phase of 1 day and follow-up phase of 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
bacTRL-Spike
Arm Type
Experimental
Arm Description
Group 1 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 1 billion colony forming units (cfu) of Bifidobacterium longum (B. longum); Group 2 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 3 billion cfu of B. longum; Group 3 (n=3; Sentinel +2): Single dose of bacTRL-Spike, equivalent to 10 billion cfu of B. longum; Group 4 (n=3): Single Data and Safety Monitoring Board (DSMB)-defined dose of bacTRL-Spike among subjects 56 years of age and older. Group 5 (n=12): DSMB-defined prime and boost doses of bacTRL-Spike delivered with a 28-day intervening interval.
Intervention Type
Biological
Intervention Name(s)
bacTRL-Spike
Intervention Description
Each oral dose of bacTRL-Spike contains bacterial medium with either 1 billion (Group 1), 3 billion (Group 2) or 10 billion (Group 3) colony-forming-units of live Bifidobacterium longum, which has been engineered to deliver plasmids containing synthetic DNA encoding spike protein from SARS-CoV-2.
Primary Outcome Measure Information:
Title
Frequency of Adverse Events
Description
Adverse events (specifically including incidence of gastrointestinal-associated events) following administration of oral bacTRL-Spike
Time Frame
Up to12 months post-vaccination
Secondary Outcome Measure Information:
Title
Immune response against SARS-CoV-2 Spike protein
Description
Antibody against SARS-CoV-2 Spike protein
Time Frame
Baseline (pre-vaccination), and 1, 3 and 12 months post-vaccination
Title
Incidence of COVID-19 infection
Description
Incidence and clinical phenotype of confirmed and probable COVID-19 infection among vaccinated participants, based on current public health definitions
Time Frame
Up to 12 months post-vaccination
Title
bacTRL-Spike in stool post-vaccination
Description
Isolation of viable bacTRL-Spike from stool post-vaccination
Time Frame
Days 8, 15, 22, and 1 and 3 months post-vaccination
Title
Immunity against SARS-CoV-2
Description
Collection of biological samples for future studies to understand immunity against SARS-CoV-2.
Time Frame
Up to 12 months post-vaccination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
INCLUSION CRITERIA Age 18 years inclusive at time of enrollment and older; Capable to and does provide written informed consent; Able to understand and agrees to comply with planned study procedures and be available for all study visits; Body Mass Index 18-32 kg/square meter, inclusive, at screening; Male or non-pregnant, non-breastfeeding females who agree to comply with applicable contraceptive requirements of the protocol (see Table 1: Acceptable Contraceptive Methods.) Women of childbearing potential must have a negative urine or serum pregnancy test within 24 hours prior to initiation of vaccination; Pulse no greater than 100 beats per minute; Systolic blood pressure (BP) is 85 to 150 mmHg, inclusive; Clinical screening laboratory evaluations: Absolute neutrophil count (ANC) ≥1500 cells/mm3 Hemoglobin ≥12.0 g/dL for men and ≥11.0 g/dL for women Platelet count ≥120,000/mm3 Creatinine clearance (CrCl) >80 mL/min ); Refer to the calculator located on the Frontier Science and Technology Research Foundation (FSTRF) website (at https://www.frontierscience.org/): Calculated Creatinine Clearance - Cockcroft-Gault Equation (Adult). Aspartate aminotransferase (AST) <1.25 x upper limit of normal (ULN) Alanine aminotransferase (ALT) <1.25 x ULN Alkaline phosphatase <2.0 x ULN Total bilirubin <1.1 x ULN Lipase <1.1 x ULN Prothrombin time (PT) <1.1 x ULN Partial thromboplastin time (PTT) <1.1 x ULN CRP < 2.0 x ULN Agree to have samples stored for secondary research related to coronaviruses. EXCLUSION CRITERIA Positive pregnancy test either at screening or just prior to vaccine administration. Female participant who is breastfeeding or plans to breastfeed from the time of the study vaccination through 3 months after the study vaccination. Has acute or chronic inflammatory condition of the gastrointestinal tract including, but not limited to, Crohn's disease, ulcerative colitis, gastritis, proctitis, or any other inflammatory bowel disorder. Has any medical disease, history, or behavior that may predispose to more severe COVID-19 infection, including hypertension, diabetes, current vaping and/or smoking, history of chronic smoking within the prior year (average of at least one cigarette per day or more), or body mass index of greater than 32; stable hypertension controlled with a stable dose of medication is permitted. Has any medical disease or condition that, in the opinion of the site PI or appropriate sub-investigator, precludes study participation (including but not limited to acute, subacute, intermittent or chronic medical disease or condition that would place the participant at an unacceptable risk of injury, render the participant unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the participant's successful completion of this trial.) Presence of self-reported or medically documented significant medical or psychiatric condition(s). Significant medical or psychiatric conditions include but are not limited to: Respiratory disease (e.g., chronic obstructive pulmonary disease, asthma) requiring daily medications currently or any treatment of respiratory disease exacerbations (e.g., asthma exacerbation) in the last 5 years. Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics. Significant cardiovascular disease (e.g., congestive heart failure, cardiomyopathy, ischemic heart disease) or history of myocarditis or pericarditis as an adult. Neurological or neurodevelopmental conditions (e.g., migraines, epilepsy, stroke, seizures in the last 3 years, encephalopathy, focal neurologic deficits, Guillain-Barré syndrome, encephalomyelitis or transverse myelitis).Ongoing malignancy or recent diagnosis of malignancy in the last five years excluding basal cell and squamous cell carcinoma of the skin, which are allowed. An autoimmune disease, including hypothyroidism without a defined non-autoimmune cause, localized or history of psoriasis. An immunodeficiency of any cause or are immune-suppressed. Has an acute illness, as determined by the site PI or appropriate sub-investigator, with or without fever (oral temperature >38.0 degrees Celsius [100.4 degrees Fahrenheit]) within 72 hours prior to study vaccination administration. Has a positive test result for hepatitis B surface antigen, hepatitis C virus antibody, or human immunodeficiency virus (HIV) types 1 or 2 antibodies at screening. Has participated in another investigational study involving any investigational product (study drug, biologic or device) within 60 days, or 5 half-lives, whichever is longer, before study vaccine administration. Currently enrolled in or plans to participate in another clinical trial with an investigational agent (including licensed or unlicensed vaccine, drug, biologic, device, blood product, or medication) that will be received during the trial period. Has a history of hypersensitivity or severe allergic reaction (e.g., anaphylaxis, generalized urticaria, angioedema, other significant reaction) to any previous licensed or unlicensed vaccines. Chronic use (more than 14 continuous days) or anticipated use within the next 6 months of any medications that may be associated with impaired immune responsiveness. Including, but not limited to the following excluded drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1). The use of low dose topical, ophthalmic, inhaled and intranasal steroid preparations will be permitted. Received immunoglobulins and/or any blood or blood products within the 4 months before study vaccine administration or at any time during the study. Has any blood dyscrasias or significant disorder of coagulation. Has any chronic liver disease, including fatty liver. Has a history of alcohol or drug abuse or tests positive for drugs of abuse at screening. Received or plans to receive a licensed, live vaccine within 4 weeks before or after each vaccination. Received or plans to receive a licensed, inactivated vaccine within 2 weeks before or after each vaccination. Receipt of any other SARS-CoV-2/COVID-19, or other experimental coronavirus vaccine at any time prior to or during the study. Known current or previous laboratory-confirmed SARS CoV-1 OR SARS-CoV-2/COVID-19 infection as documented by a positive PCR test from a nasal swab. Known close contact of anyone with laboratory-confirmed SARS-CoV-2/COVID-19 infection within 2 weeks prior to vaccine administration. Has traveled outside Australia for any duration within 30 days before study vaccination. Currently working in occupation with high risk of exposure to SARS-CoV-2 (e.g., health care worker, emergency response personnel). Allergy to BOTH amoxicillin (or any penicillin derivative) AND erythromycin Household contact, including neonates up to the age of 28 days, with any medical condition or taking medications that may result in immunosuppression. The participant must agree to refrain from donating blood or plasma during the study. Excluded medications (summarized): Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics; Excluded immunosuppressive drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1); Excluded other medications - current use of any antibiotics, probiotic supplements, H2 blockers or proton pump inhibitors within 7 days prior to vaccination and any anticipated use for 7 days post vaccination.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric L Sievers, MD
Organizational Affiliation
Chief Medical Officer
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Paul Griffin, FRACP FRCPA FACTM FIML AFACHSM
Organizational Affiliation
Principal Investigator
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nucleus Network Pty Ltd Brisbane (QPharm)
City
Brisbane
State/Province
Queensland
ZIP/Postal Code
3004
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Evaluating the Safety, Tolerability and Immunogenicity of bacTRL-Spike Vaccine for Prevention of COVID-19

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