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Study of a Group B Streptococcus Vaccine in Pregnant Women Living With HIV and in Pregnant Women Who do Not Have HIV

Primary Purpose

Group B Streptococcal Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
GBS-NN/NN2
Placebo
Sponsored by
Minervax ApS
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Group B Streptococcal Infection

Eligibility Criteria

18 Years - 40 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. Participants at least 18 years old and not older than 40 years of age.
  2. Pregnant women who are between 26 weeks and 30 weeks (inclusive) gestation on the planned day of vaccination with a singleton, uncomplicated pregnancy. Gestational age to be determined on the following hierarchal basis with guidance to the GAIA (Global Alignment of Immunisation Safety Assessment in pregnancy) criteria:

    1. ultrasound estimate of gestational age,
    2. date of last menstrual period
    3. fundal height
  3. HIV status to be based on rapid, confirmatory test, unless a documented test of the participant being sero-positive for HIV and history documented in the notes.
  4. Women living with HIV, HIV viral load <1000, on antiretroviral therapy for at least 3 months prior to screening and clinically well.
  5. Expected to be available for the scheduled clinic visits for the duration of the study, agree to be contacted by telephone during study participation, and is willing to give parental consent for her infant to participate in the study

Exclusion Criteria:

  1. Women who are HBSAg and/or HCV (hepatitis C virus) positive
  2. Women who test positive for syphilis as per standard testing
  3. Women knowingly carrying, at screening, a malformed or genetically abnormal foetus based on ultrasound
  4. Women who have experienced a previous stillbirth prior to going into labour
  5. Women with placenta previa
  6. Women with documented chronic or pregnancy induced hypertension at screening
  7. Women with 1+ protein in urine and hypertension defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) at ≥20 weeks of gestation in a woman with a previously normal blood pressure
  8. Women with >1+ of protein in urine (regardless of blood pressure)
  9. Women with gestational, type 1 or type 2 diabetes.
  10. Women with glycosuria on dipstick
  11. Women known to be allergic to any components of the vaccine, who are known to be allergic to aluminium or have had an allergic reaction to any previous vaccination.
  12. Women with HIV viral load >1000 at screening.
  13. Women living with HIV who have been on antiretroviral therapy for less than 3 months prior to screening. (Women who are diagnosed with HIV between screening and dosing will not be eligible.)
  14. Women with history or presence of significant cardiovascular disease, pulmonary, hepatic, gallbladder or biliary tract, renal, haematological, gastrointestinal, endocrine, immunologic, dermatological, neurological, psychiatric, autoimmune disease, cognitive disorder or current infection and significant illness 4 weeks prior to randomization.
  15. Women with current or history of drug or alcohol abuse within the last two years.
  16. Women who have received a vaccine within 28 days of receiving the first dose of GBS NN/NN2 or placebo or who expect to require vaccination during the course of the study. (Vaccines recommended for administration during pregnancy e.g. tetanus toxoid, pertussis and influenza are permitted. Administration of concurrent vaccines must not be within 7 days of investigational vaccine.)
  17. Women who have a fever (axillary temperature >37.9°C) on the day of dosing or have had an acute infection in the 7 days before dosing.
  18. Women who have any bleeding disorders that prolong the bleeding time.
  19. Women who are receiving immunosuppressive medication, including systemic steroids (inhaled and topical steroids are acceptable).
  20. Women who have received blood or blood products and/or plasma derivatives or any immunoglobulin preparations in 12 weeks preceding screening.
  21. Women with severe anaemia, haemoglobin < 9g/dL (90 g/L) as per Sheffield grading system ( > Grade 1)
  22. Women who are currently breast feeding
  23. Women who are part of the study personnel or a close family member of study personnel.
  24. Women who in the opinion of the investigator are not suitable to participate in the study.
  25. Concurrent participation in another clinical trial during which subject will be exposed to an investigational product .

Sites / Locations

  • Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital
  • University of the Witwatersrand, Johannesburg (Respiratory and Meningeal Pathogens Research unit)
  • MUJHU Research Collaboration/MUJHU Care Ltd, Kawempe National Referral Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

GBS-NN/NN2 in pregnant women living with HIV

Placebo Comparator in pregnant women living with HIV

GBS-NN/NN2 in pregnant women who do not have HIV

Placebo Comparator in pregnant women who do not have HIV

Arm Description

2 doses of 0.5mL intramuscular injection GBS-NN/NN2 containing 50 µg GBS-NN and 50 µg NN2 administered 28 days apart in pregnant women living with HIV

2 doses of 0.5mL intramuscular injection 0.9% normal saline administered 28 days apart in pregnant women living with HIV

2 doses of 0.5mL intramuscular injection GBS-NN/NN2 containing 50 µg GBS-NN and 50 µg NN2 administered 28 days apart in pregnant women who do not have HIV

2 doses of 0.5mL intramuscular injection 0.9% normal saline administered 28 days apart in pregnant women who do not have HIV

Outcomes

Primary Outcome Measures

Incidence of treatment emergent adverse events
Adverse events
Gestational age of newborn baby
Gestational age of newborn baby
Weight of newborn baby
Weight of newborn baby
Length of newborn baby
Length of newborn baby
Head circumference of newborn baby
Head circumference of newborn baby
Apgar score for newborn baby
Apgar score for newborn baby
IgG (Immunoglobulin G) antibody concentration
IgG antibody concentration specific to the GBS-NN/NN2 vaccine measured in maternal blood and cord blood

Secondary Outcome Measures

Incidence of significant adverse reactions in mothers
Significant adverse reactions
Developmental milestones of babies
Milestones assessed using ages and stages questionnaires
Geometric mean antibody concentration
Geometric mean antibody concentration
Geometric mean antibody concentration of cord and maternal blood
Geometric mean antibody concentration of cord (or newborn blood within 48 hours of birth) and maternal blood
Geometric mean fold increase in antibody concentration in maternal blood
Geometric mean fold increase in antibody concentration in maternal blood
Geometric mean fold increase in antibody concentration in maternal blood
Geometric mean fold increase in antibody concentration in maternal blood
Proportion of mothers and newborn babies achieving vaccine specific IgG antibody concentrations
Proportion of mothers and newborn babies achieving vaccine specific IgG antibody concentrations in maternal and cord blood samples respectively, above pre-defined arbitrary thresholds.

Full Information

First Posted
October 14, 2020
Last Updated
August 22, 2023
Sponsor
Minervax ApS
Collaborators
European and Developing Countries Clinical Trials Partnership (EDCTP)
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1. Study Identification

Unique Protocol Identification Number
NCT04596878
Brief Title
Study of a Group B Streptococcus Vaccine in Pregnant Women Living With HIV and in Pregnant Women Who do Not Have HIV
Official Title
A Multi-centre Study to Evaluate the Safety, Tolerability and Immunogenicity of Two Doses of a Group B Streptococcus Vaccine (GBS-NN/NN2) in Women Who Are Pregnant and Living With HIV and Women Who Are Pregnant and do Not Have HIV
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
November 19, 2020 (Actual)
Primary Completion Date
May 18, 2022 (Actual)
Study Completion Date
May 11, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Minervax ApS
Collaborators
European and Developing Countries Clinical Trials Partnership (EDCTP)

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
A randomised, placebo-controlled, double-blind study to evaluate the safety, tolerability and immunogenicity of the GBS-NN/NN2 (Recombinant protein vaccine against Group B Streptococcus) vaccine in women living with HIV and women without HIV,and their newborn babies from vaccination up to delivery/birth. Mothers and babies will be followed up for 6 months post-delivery.
Detailed Description
100 women who are pregnant and living with HIV will randomly receive two 0.5 mL (millilitre) intramuscular injections of GBS-NN/NN2 vaccine (60 women) or placebo (15 women). 100 women who are pregnant and do not have HIV will randomly receive two 0.5 mL intramuscular injections of GBS-NN/NN2 vaccine (60 women) or placebo (15 women). Participants will be screened at 24 to 28 weeks gestation (Days -14 to Day -1) and the groups will be dosed in parallel. The first dose of vaccine or placebo will be administered at Day 0 and the second dose will be administered 28±2 days later. Delivery is anticipated to be approximately 10 to 14 weeks after the first dose of vaccine. For the analysis of the immune response, the placebo groups will be combined. For safety, the placebo groups will be analysed separately and will be combined for comparison with the potential vaccine groups.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Group B Streptococcal Infection

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomised, placebo controlled, double-blind, parallel group, multicentre study.
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
205 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GBS-NN/NN2 in pregnant women living with HIV
Arm Type
Experimental
Arm Description
2 doses of 0.5mL intramuscular injection GBS-NN/NN2 containing 50 µg GBS-NN and 50 µg NN2 administered 28 days apart in pregnant women living with HIV
Arm Title
Placebo Comparator in pregnant women living with HIV
Arm Type
Placebo Comparator
Arm Description
2 doses of 0.5mL intramuscular injection 0.9% normal saline administered 28 days apart in pregnant women living with HIV
Arm Title
GBS-NN/NN2 in pregnant women who do not have HIV
Arm Type
Experimental
Arm Description
2 doses of 0.5mL intramuscular injection GBS-NN/NN2 containing 50 µg GBS-NN and 50 µg NN2 administered 28 days apart in pregnant women who do not have HIV
Arm Title
Placebo Comparator in pregnant women who do not have HIV
Arm Type
Placebo Comparator
Arm Description
2 doses of 0.5mL intramuscular injection 0.9% normal saline administered 28 days apart in pregnant women who do not have HIV
Intervention Type
Biological
Intervention Name(s)
GBS-NN/NN2
Intervention Description
GBS-NN/NN2 bound to Alhydrogel as an adjuvant.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Normal Saline 0.9%
Primary Outcome Measure Information:
Title
Incidence of treatment emergent adverse events
Description
Adverse events
Time Frame
From vaccination up to delivery/birth
Title
Gestational age of newborn baby
Description
Gestational age of newborn baby
Time Frame
At birth
Title
Weight of newborn baby
Description
Weight of newborn baby
Time Frame
At birth
Title
Length of newborn baby
Description
Length of newborn baby
Time Frame
At birth
Title
Head circumference of newborn baby
Description
Head circumference of newborn baby
Time Frame
At birth
Title
Apgar score for newborn baby
Description
Apgar score for newborn baby
Time Frame
At birth
Title
IgG (Immunoglobulin G) antibody concentration
Description
IgG antibody concentration specific to the GBS-NN/NN2 vaccine measured in maternal blood and cord blood
Time Frame
At birth
Secondary Outcome Measure Information:
Title
Incidence of significant adverse reactions in mothers
Description
Significant adverse reactions
Time Frame
From delivery to 6 months post-delivery
Title
Developmental milestones of babies
Description
Milestones assessed using ages and stages questionnaires
Time Frame
At 6 months
Title
Geometric mean antibody concentration
Description
Geometric mean antibody concentration
Time Frame
At 4 weeks post first injection and at 4 weeks post second injection
Title
Geometric mean antibody concentration of cord and maternal blood
Description
Geometric mean antibody concentration of cord (or newborn blood within 48 hours of birth) and maternal blood
Time Frame
At delivery
Title
Geometric mean fold increase in antibody concentration in maternal blood
Description
Geometric mean fold increase in antibody concentration in maternal blood
Time Frame
At 4 weeks post first injection and at 4 weeks post second injection
Title
Geometric mean fold increase in antibody concentration in maternal blood
Description
Geometric mean fold increase in antibody concentration in maternal blood
Time Frame
From baseline to delivery
Title
Proportion of mothers and newborn babies achieving vaccine specific IgG antibody concentrations
Description
Proportion of mothers and newborn babies achieving vaccine specific IgG antibody concentrations in maternal and cord blood samples respectively, above pre-defined arbitrary thresholds.
Time Frame
At delivery

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participants at least 18 years old and not older than 40 years of age. Pregnant women who are between 26 weeks and 30 weeks (inclusive) gestation on the planned day of vaccination with a singleton, uncomplicated pregnancy. Gestational age to be determined on the following hierarchal basis with guidance to the GAIA (Global Alignment of Immunisation Safety Assessment in pregnancy) criteria: ultrasound estimate of gestational age, date of last menstrual period fundal height HIV status to be based on rapid, confirmatory test, unless a documented test of the participant being sero-positive for HIV and history documented in the notes. Women living with HIV, HIV viral load <1000, on antiretroviral therapy for at least 3 months prior to screening and clinically well. Expected to be available for the scheduled clinic visits for the duration of the study, agree to be contacted by telephone during study participation, and is willing to give parental consent for her infant to participate in the study Exclusion Criteria: Women who are HBSAg and/or HCV (hepatitis C virus) positive Women who test positive for syphilis as per standard testing Women knowingly carrying, at screening, a malformed or genetically abnormal foetus based on ultrasound Women who have experienced a previous stillbirth prior to going into labour Women with placenta previa Women with documented chronic or pregnancy induced hypertension at screening Women with 1+ protein in urine and hypertension defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) at ≥20 weeks of gestation in a woman with a previously normal blood pressure Women with >1+ of protein in urine (regardless of blood pressure) Women with gestational, type 1 or type 2 diabetes. Women with glycosuria on dipstick Women known to be allergic to any components of the vaccine, who are known to be allergic to aluminium or have had an allergic reaction to any previous vaccination. Women with HIV viral load >1000 at screening. Women living with HIV who have been on antiretroviral therapy for less than 3 months prior to screening. (Women who are diagnosed with HIV between screening and dosing will not be eligible.) Women with history or presence of significant cardiovascular disease, pulmonary, hepatic, gallbladder or biliary tract, renal, haematological, gastrointestinal, endocrine, immunologic, dermatological, neurological, psychiatric, autoimmune disease, cognitive disorder or current infection and significant illness 4 weeks prior to randomization. Women with current or history of drug or alcohol abuse within the last two years. Women who have received a vaccine within 28 days of receiving the first dose of GBS NN/NN2 or placebo or who expect to require vaccination during the course of the study. (Vaccines recommended for administration during pregnancy e.g. tetanus toxoid, pertussis and influenza are permitted. Administration of concurrent vaccines must not be within 7 days of investigational vaccine.) Women who have a fever (axillary temperature >37.9°C) on the day of dosing or have had an acute infection in the 7 days before dosing. Women who have any bleeding disorders that prolong the bleeding time. Women who are receiving immunosuppressive medication, including systemic steroids (inhaled and topical steroids are acceptable). Women who have received blood or blood products and/or plasma derivatives or any immunoglobulin preparations in 12 weeks preceding screening. Women with severe anaemia, haemoglobin < 9g/dL (90 g/L) as per Sheffield grading system ( > Grade 1) Women who are currently breast feeding Women who are part of the study personnel or a close family member of study personnel. Women who in the opinion of the investigator are not suitable to participate in the study. Concurrent participation in another clinical trial during which subject will be exposed to an investigational product .
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Geoff Kitson
Organizational Affiliation
gkitson@propharmapartners.uk.com
Official's Role
Study Director
Facility Information:
Facility Name
Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital
City
Johannesburg
Country
South Africa
Facility Name
University of the Witwatersrand, Johannesburg (Respiratory and Meningeal Pathogens Research unit)
City
Johannesburg
Country
South Africa
Facility Name
MUJHU Research Collaboration/MUJHU Care Ltd, Kawempe National Referral Hospital
City
Kawempe
Country
Uganda

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of a Group B Streptococcus Vaccine in Pregnant Women Living With HIV and in Pregnant Women Who do Not Have HIV

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