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COVID-19 Protection After Transplant Pilot Study (CPAT)

Primary Purpose

Kidney Transplant Recipients

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
mRNA-1273 vaccine (Pfizer/BioNTech)
mRNA-1273 vaccine (Moderna)
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Kidney Transplant Recipients focused on measuring COVID-19 vaccine, SARS-CoV-2 antibody response

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Individuals who meet all the following criteria are eligible for enrollment as study participants-

  1. Able to understand and provide informed consent;
  2. Recipient of kidney transplant ≥12 months prior to enrollment, without treated allograft rejection in the 6 months preceding enrollment;
  3. Received 2 doses of either the Moderna COVID-19 vaccine or Pfizer-BioNTech COVID-19 vaccine as specified in the respective Food and Drug Administration Emergency Use Authorization (FDA EUAs), >30 days and <8 months prior to enrollment ; and,
  4. Negative (antibody titer < 0.8U/mL) or low (antibodies detected at titer ≤ 50 U/mL) response to the vaccine at > 30 days from dose 2 of the Moderna COVID-19 vaccine or the Pfizer BioNTech vaccine, using the Roche Elecsys® anti-Receptor Binding Domain (RBD) assay.

Exclusion Criteria:

Individuals who meet any of these criteria are not eligible for enrollment as study participants-

  1. Recipient of any number of doses of any COVID vaccine product other than the Moderna COVID-19 vaccine or the Pfizer-BioNTech COVID-19 vaccine;
  2. Known history of severe allergic reaction to any component of either the Moderna COVID-19 vaccine or Pfizer-BioNTech COVID-19 vaccine;
  3. Thrombotic events, myocarditis, or pericarditis temporally associated with prior dose of COVID-19 vaccine;
  4. Any change in transplant immunosuppression regimen (drug or dose) in response to suspected or proven rejection within the last 6 months;
  5. Significant graft dysfunction;
  6. Receipt of any cellular depleting agent (e.g. ATG, Rituximab, Alemtuzumab, Cyclophosphamide) within 12 months preceding enrollment;
  7. Receiving systemic immunomodulatory medication(s) for any condition other than transplant;
  8. Any untreated active infection, including BK viremia >10^4 copies;
  9. Infection with human immunodeficiency virus (HIV);
  10. Maintenance immunosuppressive regimen that includes belatacept or abatacept;
  11. Recent (within one year) or ongoing treatment for malignancy; or
  12. Any past or current medical problems, treatments, or findings which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the candidate's ability to comply with study requirements or may impact the quality or interpretation of the data obtained from the study.

Sites / Locations

  • Johns Hopkins Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

mRNA-1273 vaccine (Pfizer/BioNTech)

mRNA-1273 vaccine (Moderna)

Arm Description

The mRNA-1273 vaccine was developed to prevent COVID-19, the disease resulting from Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2) infection. Kidney transplant recipients who had a suboptimal antibody response to the standard two doses of vaccination with Pfizer/BioNTech will receive a third dose of the the same vaccine. Administration: One dose administered intramuscularly, upper arm.

The mRNA-1273 vaccine was developed to prevent COVID-19, the disease resulting from Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2) infection. Kidney transplant recipients who had a suboptimal antibody response to the standard two doses of vaccination with Moderna will receive a third dose of the same vaccine. Administration: One dose administered intramuscularly, upper arm.

Outcomes

Primary Outcome Measures

Proportion of Participants Who Achieve an Antibody Response >50 U/mL
Efficacy measure status post third mRNA-1273 vaccination.

Secondary Outcome Measures

Frequency of Solicited Local Reactogenicity Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Safety measure status post third mRNA-1273 vaccination.
Frequency of Solicited Local Allergic Reaction Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Safety measure status post third mRNA-1273 vaccination.
Frequency of Solicited Systemic Reactogenicity Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Safety measure status post third mRNA-1273 vaccination.
Frequency of Solicited Systemic Allergic Reaction Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Safety measure status post third mRNA-1273 vaccination.
Frequency of Any Serious Adverse Events (SAEs)
Safety measure status post third mRNA-1273 vaccination.
Frequency of Any Unsolicited Adverse Events (AEs)
Safety measure. An AE associated with the third dose of vaccine and/or study mandated procedures.
Frequency of Any Serious Adverse Events (SAEs)
Safety measure status post third mRNA-1273 vaccination.
Frequency of Any Serious Adverse Events (SAEs)
Safety measure status post third mRNA-1273 vaccination.
Frequency of Any Unsolicited Adverse Events (AEs)
Safety measure. An AE associated with the third dose of vaccine and/or study mandated procedures.
Proportion of Participants Treated for Acute Cell-Mediated and/or Antibody-Mediated Allograft Rejection
Safety measure status post third mRNA-1273 vaccination.
Proportion of Participants who Develop de Novo Donor-Specific Anti-Human Leukocyte Antigens (HLA) Antibody
Safety measure status post third mRNA-1273 vaccination.
Proportion of Participants with Graft Loss
Safety measure status post third mRNA-1273 vaccination.
Occurrence of Death Among Participants
Safety measure status post third mRNA-1273 vaccination.

Full Information

First Posted
July 16, 2021
Last Updated
March 23, 2023
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
PPD
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1. Study Identification

Unique Protocol Identification Number
NCT04969263
Brief Title
COVID-19 Protection After Transplant Pilot Study
Acronym
CPAT
Official Title
Immunogenicity of a Third Dose of Either the Moderna COVID-19 Vaccine or Pfizer-BioNTech COVID-19 Vaccine in Kidney Transplant Recipients Who Failed to Respond After Two Previous Doses
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
August 10, 2021 (Actual)
Primary Completion Date
November 10, 2022 (Actual)
Study Completion Date
March 10, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
PPD

4. Oversight

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

5. Study Description

Brief Summary
Antibodies are an important part of the body's defense against infection. Individuals who have no antibodies or very low antibody levels are considered less well protected from Coronavirus Disease 2019 (COVID-19) than those who have higher antibody levels. What level of antibodies is necessary for protection is currently unknown. Inadequate antibody response to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination has been described among kidney transplant recipients. The aim of this study is to elicit an antibody response to vaccination against SARS-CoV-2 in kidney transplant recipients who have failed to respond to two doses of either the Moderna COVID-19 vaccine or Pfizer-BioNTech Coronavirus Disease 2019 (COVID-19) vaccine.
Detailed Description
This is an open label, non-randomized study in kidney transplant recipients who received two doses of either mRNA COVID-19 vaccine and have a negative (<0.8 U/mL) or low (titer <50 U/mL) SARS-CoV-2 antibody response using the Roche Elecsys® anti-RBD assay. Eligible participants will receive a third dose of the same mRNA vaccine as the prior two doses.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Transplant Recipients
Keywords
COVID-19 vaccine, SARS-CoV-2 antibody response

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Open label, non-randomized.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
81 (Actual)

8. Arms, Groups, and Interventions

Arm Title
mRNA-1273 vaccine (Pfizer/BioNTech)
Arm Type
Experimental
Arm Description
The mRNA-1273 vaccine was developed to prevent COVID-19, the disease resulting from Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2) infection. Kidney transplant recipients who had a suboptimal antibody response to the standard two doses of vaccination with Pfizer/BioNTech will receive a third dose of the the same vaccine. Administration: One dose administered intramuscularly, upper arm.
Arm Title
mRNA-1273 vaccine (Moderna)
Arm Type
Experimental
Arm Description
The mRNA-1273 vaccine was developed to prevent COVID-19, the disease resulting from Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2) infection. Kidney transplant recipients who had a suboptimal antibody response to the standard two doses of vaccination with Moderna will receive a third dose of the same vaccine. Administration: One dose administered intramuscularly, upper arm.
Intervention Type
Biological
Intervention Name(s)
mRNA-1273 vaccine (Pfizer/BioNTech)
Other Intervention Name(s)
BNT162b2 vaccine, SARS-CoV-2 RNA vaccine, Pfizer-BioNTech COVID-19 vaccine
Intervention Description
30 microgram dose
Intervention Type
Biological
Intervention Name(s)
mRNA-1273 vaccine (Moderna)
Other Intervention Name(s)
SARS-CoV-2 RNA vaccine, Moderna COVID-19 vaccine
Intervention Description
100 microgram dose
Primary Outcome Measure Information:
Title
Proportion of Participants Who Achieve an Antibody Response >50 U/mL
Description
Efficacy measure status post third mRNA-1273 vaccination.
Time Frame
Day 30 Post-Vaccination (Dose 3)
Secondary Outcome Measure Information:
Title
Frequency of Solicited Local Reactogenicity Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 7 Post-Vaccination (Dose 3)
Title
Frequency of Solicited Local Allergic Reaction Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 7 Post-Vaccination (Dose 3)
Title
Frequency of Solicited Systemic Reactogenicity Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 7 Post-Vaccination (Dose 3)
Title
Frequency of Solicited Systemic Allergic Reaction Adverse Events (AEs) to the mRNA-Based COVID-19 Vaccine
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 7 Post-Vaccination (Dose 3)
Title
Frequency of Any Serious Adverse Events (SAEs)
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 30 Post-Vaccination (Dose 3)
Title
Frequency of Any Unsolicited Adverse Events (AEs)
Description
Safety measure. An AE associated with the third dose of vaccine and/or study mandated procedures.
Time Frame
Through Day 30 Post-Vaccination (Dose 3)
Title
Frequency of Any Serious Adverse Events (SAEs)
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 60 Post-Vaccination (Dose 3)
Title
Frequency of Any Serious Adverse Events (SAEs)
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 365 Post-Vaccination (Dose 3)
Title
Frequency of Any Unsolicited Adverse Events (AEs)
Description
Safety measure. An AE associated with the third dose of vaccine and/or study mandated procedures.
Time Frame
Through Day 365 Post-Vaccination (Dose 3)
Title
Proportion of Participants Treated for Acute Cell-Mediated and/or Antibody-Mediated Allograft Rejection
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 60 Post-Vaccination (Dose 3)
Title
Proportion of Participants who Develop de Novo Donor-Specific Anti-Human Leukocyte Antigens (HLA) Antibody
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 60 Post-Vaccination (Dose 3)
Title
Proportion of Participants with Graft Loss
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 60 Post-Vaccination (Dose 3)
Title
Occurrence of Death Among Participants
Description
Safety measure status post third mRNA-1273 vaccination.
Time Frame
Through Day 60 Post-Vaccination (Dose 3)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals who meet all the following criteria are eligible for enrollment as study participants- Able to understand and provide informed consent; Recipient of kidney transplant ≥12 months prior to enrollment, without treated allograft rejection in the 6 months preceding enrollment; Received 2 doses of either the Moderna COVID-19 vaccine or Pfizer-BioNTech COVID-19 vaccine as specified in the respective Food and Drug Administration Emergency Use Authorization (FDA EUAs), >30 days and <8 months prior to enrollment ; and, Negative (antibody titer < 0.8U/mL) or low (antibodies detected at titer ≤ 50 U/mL) response to the vaccine at > 30 days from dose 2 of the Moderna COVID-19 vaccine or the Pfizer BioNTech vaccine, using the Roche Elecsys® anti-Receptor Binding Domain (RBD) assay. Exclusion Criteria: Individuals who meet any of these criteria are not eligible for enrollment as study participants- Recipient of any number of doses of any COVID vaccine product other than the Moderna COVID-19 vaccine or the Pfizer-BioNTech COVID-19 vaccine; Known history of severe allergic reaction to any component of either the Moderna COVID-19 vaccine or Pfizer-BioNTech COVID-19 vaccine; Thrombotic events, myocarditis, or pericarditis temporally associated with prior dose of COVID-19 vaccine; Any change in transplant immunosuppression regimen (drug or dose) in response to suspected or proven rejection within the last 6 months; Significant graft dysfunction; Receipt of any cellular depleting agent (e.g. ATG, Rituximab, Alemtuzumab, Cyclophosphamide) within 12 months preceding enrollment; Receiving systemic immunomodulatory medication(s) for any condition other than transplant; Any untreated active infection, including BK viremia >10^4 copies; Infection with human immunodeficiency virus (HIV); Maintenance immunosuppressive regimen that includes belatacept or abatacept; Recent (within one year) or ongoing treatment for malignancy; or Any past or current medical problems, treatments, or findings which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the candidate's ability to comply with study requirements or may impact the quality or interpretation of the data obtained from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dorry L. Segev, MD, PhD
Organizational Affiliation
Department of Surgery, Johns Hopkins University School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The plan is to share data upon completion of the study in: Immunology Database and Analysis Portal (ImmPort), a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.
IPD Sharing Time Frame
On average, within 24 months after database lock for the trial.
IPD Sharing Access Criteria
Open access.
IPD Sharing URL
https://www.immport.org/home
Citations:
PubMed Identifier
34125572
Citation
Werbel WA, Boyarsky BJ, Ou MT, Massie AB, Tobian AAR, Garonzik-Wang JM, Segev DL. Safety and Immunogenicity of a Third Dose of SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients: A Case Series. Ann Intern Med. 2021 Sep;174(9):1330-1332. doi: 10.7326/L21-0282. Epub 2021 Jun 15. No abstract available.
Results Reference
background

Learn more about this trial

COVID-19 Protection After Transplant Pilot Study

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