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Clinical Trial of the COVID-19 Vaccine (Recombinant, Inactivated) in Brazil (ADAPTCOV)

Primary Purpose

Coronavirus Infections, Healthy

Status
Completed
Phase
Phase 1
Locations
Brazil
Study Type
Interventional
Intervention
NDV-HXP-S 1μg
NDV-HXP-S 3μg
NDV-HXP-S 10μg
Adsorbed inactivated COVID-19 vaccine (CoronaVac)
Sponsored by
Butantan Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Coronavirus Infections focused on measuring Vaccine, SARS-CoV-2, COVID-19

Eligibility Criteria

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

Inclusion criteria

  1. Adults aged between 18 and 59 years at the time of consent;
  2. Agree to periodical contacts via phone, electronic means and home visits;
  3. Good health conditions (absence of a clinically significant medical condition, acute or chronic, determined by medical history, physical examination, and clinical evaluation by the investigator);
  4. Body Mass Index (BMI) of 17 to 40 kg/m² at the time of screening;
  5. Intention of participating in the study by signing the Informed Consent Form;
  6. A negative result for antibody testing against SARS-CoV-2 by CLIA performed within 7 days prior to study immunization;
  7. No history of COVID-19 diagnosed by RT-PCR or antigen testing at screening visit and therefore within 72 hours prior to study enrollment;
  8. No history of vaccination against COVID-19.

Exclusion criteria

  1. Use any product under investigation within 90 days prior to randomization or plan to use a product during the period of participation in the study;
  2. Have received vaccine in the last 28 days prior to inclusion in the study, or have immunization scheduled throughout the study period;
  3. Evidences of uncontrolled active neurological, cardiac, pulmonary, hepatic or renal disease, according to anamnesis or physical examination. Significant changes in treatment or hospitalizations due to worsening of the condition in the last three months are indicators of uncontrolled disease;
  4. Have a history of severe allergic reaction or anaphylaxis to the vaccine or study vaccine components;
  5. History of being allergic to chicken or eggs;
  6. History of angioedema or anaphylactic reaction;
  7. Have suspected or confirmed fever within 72 hours prior to vaccination or an axillary temperature above 37.8°C* on the day of vaccination (inclusion may be delayed until participant completes 72 hours without fever);
  8. Altered vital signs, clinically relevant in the opinion of the principal investigator;
  9. Neoplastic diseases (except basal cell carcinoma and cervical carcinoma in situ);
  10. Suspected or confirmed diseases with compromised immune system including: congenital or acquired immunodeficiencies and uncontrolled autoimmune diseases according to anamnesis or physical examination. Significant changes in treatment or hospitalizations due to worsening of the condition in the last three months are indicators of uncontrolled disease;
  11. Make use of immunosuppressive therapies six months prior to inclusion in the study or schedule use of immunosuppressants within two years of inclusion in the study. The dose of corticosteroids considered immunosuppressive is the equivalent to prednisone at a dose of 2,0 mg/kg/day for adults, for more than a week. The continuous use of topical or nasal corticosteroids is not considered immunosuppressive. The following therapies are considered immunosuppressive: antineoplastic drugs, radiotherapy, immunosuppressants to induce tolerance to transplants, among others.
  12. Have received blood products (transfusions or immunoglobulins) in the last three months prior to inclusion in the study, or schedule administration of blood products or immunoglobulins within two years of inclusion in the study.
  13. Have a history of bleeding disorders (e.g., clotting factor deficiency, coagulopathy, platelet dysfunction), or prior history of significant bleeding or bruising after IM injection or venipuncture;
  14. Have a history of any alcohol or drug abuse in the last 12 months prior to inclusion in the study that has caused medical, professional or family problems, as indicated by the clinical history;
  15. Behavioral, cognitive, or psychiatric illness that, in the opinion of the principal investigator or medical representative, affects the participant's ability to understand and collaborate with the requirements of the study protocol;
  16. The participant is a member of the team conducting the study or is in a dependent relationship with one of the members of the team conducting the study. Dependent relationships include close relatives (i.e., children, partner/spouse, siblings, parents), as well as employees or students who are directly dependent on the Researcher or local personnel conducting the study;
  17. Any other condition that, in the opinion of the principal investigator or medical representative, may jeopardize the safety or rights of a potential participant or prevent them from complying with this protocol.
  18. Abnormalities in screening laboratory tests considered to be exclusionary in the opinion of the principal investigator or medical representative. Grade 1 alterations are considered non-significant unless the principal investigator or medical representative indicates otherwise. If any alteration in the tests is considered temporary, the tests may be repeated in up to three opportunities during the screening period;
  19. Positive serological tests for the human immunodeficiency virus (ELISA anti-HIV1/2); Hepatitis B (HbsAg or Anti-HBc) or Hepatitis C (total ELISA anti-HCV);

    For females:

  20. Pregnancy (confirmed by a positive β-hCG test), breastfeeding and/or expressing intention to engage in sexual practices with reproductive potential without using a contraceptive method in the three months following vaccination

    • The temperature measured with a temporal thermometer is considered equivalent to the axillary temperature.

Sites / Locations

  • Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

NDV-HXP-S 1μg

NDV-HXP-S 3μg

NDV-HXP-S 10μg

Adsorbed inactivated COVID-19 vaccine (CoronaVac)

Arm Description

NDV-HXP-S 1μg with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.

NDV-HXP-S 3μg with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.

NDV-HXP-S 10μg/0.5mL intramuscularly, with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.

Adsorbed inactivated COVID-19 vaccine 600 SU dose (0.5 mL) with an interval of 28 days apart Intramuscular (deltoid). In the original version of protocol, the control arm consisted in placebo use. There was a changing post hoc to Adsorbed inactivated COVID-19 vaccine (CoronaVac) due to decision of Data and Safety Monitoring Board, when 219 (50% of original sample) subjects have already included in the study. Therefore, those who received a placebo at the first vaccine visit started to receive active control vaccine and those who were included from that moment forward received two doses of active control vaccine. The original study protocol provided for the inclusion of the placebo arm (10% of population of study), in order to serve as a control for safety evaluations and to assess the attack rate of natural infection to which participants will be exposed during the study.

Outcomes

Primary Outcome Measures

Safety: Adverse reactions.
Number and intensity of solicited local and systemic adverse reactions.
Safety: Laboratory evaluations
Number, severity and summary of clinically significant changes of hematological (hemoglobin [g/dL], white blood cells [cells/mm³] and platelets [count per mm³]) and biochemical evaluations (creatinine [mg/dL], AST [U/L], ALT [U/L], and total bilirubin [mg/dL]) since the baseline within 7 days after each vaccination.
Immunogenicity: Percentage of seroconversion.
Percentage of positive SARS-CoV-2 pseudovirus neutralization assay in a participant with a baseline negative result (Wuhan strain).
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Neutralization GMT against SARS-CoV-2 pseudovirus (Wuhan strain)
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Neutralization GMT against SARS-CoV-2 pseudovirus (Wuhan strain)
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Neutralization GMT against SARS-CoV-2 pseudovirus (beta and gamma strains)

Secondary Outcome Measures

Safety: all unsolicited adverse reactions.
Number, intensity, and relatedness of all unsolicited adverse reactions.
Safety: serious and medically-attended adverse reactions.
Number, intensity, and relatedness of serious adverse reactions
Safety: events of special interest.
Number, intensity, and relatedness of events of special interest.
Immunogenicity: Levels of antibodies.
Levels of antibodies against SARS-CoV-2 Nucleocapsid protein and RBD
Immunogenicity: Neutralization GMT of SARS-CoV-2 pseudovirus.
Neutralization GMT against SARS-CoV-2 pseudovirus per age group
Exploratory Endpoints: Levels of antibodies.
Levels of antibodies against SARS-CoV-2 Nucleocapsid protein and RBD.
Exploratory Endpoints: Neutralization GMT of SARS-CoV-2 pseudovirus.
Neutralization GMT against SARS-CoV-2 pseudovirus at 3 months, 6 months, 9 months, and 12 months after first vaccination in subjects.
Exploratory Endpoints - COVID-19 cases.
Number and intensity of COVID-19 cases diagnosed.

Full Information

First Posted
August 3, 2021
Last Updated
August 17, 2023
Sponsor
Butantan Institute
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1. Study Identification

Unique Protocol Identification Number
NCT04993209
Brief Title
Clinical Trial of the COVID-19 Vaccine (Recombinant, Inactivated) in Brazil
Acronym
ADAPTCOV
Official Title
Double-blind, Randomized, With an Active Control Vaccine, Phase I Clinical Trial for Evaluation of Safety and Immunogenicity of a Recombinant Inactivated COVID-19 Vaccine in Adults in Brazil - ADAPTCOV
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
July 9, 2021 (Actual)
Primary Completion Date
December 10, 2021 (Actual)
Study Completion Date
November 4, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Butantan Institute

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
NDV-HXP-S is an inactivated COVID-19 vectored-vaccine virus using the Newcastle Disease Virus as basis and expressing S protein from SARS-CoV-2 stabilized in pre-fusion form with Hexapro technology. This vaccine was successfully tested in non-clinical study with a good safety profile and eliciting neutralizing antibodies against SARS-CoV-2. Clinical testing is conducted by an international consortium including three different manufacturers. Butantan, in Brazil, is one of them.
Detailed Description
The present protocol aims, to respond to several regulatory requirements to advance the clinical development of the product through a dose-escalation, controlled, randomized, adult clinical trial. The results of the Phase I (former Stage A), allow us to base the decision to evaluate the safety and immunogenicity of three doses of HDV-HXP-S (1μg, 3μg or 10μg).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronavirus Infections, Healthy
Keywords
Vaccine, SARS-CoV-2, COVID-19

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
Stage A (blinding form) will verify the product safety and support the decision on the dose selection among 1 μg, 3 μg and 10 μg, based on the immune response assessment. These results will also explore the response against 2 variants of concern in SARS-CoV-2: γ and β.
Masking
ParticipantCare ProviderInvestigator
Masking Description
An electronic central randomization system will be used to designate the investigational product (IP) that each participant must receive. A team study non-blind, qualified member (nurse/pharmacist) will obtain the corresponding randomization, will separate the respective IP, will blind the product and deliver it to blind staff. The product will be in a syringe that is in a blister labeled with the sponsor's name, IP code, administration route, IP dose and expiration date. The study non-blind staff will not have contact with the participants, will not have access to identification data or any other involvement with the study, besides randomizing the participant, separating the syringe containing placebo or vaccine, checking if the information on the blister label corresponds the information on the cartridge label and the syringe is labeled with the clinical trial code, ID, corresponding visit and investigator's name. Blinding is maintained with the opacity of the label.
Allocation
Randomized
Enrollment
320 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NDV-HXP-S 1μg
Arm Type
Experimental
Arm Description
NDV-HXP-S 1μg with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.
Arm Title
NDV-HXP-S 3μg
Arm Type
Experimental
Arm Description
NDV-HXP-S 3μg with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.
Arm Title
NDV-HXP-S 10μg
Arm Type
Experimental
Arm Description
NDV-HXP-S 10μg/0.5mL intramuscularly, with an interval of 28 days apart. A dose escalation will be performed with an interval of two days between each dose in a blinded form. The aim is to verify the product safety and support the decision on the dose selection among three alternatives, 1 μg, 3 μg and 10 μg, based on the immune response evaluation. These results will also explore the response against two variants of concern in SARS-CoV-2: γ and β. The Phase I (former stage A) is designed as a non-inferiority test comparing the three different doses.
Arm Title
Adsorbed inactivated COVID-19 vaccine (CoronaVac)
Arm Type
Active Comparator
Arm Description
Adsorbed inactivated COVID-19 vaccine 600 SU dose (0.5 mL) with an interval of 28 days apart Intramuscular (deltoid). In the original version of protocol, the control arm consisted in placebo use. There was a changing post hoc to Adsorbed inactivated COVID-19 vaccine (CoronaVac) due to decision of Data and Safety Monitoring Board, when 219 (50% of original sample) subjects have already included in the study. Therefore, those who received a placebo at the first vaccine visit started to receive active control vaccine and those who were included from that moment forward received two doses of active control vaccine. The original study protocol provided for the inclusion of the placebo arm (10% of population of study), in order to serve as a control for safety evaluations and to assess the attack rate of natural infection to which participants will be exposed during the study.
Intervention Type
Biological
Intervention Name(s)
NDV-HXP-S 1μg
Intervention Description
NDV-HXP-S 1μg 0.5mL 2 doses intramuscular (deltoid) 28 days apart
Intervention Type
Biological
Intervention Name(s)
NDV-HXP-S 3μg
Intervention Description
NDV-HXP-S 3μg 0.5mL 2 doses intramuscular (deltoid) 28 days apart
Intervention Type
Biological
Intervention Name(s)
NDV-HXP-S 10μg
Intervention Description
NDV-HXP-S 10μg 0.5mL 2 doses intramuscular (deltoid) 28 days apart
Intervention Type
Other
Intervention Name(s)
Adsorbed inactivated COVID-19 vaccine (CoronaVac)
Intervention Description
Adsorbed inactivated COVID-19 vaccine 600 SU/0.5 mL 2 doses intramuscular (deltoid) 28 days apart
Primary Outcome Measure Information:
Title
Safety: Adverse reactions.
Description
Number and intensity of solicited local and systemic adverse reactions.
Time Frame
7 days after each vaccination.
Title
Safety: Laboratory evaluations
Description
Number, severity and summary of clinically significant changes of hematological (hemoglobin [g/dL], white blood cells [cells/mm³] and platelets [count per mm³]) and biochemical evaluations (creatinine [mg/dL], AST [U/L], ALT [U/L], and total bilirubin [mg/dL]) since the baseline within 7 days after each vaccination.
Time Frame
7 days after each vaccination.
Title
Immunogenicity: Percentage of seroconversion.
Description
Percentage of positive SARS-CoV-2 pseudovirus neutralization assay in a participant with a baseline negative result (Wuhan strain).
Time Frame
42(+7) days after the first dose.
Title
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Description
Neutralization GMT against SARS-CoV-2 pseudovirus (Wuhan strain)
Time Frame
28 days after the first vaccination.
Title
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Description
Neutralization GMT against SARS-CoV-2 pseudovirus (Wuhan strain)
Time Frame
14 days after the second vaccination.
Title
Immunogenicity: Neutralization GMT SARS-CoV-2 pseudovirus.
Description
Neutralization GMT against SARS-CoV-2 pseudovirus (beta and gamma strains)
Time Frame
42(+7) days after the first dose.
Secondary Outcome Measure Information:
Title
Safety: all unsolicited adverse reactions.
Description
Number, intensity, and relatedness of all unsolicited adverse reactions.
Time Frame
28 days after each vaccination.
Title
Safety: serious and medically-attended adverse reactions.
Description
Number, intensity, and relatedness of serious adverse reactions
Time Frame
Throughout the entire study period.
Title
Safety: events of special interest.
Description
Number, intensity, and relatedness of events of special interest.
Time Frame
Throughout the entire study period.
Title
Immunogenicity: Levels of antibodies.
Description
Levels of antibodies against SARS-CoV-2 Nucleocapsid protein and RBD
Time Frame
At baseline, 28 days after the first vaccination, and 14 days after the second vaccination, and 3, 6, 9, and 12 months after first vaccination.
Title
Immunogenicity: Neutralization GMT of SARS-CoV-2 pseudovirus.
Description
Neutralization GMT against SARS-CoV-2 pseudovirus per age group
Time Frame
28 days after the first vaccination, and 14 days after the second vaccination.
Title
Exploratory Endpoints: Levels of antibodies.
Description
Levels of antibodies against SARS-CoV-2 Nucleocapsid protein and RBD.
Time Frame
At baseline, 28 days after the first vaccination, and 14 days after the second vaccination, and 3 months, 6 months, 9 months, and 12 months after first vaccination.
Title
Exploratory Endpoints: Neutralization GMT of SARS-CoV-2 pseudovirus.
Description
Neutralization GMT against SARS-CoV-2 pseudovirus at 3 months, 6 months, 9 months, and 12 months after first vaccination in subjects.
Time Frame
at 3 months, 6 months, 9 months, and 12 months after first vaccination in subjects.
Title
Exploratory Endpoints - COVID-19 cases.
Description
Number and intensity of COVID-19 cases diagnosed.
Time Frame
14 days after first and second vaccination.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion criteria Adults aged between 18 and 59 years at the time of consent; Agree to periodical contacts via phone, electronic means and home visits; Good health conditions (absence of a clinically significant medical condition, acute or chronic, determined by medical history, physical examination, and clinical evaluation by the investigator); Body Mass Index (BMI) of 17 to 40 kg/m² at the time of screening; Intention of participating in the study by signing the Informed Consent Form; A negative result for antibody testing against SARS-CoV-2 by CLIA performed within 7 days prior to study immunization; No history of COVID-19 diagnosed by RT-PCR or antigen testing at screening visit and therefore within 72 hours prior to study enrollment; No history of vaccination against COVID-19. Exclusion criteria Use any product under investigation within 90 days prior to randomization or plan to use a product during the period of participation in the study; Have received vaccine in the last 28 days prior to inclusion in the study, or have immunization scheduled throughout the study period; Evidences of uncontrolled active neurological, cardiac, pulmonary, hepatic or renal disease, according to anamnesis or physical examination. Significant changes in treatment or hospitalizations due to worsening of the condition in the last three months are indicators of uncontrolled disease; Have a history of severe allergic reaction or anaphylaxis to the vaccine or study vaccine components; History of being allergic to chicken or eggs; History of angioedema or anaphylactic reaction; Have suspected or confirmed fever within 72 hours prior to vaccination or an axillary temperature above 37.8°C* on the day of vaccination (inclusion may be delayed until participant completes 72 hours without fever); Altered vital signs, clinically relevant in the opinion of the principal investigator; Neoplastic diseases (except basal cell carcinoma and cervical carcinoma in situ); Suspected or confirmed diseases with compromised immune system including: congenital or acquired immunodeficiencies and uncontrolled autoimmune diseases according to anamnesis or physical examination. Significant changes in treatment or hospitalizations due to worsening of the condition in the last three months are indicators of uncontrolled disease; Make use of immunosuppressive therapies six months prior to inclusion in the study or schedule use of immunosuppressants within two years of inclusion in the study. The dose of corticosteroids considered immunosuppressive is the equivalent to prednisone at a dose of 2,0 mg/kg/day for adults, for more than a week. The continuous use of topical or nasal corticosteroids is not considered immunosuppressive. The following therapies are considered immunosuppressive: antineoplastic drugs, radiotherapy, immunosuppressants to induce tolerance to transplants, among others. Have received blood products (transfusions or immunoglobulins) in the last three months prior to inclusion in the study, or schedule administration of blood products or immunoglobulins within two years of inclusion in the study. Have a history of bleeding disorders (e.g., clotting factor deficiency, coagulopathy, platelet dysfunction), or prior history of significant bleeding or bruising after IM injection or venipuncture; Have a history of any alcohol or drug abuse in the last 12 months prior to inclusion in the study that has caused medical, professional or family problems, as indicated by the clinical history; Behavioral, cognitive, or psychiatric illness that, in the opinion of the principal investigator or medical representative, affects the participant's ability to understand and collaborate with the requirements of the study protocol; The participant is a member of the team conducting the study or is in a dependent relationship with one of the members of the team conducting the study. Dependent relationships include close relatives (i.e., children, partner/spouse, siblings, parents), as well as employees or students who are directly dependent on the Researcher or local personnel conducting the study; Any other condition that, in the opinion of the principal investigator or medical representative, may jeopardize the safety or rights of a potential participant or prevent them from complying with this protocol. Abnormalities in screening laboratory tests considered to be exclusionary in the opinion of the principal investigator or medical representative. Grade 1 alterations are considered non-significant unless the principal investigator or medical representative indicates otherwise. If any alteration in the tests is considered temporary, the tests may be repeated in up to three opportunities during the screening period; Positive serological tests for the human immunodeficiency virus (ELISA anti-HIV1/2); Hepatitis B (HbsAg or Anti-HBc) or Hepatitis C (total ELISA anti-HCV); For females: Pregnancy (confirmed by a positive β-hCG test), breastfeeding and/or expressing intention to engage in sexual practices with reproductive potential without using a contraceptive method in the three months following vaccination The temperature measured with a temporal thermometer is considered equivalent to the axillary temperature.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fernanda Castro Boulos, MD,PhD
Organizational Affiliation
Butantan Institute
Official's Role
Study Director
Facility Information:
Facility Name
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
City
Ribeirão Preto
State/Province
São Paulo
ZIP/Postal Code
14015-069
Country
Brazil

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial of the COVID-19 Vaccine (Recombinant, Inactivated) in Brazil

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