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A Safety, Immunogenicity and Efficacy Study of PvRII/Matrix-M in Healthy Thai Adults Living in Thailand ( MIST3 ) (MIST3)

Primary Purpose

Plasmodium Vivax Infection, Malaria Vaccine

Status
Not yet recruiting
Phase
Phase 2
Locations
Thailand
Study Type
Interventional
Intervention
Malaria Vaccine
HBV vaccine
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Plasmodium Vivax Infection

Eligibility Criteria

20 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy Thai adults aged 20 to 55 years with a weight of at least 50 kg.
  2. Graduated with a minimum of high school or equivalent
  3. Red blood cells positive for the Duffy antigen/chemokine receptor (DARC)
  4. Women only: Must practice continuous effective contraception for the duration of the study period until 3 months post-challenge.
  5. Agreement to refrain from blood donation during the study and for 1 year after the initiation of antimalarial treatment.
  6. Willing to be admitted to the Hospital for Tropical Diseases for clinical monitoring until antimalarial treatment is completed and their symptoms are settling, willing to take a curative antimalarial treatment following CHMI, and willing to reside in Bangkok and its vicinity for 2 months after malarial treatment initiation.
  7. Able to read and write in Thai.
  8. Provide written informed consent to participate in the trial
  9. Answer all questions on the informed consent quiz correctly
  10. Completed COVID-19 vaccination 3 doses of any WHO-approved vaccines

Exclusion Criteria:

  1. Positive malaria qPCR OR malaria film
  2. Presence of any medical condition (either physical or psychological) that, in the judgment of the investigator, would place the participant at undue risk (including the history of clinically significant contact dermatitis) or interfere with the results of the study (e.g., underlying severe cardiac, renal, hepatic or neurological disease; severe malnutrition; congenital defects or febrile condition)
  3. Presence of chronic disease or chronically use of medication
  4. Prior receipt of an investigational vaccine is likely to impact the interpretation of the trial data or the P. vivax parasite as assessed by the Investigator.
  5. Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection, asplenia, history of splenectomy, recurrent, severe infections, and chronic infection
  6. Immunosuppressant medication within the past 6 months preceding enrolment (D0) (inhaled and topical steroids are allowed)
  7. History of allergic disease or reactions likely to be exacerbated by malaria infection
  8. Female participant who is pregnant as evidenced by positive beta-human chorionic gonadotropin (β-HCG) test, lactating or planning pregnancy during the course of the study
  9. Contraindications to the use of antimalarial treatment (e.g., chloroquine, atovaquone/proguanil, or dihydroartemisinin/piperaquine)
  10. Use of medications known to have potentially clinically significant interaction with the antimalarial drug that will be used in this study (chloroquine, atovaquone/proguanil, or dihydroartemisinin/piperaquine)
  11. History of cardiac arrhythmia, including clinically relevant bradycardia or Known existing positive family history in both 1st AND 2nd-degree relatives < 50 years old for cardiac disease
  12. Family history of congenital QT prolongation or sudden death
  13. Any clinical condition, including using medications known to prolong the QT interval or screening electrocardiogram (ECG), demonstrates a QTc interval ≥ 450 ms.
  14. Suspected or known history of alcohol abuse or history of drug abuse.
  15. Concurrently participating in another clinical study, at any time during the study period
  16. Positive hepatitis B surface antigen or seropositive for hepatitis C virus, or HIV
  17. Finding on safety laboratory values as defined below:

    • Abnormal ALT [upper normal range]
    • Abnormal serum creatinine [upper normal range]
    • Abnormalities corrected calcium and magnesium blood levels
  18. Blood group Rhesus negative
  19. Blood incompatibility to the inoculum
  20. Positive for COVID-19
  21. History of allergic disease or reactions likely to be exacerbated by any component of the vaccine
  22. Any history of anaphylaxis in reaction to vaccinations

Vaccination and re-vaccination exclusion criteria

  1. Acute disease at the time of vaccination. (Acute disease is defined as the presence of a moderate or severe illness with or without fever).
  2. Current COVID-19 infection is defined as ongoing symptoms with a positive COVID-19 PCR swab test taken during the current illness or a positive COVID-19 PCR swab test within 14 days without symptoms. Vaccinations will be delayed by a minimum of 2 weeks from the date of the 1st positive COVID-19 PCR swab as long as symptoms are improving or resolved. It will be at the discretion of the Investigator to withdraw a participant if they develop severe COVID-19 disease.

The following adverse events associated with vaccine immunisation constitute absolute contraindications to further vaccine administration. If any of these events occur during the study, the subject must be withdrawn and followed until the resolution of the event, as with any adverse event:

  1. Anaphylactic reaction following administration of the vaccine
  2. Pregnancy

Exclusion criteria on the day of CHMI

The following constitute absolute contraindications to CHMI:

  1. Acute disease, defined as a moderate or severe illness with or without fever
  2. Current COVID-19 infection is defined as ongoing symptoms with a positive COVID-19 PCR swab test taken during the current illness or a positive COVID-19 PCR swab test within 14 days without symptoms.
  3. Pregnancy
  4. Use of systemic antibiotics with known antimalarial activity in the 30 days before challenge (e.g., trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, and azithromycin) -

Sites / Locations

  • Faculty of Tropical Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Malaria Vaccine

control

Arm Description

PvRII/Matrix-M month 0, month 1, month 6

HBV vaccine month 0, month 1, month 6

Outcomes

Primary Outcome Measures

solicited local adverse event
occurrence of solicited local reactogenicity signs and symptoms
solicited systemic adverse event
occurrence of solicited systemic reactogenicity signs and symptoms
unsolicited adverse events
Occurrence of unsolicited adverse events
safety laboratory measures
Number of participants with abnormal laboratory test results
serious adverse events
Occurrence of serious adverse events during the whole study duration
feasibility of primary P. vivax blood-stage CHMI
successful infection (development of detectable persistent parasitaemia by thick blood film +/- clinical symptoms)

Secondary Outcome Measures

Full Information

First Posted
April 13, 2022
Last Updated
June 15, 2023
Sponsor
University of Oxford
Collaborators
Mahidol University
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1. Study Identification

Unique Protocol Identification Number
NCT05380388
Brief Title
A Safety, Immunogenicity and Efficacy Study of PvRII/Matrix-M in Healthy Thai Adults Living in Thailand ( MIST3 )
Acronym
MIST3
Official Title
A Phase II Clinical Study to Assess the Safety, Immunogenicity, and Efficacy of Blood-stage Plasmodium Vivax Malaria Vaccine Candidate PvRII/Matrix-M in Healthy Thai Adults Living in Thailand
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 2023 (Anticipated)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
May 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford
Collaborators
Mahidol University

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
This project is the third part of a 5-year research program entitled "Malaria Infection Studies in Thailand (MIST)" and known as MIST3. MIST3's primary objectives are to assess the safety of the PvRII/Matrix-M vaccine candidate in healthy adult Thai volunteers and to establish whether the PvRII/Matrix-M vaccine can demonstrate a reduced parasite multiplication rate in vaccinated volunteers compared to a controlled group (placebo vaccine) in a blood-stage controlled human malaria infection model. This study will recruit up to 36 eligible healthy volunteers aged 20-55 in Thailand at the Faculty of Tropical Medicine, Mahidol University. Eighteen volunteers will receive three doses of the PvRII/Matrix-M candidate vaccine, and 18 volunteers will receive three doses of the placebo vaccine. Safety and immunogenicity will be evaluated after each dose as per protocol. Approximately four weeks after receiving the third vaccination, 24 volunteers will undergo blood-stage CHMI with Plasmodium vivax. The volunteers will be monitored closely as in-patients in the Hospital for Tropical Diseases and treated according to the Research Proposal Submission Form. This study is funded by the UK Wellcome Trust. The grant reference number are Oxford/MORU: 212336/Z/18/Z and 212336/Z/18/A, and Mahidol University: 212336/A/18/Z and 212336/A/18/A
Detailed Description
Summary of trial design: Phase II, double-blinded, randomized controlled trial with CHMI, designed to assess the safety, immunogenicity, and protective efficacy of PvRII/Matrix-M vaccine. Overview: This is a randomized controlled single-centre Phase II P. vivax blood-stage CHMI trial to assess the safety, immunogenicity, and efficacy of the candidate malaria vaccine PvRII/Matrix-M. Healthy Thai adults aged between 20 and 55 years will be recruited and randomized at the Faculty of Tropical Medicine, Mahidol University in Bangkok. Vaccination group: Up to 18 healthy adults aged between 20 and 55 years will be recruited. These volunteers will receive three doses of the PvRII/Matrix-M vaccine intramuscularly at months 0, 1, and 6. Approximately three to four weeks post-boost (3rd vaccination), 12 volunteers will undergo P. vivax blood-stage CHMI, induced by injection of P. vivax infected erythrocytes. Control group: Up to 18 healthy adults aged between 20 and 55 years will be recruited. These volunteers will receive three doses of HBV vaccine intramuscularly at months 0, 1, and 6. 12 volunteers will undergo P. vivax blood-stage CHMI, induced by injection of P. vivax infected erythrocytes. Volunteers will have blood taken at regular intervals following vaccination and in the post-CHMI period to assess the immune response to vaccination and subsequent challenge, as well as parasite growth dynamics and gametocytaemia. Close monitoring will continue until volunteers meet the criteria for treatment or until 28 days after the challenge, when treatment will be started empirically. Therapy will be with a standard course of chloroquine where not contraindicated. As infection will be induced via intravenous injection of blood-stage parasites, there will be no liver-stage infection and no hypnozoite formation, thereby eliminating the need for radical cure with primaquine therapy. Follow-up at the study site will be up to 1 year after antimalarial treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Vivax Infection, Malaria Vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomized placebo-controlled trial
Masking
ParticipantCare ProviderInvestigator
Masking Description
double-blinded placebo
Allocation
Randomized
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Malaria Vaccine
Arm Type
Experimental
Arm Description
PvRII/Matrix-M month 0, month 1, month 6
Arm Title
control
Arm Type
Other
Arm Description
HBV vaccine month 0, month 1, month 6
Intervention Type
Biological
Intervention Name(s)
Malaria Vaccine
Other Intervention Name(s)
PvRII/Matrix-M
Intervention Description
blood stage Plasmodium vivax malaria vaccine
Intervention Type
Biological
Intervention Name(s)
HBV vaccine
Intervention Description
HBV Vaccine
Primary Outcome Measure Information:
Title
solicited local adverse event
Description
occurrence of solicited local reactogenicity signs and symptoms
Time Frame
7 days following each vaccination
Title
solicited systemic adverse event
Description
occurrence of solicited systemic reactogenicity signs and symptoms
Time Frame
7 days following each vaccination
Title
unsolicited adverse events
Description
Occurrence of unsolicited adverse events
Time Frame
28 days following each vaccination
Title
safety laboratory measures
Description
Number of participants with abnormal laboratory test results
Time Frame
28 days following each vaccination
Title
serious adverse events
Description
Occurrence of serious adverse events during the whole study duration
Time Frame
through study completion, an average of 1 year
Title
feasibility of primary P. vivax blood-stage CHMI
Description
successful infection (development of detectable persistent parasitaemia by thick blood film +/- clinical symptoms)
Time Frame
within 21 days following CHMI

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy Thai adults aged 20 to 55 years Minimum educational level of high school or equivalent Red blood cells positive for the Duffy antigen/chemokine receptor (DARC) Women only: Must practice continuous effective contraception for the duration of the study period until 3 months post-challenge. Agreement to refrain from blood donation during the study and for 1 year after the initiation of antimalarial treatment. Willing to be admitted to the Hospital for Tropical Diseases for clinical monitoring as required by the protocol until antimalarial treatment is completed and their symptoms are settling, willing to take a curative antimalarial treatment following CHMI, and willing to reside in Bangkok and its vicinity for 2 months after malarial treatment initiation. Able to read and write in Thai. Provide written informed consent to participate in the trial Answer all questions on the informed consent quiz correctly Completed COVID-19 vaccination with 2 doses of any WHO-approved vaccine Exclusion Criteria: Positive malaria qPCR OR malaria film prior to vaccination and challenge Presence of any medical condition (either physical or psychological) that, in the judgment of the investigator, would place the participant at undue risk (including the history of clinically significant contact dermatitis) or interfere with the results of the study (e.g., underlying cardiac, renal, hepatic or neurological disease; severe malnutrition; congenital defects or febrile condition) Presence of chronic disease or chronic use of medication Prior receipt of other investigational vaccine which is likely to impact the interpretation of the trial data as assessed by the Investigator. Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection, asplenia, history of splenectomy, recurrent severe infections, and chronic infection Immunosuppressant medication within the past 6 months preceding enrolment (D0) or plan to use during the study (inhaled and topical steroids are allowed) History of allergic disease or reactions likely to be exacerbated by malaria infection Female participant who is pregnant as evidenced by positive beta-human chorionic gonadotropin (β-HCG) test, or who is lactating or planning pregnancy during the course of the study. Contraindications to the use of antimalarial treatment (e.g., chloroquine, atovaquone/proguanil, or dihydroartemisinin/piperaquine) Use of medications known to have potentially clinically significant interaction with the antimalarial drugs that will be used in this study (chloroquine, atovaquone/proguanil, or dihydroartemisinin/piperaquine) History of cardiac arrhythmia, including clinically relevant bradycardia or Known existing positive family history in both 1st AND 2nd-degree relatives < 50 years old for cardiac disease Family history of congenital QT prolongation or sudden death Any clinical condition, including using medications known to prolong the QT interval or screening electrocardiogram (ECG), demonstrates a QTc interval ≥ 450 ms. Suspected or known history of alcohol abuse or history of drug abuse. Concurrently participating in another clinical study, at any time during the study period Positive hepatitis B surface antigen or seropositive for hepatitis C virus, or HIV Finding on safety laboratory values as defined below: Abnormal ALT [>upper normal range] Abnormal serum creatinine [>upper normal range] Clinically significant abnormalities in corrected calcium and magnesium blood levels Haemoglobin < 11 g/dL Blood group Rhesus negative Blood incompatibility to the inoculum History of allergic disease or reactions likely to be exacerbated by any component of the vaccine Any history of anaphylaxis in reaction to vaccinations Vaccination and re-vaccination exclusion criteria 1. Acute disease at the time of vaccination. (acute disease is defined as the presence of a moderate or severe illness with or without fever). The following adverse events associated with vaccine immunisation constitute absolute contraindications to further vaccine administration. If any of these events occur during the study, the participant must be withdrawn and followed until the resolution of the event, as with any adverse event: Anaphylactic reaction following administration of the vaccine Pregnancy Exclusion criteria on the day of CHMI The following constitute absolute contraindications to CHMI: Acute disease, defined as a moderate or severe illness with or without fever Pregnancy Use of systemic antibiotics with known antimalarial activity in the 30 days before challenge (e.g., trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, and azithromycin)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nicholas Day, MD
Phone
+66-(0)2-3549170
Email
Nickd@tropmedres.ac
First Name & Middle Initial & Last Name or Official Title & Degree
Jetsumon Sattabongkot Prachumsri, Ph. D
Phone
+66-(0)2-3549100
Ext
2022
Email
jetsumon.pra@mahidol.ac.th
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nicholas Day, MD
Organizational Affiliation
University of Oxford
Official's Role
Principal Investigator
Facility Information:
Facility Name
Faculty of Tropical Medicine
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kittiyod Poovorawan, MD
Phone
+(662)3069100-9
Ext
3160-2
Email
kittiyod.poo@mahidol.ac.th

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
With participant's consent, suitably anonymised clinical data and results from blood analyses stored in the database may be shared according to the terms defined in the MORU data sharing policy with other researchers to use in the future.

Learn more about this trial

A Safety, Immunogenicity and Efficacy Study of PvRII/Matrix-M in Healthy Thai Adults Living in Thailand ( MIST3 )

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