Safety and Immunogenicity of VPM1002 Vaccination or BCG Revaccination Against TB in Pre-Adolescents Living With and Without HIV in South Africa
Primary Purpose
Tuberculosis, HIV Infections
Status
Not yet recruiting
Phase
Phase 1
Locations
South Africa
Study Type
Interventional
Intervention
VPM1002 Vaccine
BCG Vaccine
Placebo
Sponsored by
About this trial
This is an interventional prevention trial for Tuberculosis focused on measuring Bacterial and fungal diseases, Tuberculosis, Vaccine, Live vaccine, rBCG
Eligibility Criteria
Inclusion Criteria:
- Parent or legal guardian is willing and able to provide written informed consent; when applicable potential participant is willing and able to provide written assent
- Age 8-14 years (inclusive) at entry
- Received birth dose of BCG vaccine
- Has a negative nucleic acid test result for M.tb at screening and no other evidence of current active TB disease at screening
- M.tb sensitization status (positive or negative) determined based on IGRA testing at screening
- HIV status determined
- For participants living with HIV: has been receiving antiretroviral therapy for at least six months prior to study entry, has a CD4+ cell count of at least 200 cells/mm^3 at screening, has had a suppressed HIV viral load for at least three months prior to entry
- Has normal or grade 1 results for all of the following at screening: Hemoglobin, White blood cell count, Platelet count, Creatinine, ALT, AST, Total bilirubin
- Has a normal temperature and no signs or symptoms of acute illness
- For participants assigned female sex at birth or who could otherwise become pregnant: not pregnant
- For participants assigned female sex at birth or who could otherwise breastfeed: not breastfeeding
- Expected to be available for 48 weeks of study participation
- Not expected to participate in any other study of an investigational agent during the 48 weeks of study participation
Exclusion Criteria:
- Known significant exposure to TB or receipt of tuberculin skin test in the six months prior to study entry
- Receipt of treatment for active TB disease in the 24 months prior to study entry
- Receipt of TB preventive therapy within 30 days prior to study entry or expected to initiate TB preventive therapy within the 48 weeks following study entry
- For participants living with HIV, current active AIDS-defining condition
- Receipt of any of the following: Any investigational TB vaccine, More than 14 consecutive days of systemic immunosuppressants or other immune-modifying therapy within the six months prior to study entry, Any immunoglobulin or other blood product within the three months prior to study entry,
- Receipt of any vaccine within the 30 days prior to study entry or is expected to receive any vaccine between study entry and the Week 4 Visit
- Receipt of allergy treatment with an antigen injection within the 30 days prior to study entry or is expected to receive one or more antigen injections between study entry and the Week 48 Visit
- History of any of the following: serious adverse reaction to any vaccine, allergy or hypersensitivity to BCG vaccine, allergy or hypersensitivity to the components of VPM1002 vaccine, anaphylaxis, generalized urticaria, autoimmune disease, diabetes mellitus type 1 or type 2, mild persistent, moderate, or severe asthma, bleeding disorder, malignancy, any condition resulting in the absence of a functional spleen (asplenia), including but not limited to sickle cell disease
- History of seizure or use of any medication to prevent or treat seizure within the three years prior to entry
- History of suspected or confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosed within the 30 days prior to entry
- Any other documented or suspected clinically significant medical, psychiatric, or behavioral condition or any other condition that, in the opinion of the site investigator, would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
Sites / Locations
- Soweto IMPAACT CRS
- Setshaba Research Centre CRS
- Isipingo CRS
- Klerksdorp CRS
- Desmond Tutu TB Centre - Stellenbosch University (SU) CRS
- Emavundleni CRS
- Umlazi CRS
- Wits RHI Shandukani Research CRS
- Family Clinical Research Unit (FAM-CRU) CRS
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
VPM1002 Vaccine Arm
BCG Vaccine Arm
Placebo Arm
Arm Description
Participants stratified by HIV and M.tb sensitization status.
Participants stratified by HIV and M.tb sensitization status.
Participants stratified by HIV and M.tb sensitization status.
Outcomes
Primary Outcome Measures
All adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Solicited adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Grade 3 or higher adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Serious adverse events
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Adverse pregnancy outcomes
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Measured by ICS and flow cytometry on cryopreserved PBMCs
Secondary Outcome Measures
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Measured by ICS and flow cytometry on cryopreserved PBMC
Mycobacteria-specific IgA, IgG, and IgM binding antibodies
Measured using BAMA
Association of HIV and IGRA with primary safety outcomes (All AEs, solicitated AEs, grade 3 or higher AEs, serious adverse events, adverse pregnancy outcomes).
Based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Cellular immunogenicity outcome measures associated with HIV and IGRA status
VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines, measured by ICS and flow cytometry on cryopreserved PBMCs
Humoral immunogenicity outcome measures associated with HIV and IGRA status
Mycobacteria-specific IgA, IgG, and IgM binding antibodies, measured using BAMA
Gene expression profiles
Measured by RNA-seq in whole blood
Differential leukocyte count and immunophenotype
Measured in cryopreserved ex vivo whole blood (DLC-ICE) by flow cytometry
Measurement of soluble proinflammatory mediators
Based on serum measurement
Acceptability of the study products
Based on scores derived from questionnaire responses
Full Information
NCT ID
NCT05539989
First Posted
September 9, 2022
Last Updated
August 9, 2023
Sponsor
International Maternal Pediatric Adolescent AIDS Clinical Trials Group
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Mental Health (NIMH)
1. Study Identification
Unique Protocol Identification Number
NCT05539989
Brief Title
Safety and Immunogenicity of VPM1002 Vaccination or BCG Revaccination Against TB in Pre-Adolescents Living With and Without HIV in South Africa
Official Title
Phase I/II Randomized, Placebo-Controlled Study of the Safety and Immunogenicity of VPM1002 Vaccination or BCG Revaccination Against Tuberculosis in Pre-Adolescents Living With and Without HIV in South Africa
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
March 30, 2024 (Anticipated)
Primary Completion Date
October 31, 2026 (Anticipated)
Study Completion Date
October 31, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
International Maternal Pediatric Adolescent AIDS Clinical Trials Group
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Mental Health (NIMH)
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to assess whether Mycobacterium bovis rBCGΔureC::hly (VPM1002) vaccination and Mycobacterium bovis bacille Calmette-Guérin (BCG) revaccination are safe and immunogenic in pre-adolescents with and without HIV and with and without Mycobacterium tuberculosis (M.tb) sensitization.
Detailed Description
Phase I/II, double-blinded, placebo-controlled, randomized (1:1:1) multi-center study. Randomization will be stratified by HIV status and M.tb sensitization status. The study will enroll approximately 480 pre-adolescents (8-14 years of age inclusive) with or without HIV and with or without M.tb sensitization who received BCG vaccination at birth. Participants with HIV will be immunocompetent and virologically suppressed on antiretroviral therapy.
Participants will be randomized to one of three study product arms: VPM1002 Vaccine, BCG Vaccine, or Placebo. Each participant will receive a single intradermal injection of the assigned study product.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis, HIV Infections
Keywords
Bacterial and fungal diseases, Tuberculosis, Vaccine, Live vaccine, rBCG
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
480 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
VPM1002 Vaccine Arm
Arm Type
Experimental
Arm Description
Participants stratified by HIV and M.tb sensitization status.
Arm Title
BCG Vaccine Arm
Arm Type
Experimental
Arm Description
Participants stratified by HIV and M.tb sensitization status.
Arm Title
Placebo Arm
Arm Type
Placebo Comparator
Arm Description
Participants stratified by HIV and M.tb sensitization status.
Intervention Type
Biological
Intervention Name(s)
VPM1002 Vaccine
Intervention Description
0.1 mL (2-8x10^5 CFU)
Intervention Type
Biological
Intervention Name(s)
BCG Vaccine
Intervention Description
0.1mL (0.075 Mycobacterium bovis)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
0.1 mL (sodium chloride for injection 0.9%)
Primary Outcome Measure Information:
Title
All adverse events
Description
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 48
Title
Solicited adverse events
Description
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 16
Title
Grade 3 or higher adverse events
Description
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 48
Title
Serious adverse events
Description
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 48
Title
Adverse pregnancy outcomes
Description
Proportion of participants, based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 48 or delivery or other pregnancy outcome, whichever occurs later
Title
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Description
Measured by ICS and flow cytometry on cryopreserved PBMCs
Time Frame
Through Week 10
Secondary Outcome Measure Information:
Title
Frequency and response of VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines
Description
Measured by ICS and flow cytometry on cryopreserved PBMC
Time Frame
Weeks 24 and 48
Title
Mycobacteria-specific IgA, IgG, and IgM binding antibodies
Description
Measured using BAMA
Time Frame
Entry and Weeks 4, 10, 24, and 48
Title
Association of HIV and IGRA with primary safety outcomes (All AEs, solicitated AEs, grade 3 or higher AEs, serious adverse events, adverse pregnancy outcomes).
Description
Based on the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), Corrected Version 2.1, dated July 2017
Time Frame
Through Week 48 or delivery or other pregnancy outcome, whichever occurs later
Title
Cellular immunogenicity outcome measures associated with HIV and IGRA status
Description
VPM1002-specific and BCG-specific CD4+ and CD8+ T cells expressing Th1 and/or Th17 cytokines, measured by ICS and flow cytometry on cryopreserved PBMCs
Time Frame
Through Week 48
Title
Humoral immunogenicity outcome measures associated with HIV and IGRA status
Description
Mycobacteria-specific IgA, IgG, and IgM binding antibodies, measured using BAMA
Time Frame
Through Week 48
Title
Gene expression profiles
Description
Measured by RNA-seq in whole blood
Time Frame
Entry and Weeks 1, 4, and 10
Title
Differential leukocyte count and immunophenotype
Description
Measured in cryopreserved ex vivo whole blood (DLC-ICE) by flow cytometry
Time Frame
Entry and Weeks 1, 4, and 10
Title
Measurement of soluble proinflammatory mediators
Description
Based on serum measurement
Time Frame
Entry and Weeks 1, 4, and 10
Title
Acceptability of the study products
Description
Based on scores derived from questionnaire responses
Time Frame
Week 24
10. Eligibility
Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
14 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Parent or legal guardian is willing and able to provide written informed consent; when applicable potential participant is willing and able to provide written assent
Age 8-14 years (inclusive) at entry
Received birth dose of BCG vaccine
Has a negative nucleic acid test result for M.tb at screening and no other evidence of current active TB disease at screening
M.tb sensitization status (positive or negative) determined based on IGRA testing at screening
HIV status determined
For participants living with HIV: has been receiving antiretroviral therapy for at least six months prior to study entry, has a CD4+ cell count of at least 200 cells/mm^3 at screening, has had a suppressed HIV viral load for at least three months prior to entry
Has normal or grade 1 results for all of the following at screening: Hemoglobin, White blood cell count, Platelet count, Creatinine, ALT, AST, Total bilirubin
Has a normal temperature and no signs or symptoms of acute illness
For participants assigned female sex at birth or who could otherwise become pregnant: not pregnant
For participants assigned female sex at birth or who could otherwise breastfeed: not breastfeeding
Expected to be available for 48 weeks of study participation
Not expected to participate in any other study of an investigational agent during the 48 weeks of study participation
Exclusion Criteria:
Known significant exposure to TB or receipt of tuberculin skin test in the six months prior to study entry
Receipt of treatment for active TB disease in the 24 months prior to study entry
Receipt of TB preventive therapy within 30 days prior to study entry or expected to initiate TB preventive therapy within the 48 weeks following study entry
For participants living with HIV, current active AIDS-defining condition
Receipt of any of the following: Any investigational TB vaccine, More than 14 consecutive days of systemic immunosuppressants or other immune-modifying therapy within the six months prior to study entry, Any immunoglobulin or other blood product within the three months prior to study entry,
Receipt of any vaccine within the 30 days prior to study entry or is expected to receive any vaccine between study entry and the Week 4 Visit
Receipt of allergy treatment with an antigen injection within the 30 days prior to study entry or is expected to receive one or more antigen injections between study entry and the Week 48 Visit
History of any of the following: serious adverse reaction to any vaccine, allergy or hypersensitivity to BCG vaccine, allergy or hypersensitivity to the components of VPM1002 vaccine, anaphylaxis, generalized urticaria, autoimmune disease, diabetes mellitus type 1 or type 2, mild persistent, moderate, or severe asthma, bleeding disorder, malignancy, any condition resulting in the absence of a functional spleen (asplenia), including but not limited to sickle cell disease
History of seizure or use of any medication to prevent or treat seizure within the three years prior to entry
History of suspected or confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosed within the 30 days prior to entry
Any other documented or suspected clinically significant medical, psychiatric, or behavioral condition or any other condition that, in the opinion of the site investigator, would make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Emily Brown, MA
Phone
919-321-3806
Email
embrown@fhi360.org
First Name & Middle Initial & Last Name or Official Title & Degree
Charlotte Perlowski, MSPH
Phone
919-321-3581
Email
cperlowski@fhi360.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lisa Marie Cranmer, MD, MPH
Organizational Affiliation
Emory University
Official's Role
Study Chair
Facility Information:
Facility Name
Soweto IMPAACT CRS
City
Johannesburg
State/Province
Gauteng
ZIP/Postal Code
1862
Country
South Africa
Facility Name
Setshaba Research Centre CRS
City
Soshanguve
State/Province
Gauteng
Country
South Africa
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ntokozo Zuma-Gwala
Email
NZuma-Gwala@setshaba.org.za
First Name & Middle Initial & Last Name & Degree
Tendai Gladys Chipepera
Email
TChipepera@setshaba.org.za
Facility Name
Isipingo CRS
City
Soshanguve
State/Province
Kwa Zulu Natal
Country
South Africa
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dishiki Kalonji
Email
dishiki.kalonji@mrc.ac.za
First Name & Middle Initial & Last Name & Degree
Girisha Kistnasami
Email
girisha.kistnasami@mrc.ac.za
Facility Name
Klerksdorp CRS
City
Klerksdorp
State/Province
North West Province
Country
South Africa
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Oteng Letlape,
Email
oletlape@auruminstitute.org
First Name & Middle Initial & Last Name & Degree
Olebogeng Jonkane
Email
ojonkane@auruminstitute.org
Facility Name
Desmond Tutu TB Centre - Stellenbosch University (SU) CRS
City
Cape Town
State/Province
Western Cape
Country
South Africa
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anneke Hesseling
Email
annekeh@sun.ac.za
First Name & Middle Initial & Last Name & Degree
Mapule Mosid
Email
mmosidi@sun.ac.za
Facility Name
Emavundleni CRS
City
Cape Town
State/Province
Western Cape
Country
South Africa
Facility Name
Umlazi CRS
City
Durban
Country
South Africa
Facility Name
Wits RHI Shandukani Research CRS
City
Johannesburg
Country
South Africa
Facility Name
Family Clinical Research Unit (FAM-CRU) CRS
City
Tygerberg Hills
Country
South Africa
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Individual participant data that underlie results in the publication, after deidentification.
IPD Sharing Time Frame
Beginning 3 months following publication and available throughout period of funding of the International Maternal Pediatric Adolescent AIDS Clinical Trial (IMPAACT) Network by NIH.
IPD Sharing Access Criteria
With whom? Researchers who provide a methodologically sound proposal for use of the data that is approved by the IMPAACT Network.
For what types of analyses? To achieve aims in the proposal approved by the IMPAACT Network.
By what mechanism will data be made available?
Researchers may submit a request for access to data using the IMPAACT "Data Request" form at: https://www.impaactnetwork.org/studies/submit-research-proposal. Researchers of approved proposals will need to sign an IMPAACT Data Use Agreement before receiving the data.
IPD Sharing URL
https://www.impaactnetwork.org/studies/submit-research-proposal
Learn more about this trial
Safety and Immunogenicity of VPM1002 Vaccination or BCG Revaccination Against TB in Pre-Adolescents Living With and Without HIV in South Africa
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