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A Study to Determine the Safety and Immunogenicity of Bivalent GI.1 and GII.4 Vaccines in Healthy Volunteers

Primary Purpose

Norovirus Infections

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Open label Bivalent GII.4/GI.1 high dose vaccine 2×10 to the power 11 IU/dose
Bivalent GII.4/GI.1 high dose vaccine 2×10 to the power 11 IU/dose
Bivalent GII.4/GI.1 medium dose vaccine 1×10 to the power 11 IU/dose
Placebo
Sponsored by
Vaxart
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Norovirus Infections

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Key Inclusion Criteria: To be eligible for this study, subjects must meet all the following: In stable and good general health, without significant medical illness, based on medical history, physical examination, and vital signs at screening based on investigator judgement. Body mass index (BMI) between >/= 17.0 and </= 35.0 kg/m2 at screening SNG. Available for all planned visits and tele-health appointment, and willing to complete all protocol-defined procedures and assessments (including ability and willingness to swallow multiple small enteric-coated tablets per study dose). Female subjects must not be breastfeeding and must provide a negative pregnancy test at screening and pre-dose. Female subjects must fulfill one of the following criteria: i. At least 1 year post-menopausal (defined as amenorrhea for greater than or equal to 12 consecutive months prior to screening without alternative medical cause) or surgically sterile. ii. Female subjects of childbearing potential must be willing to use a highly effective form of contraception for 30 days prior to initial vaccination and until 60 days after last vaccination. Acceptable forms are oral, implantable, intrauterine, transdermal, intravaginal, injectable, double barrier or abstinence (subjects using diaphragms must also use condom). The form of contraception must be approved by the investigator. iii. Male subjects must agree to practice abstinence from heterosexual intercourse or to use an effective method of birth control as noted above from first vaccination to 60 days after last vaccination. Male subjects must agree to refrain from donating sperm and practice abstinence from all intercourse or to use an effective method of double barrier birth control or condom as noted above from first vaccination to 60 days after last vaccination. Capable of understanding and giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in the protocol. Key Exclusion Criteria: The subjects must be excluded from participating in the study if they meet any of the following: Known clotting/bleeding issues and/or personal and family history with increased risk of bleeding or clotting. Presence of significant uncontrolled medical or psychiatric illness (acute or chronic) including institution of new medical/surgical treatment or significant dose alteration for uncontrolled symptoms or drug toxicity within 3 months prior to screening and reconfirmed at baseline. Cancer, or treatment for cancer or any procedure or preventive medication for cancer or to prevent recurrence, within past 3 years (excluding fully treated and resolved basal cell carcinoma or squamous cell carcinoma) Presence of immunosuppression or medical condition possibly associated with impaired immune responsiveness, including diabetes mellitus- type 1 and 2 History of irritable bowel disease or other inflammatory digestive or gastrointestinal condition that could affect the distribution/safety evaluation of an orally administered vaccine targeting the mucosa of the small intestine. Such conditions may include but are not limited to: a. Any history of: i. GI malignancy ii. malabsorption iii. pancreatobiliary disorders iv. inflammatory bowel disease v. irritable bowel disease vi. hiatal hernia vii. surgical resection b. History of diagnosis or treatment in past 5 years of: i. esophageal or gastric motility disorder ii. gastro esophageal reflux disorder iii. peptic ulcer iv. cholecystectomy History of any form of angioedema History of serious reactions to vaccination such as anaphylaxis, respiratory problems, hives or abdominal pain Diagnosed bleeding disorder or significant bruising or bleeding difficulties that could make blood draws problematic. Any condition that resulted in the absence or removal of the spleen Acute disease within 72 hours prior to vaccination defined as the presence of a moderate or severe illness (as determined by the investigator through medical history and physical exam). (Assessment may be repeated once during Screening Period) Presence of a fever greater than or equal to 38°C measured orally at baseline. Any significant hospitalization within the last year which in the opinion of the investigator or sponsor could interfere with study participation. Any history or conditions that may lead to higher risk of clotting events and/or thrombocytopenia: Family or personal history of bleeding or thrombosis. History of heparin-related thrombotic events, and/or receiving heparin treatments. History of autoimmune or inflammatory disease. Presence of any of the following conditions known to increase risk of thrombosis within 6 months prior to screening: i. Recent surgery other than removal/biopsy of cutaneous lesions ii. Immobility (confined to bed or wheelchair for 3 or more successive days) iii. Head trauma with loss of consciousness or documented brain injury iv. Receipt of anticoagulants for prophylaxis of thrombosis v. Recent clinically significant infection, including hospitalization for COVID-19 infection. Any other condition that in the clinical judgement of the investigator would jeopardize the safety or rights of a subject taking the study drug, would render the subject unable to comply within the protocol or would interfere with the evaluation of the study endpoints diagnostic assessments. Positive human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg) or Hepatitis C virus (HCV) tests at the screening visit. History of GI bleeding including hematochezia (blood in stool) or melena (black stool) Positive urine drug screen for drugs of abuse at screening (positive test for marijuana is not exclusionary; however concurrent use of marijuana during the study Active period through Day 29 is prohibited). Positive breath or urine alcohol test at screening and baseline. Receipt of a licensed vaccine (including any COVID-19 vaccines under emergency use authorization) within 14 days prior to baseline vaccination or planned administration during the study active period (Day 29). Use of antibiotics, proton pump inhibitors, H2 blockers or antacids within 7 days prior to study drug administration or planned use during the active study period (Day 29). Use of medications known to affect the immune function (e.g., including but not limited to systemic corticosteroids, leukotriene modifiers, and JAK inhibitors) within 2 weeks before study drug administration or planned use during the active study period (Day 29). Daily use of nonsteroidal anti-inflammatory drugs within 7 days prior to study drug administration or planned use during the active study period (Day 29). Low dose daily ASA less than or equal to 100 mg for cardio-protection is not exclusionary. Administration of any investigational vaccine, drug or device within 8 weeks preceding study drug administration, or planned use within the duration of the study Previous participation in a Vaxart Clinical Trial or other NoV vaccine trial unless confirmed receipt of placebo. Donation or use of blood or blood products within 30 days prior to study drug administration or planned donation during the active study period (Day 29). History of drug, alcohol, or chemical abuse within 1 year of screening. History of hypersensitivity or allergic reaction to any component of the investigational vaccine, including but not limited to fish gelatin allergy.

Sites / Locations

  • Ark Clinical Research
  • Johnson County Clin-Trials
  • Nucleus Network Pty Ltd

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Open Label Sentinel

Medium Dose Arm

High Dose Arm

Placebo Arm

Arm Description

Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets total dose is 2×10 to the power 11 IU/dose (sentinel n=10)

Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 medium dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 5×10 to the power 10 tablets total dose is 1×10 to the power 11 IU/dose (N=50)

Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets total dose is 2×10 to the power 11 IU/dose (N=50)

Placebo tablets (N= 25)

Outcomes

Primary Outcome Measures

The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration and severity of Solicited Symptoms of Reactogenicity (GI and systemic)
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of unsolicited adverse events (AEs)
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of serious adverse event (SAEs).
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of adverse event of special interest (AESIs).
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of New Onset of Chronic Illness (NOCIs).
The immunogenicity of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Geometric mean concentration (GMC) of Serum -Anti IgA for both vaccines
The immunogenicity of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Geometric mean fold rise (GMFR) of Serum -Anti IgA for both vaccines

Secondary Outcome Measures

Full Information

First Posted
November 15, 2022
Last Updated
July 28, 2023
Sponsor
Vaxart
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1. Study Identification

Unique Protocol Identification Number
NCT05626803
Brief Title
A Study to Determine the Safety and Immunogenicity of Bivalent GI.1 and GII.4 Vaccines in Healthy Volunteers
Official Title
A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled, Single Dose, Dose-ranging Study to Determine the Safety and Immunogenicity of Bivalent GI.1 and GII.4 Vaccine Administered Orally to Healthy Volunteers Aged Greater Than or Equal to 18 Years and Less Than or Equal to 80 Years Old.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 28, 2022 (Actual)
Primary Completion Date
June 22, 2023 (Actual)
Study Completion Date
February 29, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vaxart

4. Oversight

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

5. Study Description

Brief Summary
This study is designed to evaluate the safety and immunogenicity of two monovalent Norovirus (NoV) oral tableted vaccine candidates, VXA-G1.1-NN and VXA-GII.4-NS co-administered (bivalent delivery) against a matching placebo arm. Bivalent GI.1 and GII.4 vaccines are being investigated for the prevention of noroviral gastroenteritis caused by norovirus GI.1 and GII.4.
Detailed Description
Norovirus infections are a leading cause of sporadic and epidemic gastroenteritis across all age groups worldwide. This study is designed as a standard double-blind placebo-controlled single administration, dose ranging study to evaluate the safety and immunogenicity of 2 different doses of VXA-GII.4-NS plus VXA-G1.1-NN (high and medium dose administered orally for the prevention of Norovirus infection), compared with a placebo. This study will enroll a total of 135 subjects with10 sentinel subjects in an open label period (dosing staggered to not-more-than 2 subjects per 24 hours) and randomize 125 subjects in three arms. The first 10 sentinel subjects will receive the open label high dose of active vaccine. If no dose-related toxicities are observed, and upon the recommendation of the SMC following review of safety data, subjects will be randomized in a 2:2:1 ratio to one of the 3 study arms to receive active vaccine or placebo. After vaccination on Day 1, the study will include an Active Study Period that runs through 4 weeks after administration (Day 29), and a Follow-up Period of one year for safety and duration of immune response.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Norovirus Infections

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
135 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Open Label Sentinel
Arm Type
Experimental
Arm Description
Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets total dose is 2×10 to the power 11 IU/dose (sentinel n=10)
Arm Title
Medium Dose Arm
Arm Type
Experimental
Arm Description
Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 medium dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 5×10 to the power 10 tablets total dose is 1×10 to the power 11 IU/dose (N=50)
Arm Title
High Dose Arm
Arm Type
Experimental
Arm Description
Bivalent GII.4/GI.1 vaccine Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets total dose is 2×10 to the power 11 IU/dose (N=50)
Arm Title
Placebo Arm
Arm Type
Placebo Comparator
Arm Description
Placebo tablets (N= 25)
Intervention Type
Drug
Intervention Name(s)
Open label Bivalent GII.4/GI.1 high dose vaccine 2×10 to the power 11 IU/dose
Intervention Description
The first 10 sentinel subjects will receive open label high dose of active vaccine. Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets; total dose is 2×10 to the power 11 IU/dose
Intervention Type
Drug
Intervention Name(s)
Bivalent GII.4/GI.1 high dose vaccine 2×10 to the power 11 IU/dose
Intervention Description
50 subjects will receive high dose of active vaccine. Bivalent GII.4/GI.1 high dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 1×10 to the power 11 tablets; total dose is 2×10 to the power 11 IU/dose
Intervention Type
Drug
Intervention Name(s)
Bivalent GII.4/GI.1 medium dose vaccine 1×10 to the power 11 IU/dose
Intervention Description
50 subjects will receive Bivalent GII.4/GI.1 medium dose vaccine (VXA-GII.4-NS plus VXA-G1.1-NN) 5×10 to the power 10 tablets; total dose is 1×10 to the power 11 IU/dose
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
25 subjects will receive matching placebo
Primary Outcome Measure Information:
Title
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration and severity of Solicited Symptoms of Reactogenicity (GI and systemic)
Time Frame
Up to 1 week
Title
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of unsolicited adverse events (AEs)
Time Frame
Up to 28 days
Title
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of serious adverse event (SAEs).
Time Frame
Up to 1 year
Title
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of adverse event of special interest (AESIs).
Time Frame
Up to 1 year
Title
The safety of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Frequency, duration, and severity of New Onset of Chronic Illness (NOCIs).
Time Frame
Up to 1 year
Title
The immunogenicity of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Geometric mean concentration (GMC) of Serum -Anti IgA for both vaccines
Time Frame
Up to Day 180
Title
The immunogenicity of a bivalent dosing regimen of GI.1 and GII.4, to select the dose level with which to safely proceed into Phase 3 development. Parameter: Geometric mean fold rise (GMFR) of Serum -Anti IgA for both vaccines
Time Frame
Up to Day 180

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Key Inclusion Criteria: To be eligible for this study, subjects must meet all the following: In stable and good general health, without significant medical illness, based on medical history, physical examination, and vital signs at screening based on investigator judgement. Body mass index (BMI) between >/= 17.0 and </= 35.0 kg/m2 at screening SNG. Available for all planned visits and tele-health appointment, and willing to complete all protocol-defined procedures and assessments (including ability and willingness to swallow multiple small enteric-coated tablets per study dose). Female subjects must not be breastfeeding and must provide a negative pregnancy test at screening and pre-dose. Female subjects must fulfill one of the following criteria: i. At least 1 year post-menopausal (defined as amenorrhea for greater than or equal to 12 consecutive months prior to screening without alternative medical cause) or surgically sterile. ii. Female subjects of childbearing potential must be willing to use a highly effective form of contraception for 30 days prior to initial vaccination and until 60 days after last vaccination. Acceptable forms are oral, implantable, intrauterine, transdermal, intravaginal, injectable, double barrier or abstinence (subjects using diaphragms must also use condom). The form of contraception must be approved by the investigator. iii. Male subjects must agree to practice abstinence from heterosexual intercourse or to use an effective method of birth control as noted above from first vaccination to 60 days after last vaccination. Male subjects must agree to refrain from donating sperm and practice abstinence from all intercourse or to use an effective method of double barrier birth control or condom as noted above from first vaccination to 60 days after last vaccination. Capable of understanding and giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in the protocol. Key Exclusion Criteria: The subjects must be excluded from participating in the study if they meet any of the following: Known clotting/bleeding issues and/or personal and family history with increased risk of bleeding or clotting. Presence of significant uncontrolled medical or psychiatric illness (acute or chronic) including institution of new medical/surgical treatment or significant dose alteration for uncontrolled symptoms or drug toxicity within 3 months prior to screening and reconfirmed at baseline. Cancer, or treatment for cancer or any procedure or preventive medication for cancer or to prevent recurrence, within past 3 years (excluding fully treated and resolved basal cell carcinoma or squamous cell carcinoma) Presence of immunosuppression or medical condition possibly associated with impaired immune responsiveness, including diabetes mellitus- type 1 and 2 History of irritable bowel disease or other inflammatory digestive or gastrointestinal condition that could affect the distribution/safety evaluation of an orally administered vaccine targeting the mucosa of the small intestine. Such conditions may include but are not limited to: a. Any history of: i. GI malignancy ii. malabsorption iii. pancreatobiliary disorders iv. inflammatory bowel disease v. irritable bowel disease vi. hiatal hernia vii. surgical resection b. History of diagnosis or treatment in past 5 years of: i. esophageal or gastric motility disorder ii. gastro esophageal reflux disorder iii. peptic ulcer iv. cholecystectomy History of any form of angioedema History of serious reactions to vaccination such as anaphylaxis, respiratory problems, hives or abdominal pain Diagnosed bleeding disorder or significant bruising or bleeding difficulties that could make blood draws problematic. Any condition that resulted in the absence or removal of the spleen Acute disease within 72 hours prior to vaccination defined as the presence of a moderate or severe illness (as determined by the investigator through medical history and physical exam). (Assessment may be repeated once during Screening Period) Presence of a fever greater than or equal to 38°C measured orally at baseline. Any significant hospitalization within the last year which in the opinion of the investigator or sponsor could interfere with study participation. Any history or conditions that may lead to higher risk of clotting events and/or thrombocytopenia: Family or personal history of bleeding or thrombosis. History of heparin-related thrombotic events, and/or receiving heparin treatments. History of autoimmune or inflammatory disease. Presence of any of the following conditions known to increase risk of thrombosis within 6 months prior to screening: i. Recent surgery other than removal/biopsy of cutaneous lesions ii. Immobility (confined to bed or wheelchair for 3 or more successive days) iii. Head trauma with loss of consciousness or documented brain injury iv. Receipt of anticoagulants for prophylaxis of thrombosis v. Recent clinically significant infection, including hospitalization for COVID-19 infection. Any other condition that in the clinical judgement of the investigator would jeopardize the safety or rights of a subject taking the study drug, would render the subject unable to comply within the protocol or would interfere with the evaluation of the study endpoints diagnostic assessments. Positive human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg) or Hepatitis C virus (HCV) tests at the screening visit. History of GI bleeding including hematochezia (blood in stool) or melena (black stool) Positive urine drug screen for drugs of abuse at screening (positive test for marijuana is not exclusionary; however concurrent use of marijuana during the study Active period through Day 29 is prohibited). Positive breath or urine alcohol test at screening and baseline. Receipt of a licensed vaccine (including any COVID-19 vaccines under emergency use authorization) within 14 days prior to baseline vaccination or planned administration during the study active period (Day 29). Use of antibiotics, proton pump inhibitors, H2 blockers or antacids within 7 days prior to study drug administration or planned use during the active study period (Day 29). Use of medications known to affect the immune function (e.g., including but not limited to systemic corticosteroids, leukotriene modifiers, and JAK inhibitors) within 2 weeks before study drug administration or planned use during the active study period (Day 29). Daily use of nonsteroidal anti-inflammatory drugs within 7 days prior to study drug administration or planned use during the active study period (Day 29). Low dose daily ASA less than or equal to 100 mg for cardio-protection is not exclusionary. Administration of any investigational vaccine, drug or device within 8 weeks preceding study drug administration, or planned use within the duration of the study Previous participation in a Vaxart Clinical Trial or other NoV vaccine trial unless confirmed receipt of placebo. Donation or use of blood or blood products within 30 days prior to study drug administration or planned donation during the active study period (Day 29). History of drug, alcohol, or chemical abuse within 1 year of screening. History of hypersensitivity or allergic reaction to any component of the investigational vaccine, including but not limited to fish gelatin allergy.
Facility Information:
Facility Name
Ark Clinical Research
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Johnson County Clin-Trials
City
Lenexa
State/Province
Kansas
ZIP/Postal Code
66219
Country
United States
Facility Name
Nucleus Network Pty Ltd
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55114
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Determine the Safety and Immunogenicity of Bivalent GI.1 and GII.4 Vaccines in Healthy Volunteers

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