search
Back to results

A Placebo Controlled Clinical Trial Investigating the Safety and Immunogenicity of GBS6 in Pregnant Women (PREPARE)

Primary Purpose

Group B Streptococcal Infection

Status
Recruiting
Phase
Phase 2
Locations
Uganda
Study Type
Interventional
Intervention
GBS6
Sponsored by
St George's, University of London
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Group B Streptococcal Infection

Eligibility Criteria

18 Years - 40 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria: Inclusion criteria for Maternal Participants Age ≥ 18 to ≤ 40 years of age, inclusive at day of signing the ICF. Pregnant at ≥ 27 0/7 to ≤35 6/7 gestation on the day of planned vaccination, verified by ultrasound scan (U/S). Low risk, singleton pregnancy, as assessed by the study physician based on ultra-sound scan and previous obstetric history. Documented negative HBV surface antigen, HCV antibody, and syphilis tests at screening. Documented HIV test during pregnancy undertaken as per the national guidelines. If HIV infected pregnant women, stable on ART for at least 3 months prior to study start Determined by medical history, physical examination, screening laboratory assessment, and clinical judgment to be appropriate for inclusion in the study. Receiving prenatal standard of care including HIV care if applicable at the clin-ics/physician offices/hospital network affiliated with the clinical study site. Willing to give birth at Kawempe Specialised National Referral Hospital, or Kisenyi Health center IV, Uganda. Willing and able to participate for the duration of the study visits and follow-up until 12-months post-delivery. Willing and able to be contacted by telephone for the full duration of the study, and to give informed consent for their infant participant to participate in the study. Inclusion criteria for Infants Inclusion criteria for Infants 1. Parent(s) willing and able to comply with scheduled visits, investigational plan, laboratory tests, and other study procedures. Exclusion Criteria: Exclusion criteria for Maternal Participants Any of the following: Investigator site staff members directly involved in the conduct of the study and their family members, site staff members otherwise supervised by the investigator, or participants who are Pfizer employees, including their family members, directly involved in the conduct of the study. Participants whose unborn baby have been fathered by investigational site staff members directly involved in the conduct of the study or their family members, site staff members otherwise supervised by the investigator, or Pfizer employees directly involved in the conduct of the study. Participation in other studies involving investigational drug(s), vaccines, or medical devices within 28 days prior to study entry and/or during study participation. Previous vaccination with any licensed or investigational GBS vaccine. History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g., anaphylaxis) to any component of the investigational product. History of microbiologically proven invasive disease caused by GBS, or history of an infant with GBS disease. Current alcohol abuse or illicit drug use. Body mass index (BMI) of ≥40 kg/m2 at the time of the screening visit. Clinical history of primary genital herpes simplex virus (HSV) infection during the current pregnancy. A prior history of or current pregnancy complications or abnormalities that will increase the risk associated with the participant's participation in, and completion of, the study, including but not limited to the following (refer to the SRM) for further details): Gestational hypertension or preeclampsia eclampsia Placental abnormality Polyhydramnios or oligohydramnios Significant bleeding or blood clotting disorder Gestational diabetes Any signs of premature labour with the current pregnancy Prior late stillbirth (defined as loss of pregnancy at any time after 28 weeks gestation) or neonatal death (defined as death of an infant within the first 28 days of life), prior low birth weight baby (defined as infant <2500 g) or premature delivery (defined as delivery before 37 0/7 weeks gestation), prior history of at least 3 miscarriages, prior pregnancies numbering greater than 5, or previous infant with a known or suspected genetic disorder or major congenital anomaly Confirmed GBS bacteriuria during the current pregnancy Major illness of the mother (outside of HIV serostatus) or conditions of the foetus that, in the investigator's judgment, will substantially increase the risk associated with the participant's participation in, and completion of, the study or could preclude the evaluation of the participant's response, including but not limited to the following (refer to the SRM) for further details): g. hypertension requiring treatment h. heart disease i. lung disease j. neurological disorders including a history of epilepsy or recurrent afebrile seizures k. kidney disease l. liver disease m. haematological disorders (including sickle cell disease) n. severe anaemia (less than 7.0g/dL) o. significant bleeding or blood clotting disorder p. endocrine disorders including known diabetes mellitus Participants with known or suspected immunodeficiency (outside of HIV positive sero-status). Participants who receive treatment with immunosuppressive therapy including cytotoxic agents or systemic corticosteroids, e.g., for cancer or an autoimmune disease, or planned receipt through the postvaccination blood draw. Inhaled/nebulised, intra articular, intra-bursal, or topical (skin or eyes) corticosteroids are permitted. Receipt of blood/plasma products or immunoglobulin, from 60 days before investigational product administration, or planned receipt through delivery. Known to be Rhesus Negative Psychiatric condition including recent (within the last year) or active suicidal ideation or behaviour or laboratory abnormalities that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study. Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalised involuntarily.

Sites / Locations

  • Makerere University, John Hopkins UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Active Comparator

Placebo Comparator

Active Comparator

Arm Label

Placebo (saline) in pregnancy HIV-uninfected pregnant woman

GBS6 in pregnancy HIV-uninfected pregnant woman

Placebo (saline) in pregnancy HIV-infected pregnant woman

GBS6 in pregnancy HIV-infected pregnant woman

Arm Description

1. HIV-uninfected women, placebo (saline) in pregnancy;

2. HIV-uninfected women, GBS6 in pregnancy;

3. HIV-infected women, placebo (saline) in pregnancy;

4. HIV-infected women, GBS6 in pregnancy;

Outcomes

Primary Outcome Measures

Primary mother outcome 1
1. Occurrence of solicited local reactions within 7 days following administration of investigational product (pain at the injection site, redness, and swelling).
Primary mother outcome 2
2. Occurrence of solicited systemic events within 7 days following administration of investigational product (fever, nausea/vomiting, diarrhoea, headache, fatigue/tiredness, muscle pain, and joint pain).
Primary mother outcome 3
3. Occurrence of solicited and unsolicited adverse events through 1 month after administration of investigational product.
Primary mother outcome 4
4. Occurrence of SAEs, MAEs, and obstetric complications (peripartum, intrapartum, and postpartum) throughout the study (Visit 1 through the 12 month postdelivery study visit) and any unsolicited events leading to study withdrawal.
Primary Infant outcome 1
1. Occurrence of unsolicited adverse events from birth to 6 weeks of age
Primary Infant outcome 2
2. Occurrence of SAEs, AEs of special interest (major congenital anomalies, developmental delay, and suspected or confirmed GBS infection), and MAEs through 12 months of age and any unsolicited events leading to study withdrawal.

Secondary Outcome Measures

Secondary mother Outcome 1
1. GBS serotype specific IgG antibody titres measured at baseline, 2 weeks, 1 month after vaccination, at delivery and 6 weeks after delivery in HIV positive and HIV negative women.
Secondary Mother Objective 2
2. GBS serotype specific OPA titres measured at baseline, and at delivery in HIV positive and HIV negative women.
Secondary infant Objective 1
1. GBS serotype specific IgG antibody titres in HIV-exposed and unexposed infant participants measured at birth, 18 weeks and 12 months of life.
Secondary infant Objective 2
2. GBS serotype specific OPA titres in HIV-exposed and unexposed infant participants measured at 18 weeks of life.
Secondary infant Objective 3
3. Placental transfer ratio of GBS-specific antibodies in HIV-exposed and unexposed pregnancies.

Full Information

First Posted
February 20, 2023
Last Updated
April 14, 2023
Sponsor
St George's, University of London
Collaborators
MU-JHU CARE, Pfizer
search

1. Study Identification

Unique Protocol Identification Number
NCT05832502
Brief Title
A Placebo Controlled Clinical Trial Investigating the Safety and Immunogenicity of GBS6 in Pregnant Women
Acronym
PREPARE
Official Title
A Placebo Controlled Clinical Trial Investigating the Safety and Immunogenicity of GBS6 in Pregnant Women With and Without Human Immunodeficiency Virus (HIV) Infection and Their Infants
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 14, 2022 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
St George's, University of London
Collaborators
MU-JHU CARE, Pfizer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A placebo controlled clinical trial investigating the safety and immunogenicity of GBS6 in pregnant women with and without human immunodeficiency virus (HIV) infection and their infants
Detailed Description
This Phase 2, randomised, placebo controlled, double blinded study will be the first evaluation of the investigational GBS6 in HIV-infected pregnant women. This study will enroll pregnant women with and without HIV to receive the GBS6 in order to provide an expanded safety and immunogenicity data set (for both pregnant women and their infants) and to support progression of the development of this vaccine.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Group B Streptococcal Infection

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Placebo (saline) in pregnancy HIV-uninfected pregnant woman
Arm Type
Placebo Comparator
Arm Description
1. HIV-uninfected women, placebo (saline) in pregnancy;
Arm Title
GBS6 in pregnancy HIV-uninfected pregnant woman
Arm Type
Active Comparator
Arm Description
2. HIV-uninfected women, GBS6 in pregnancy;
Arm Title
Placebo (saline) in pregnancy HIV-infected pregnant woman
Arm Type
Placebo Comparator
Arm Description
3. HIV-infected women, placebo (saline) in pregnancy;
Arm Title
GBS6 in pregnancy HIV-infected pregnant woman
Arm Type
Active Comparator
Arm Description
4. HIV-infected women, GBS6 in pregnancy;
Intervention Type
Drug
Intervention Name(s)
GBS6
Other Intervention Name(s)
Hexavalent anti capsular polysaccharide (CPS) / cross reactive material 197 glycoconjugate
Intervention Description
The investigational products are GBS6 and placebo (saline control). The GBS6 dose will be GBS6 20mcg without AlPO4 (equivalent to 240 mcg/mL) 0.5mL dose or 20 mcg CPS/serotype).
Primary Outcome Measure Information:
Title
Primary mother outcome 1
Description
1. Occurrence of solicited local reactions within 7 days following administration of investigational product (pain at the injection site, redness, and swelling).
Time Frame
2 years
Title
Primary mother outcome 2
Description
2. Occurrence of solicited systemic events within 7 days following administration of investigational product (fever, nausea/vomiting, diarrhoea, headache, fatigue/tiredness, muscle pain, and joint pain).
Time Frame
2 years
Title
Primary mother outcome 3
Description
3. Occurrence of solicited and unsolicited adverse events through 1 month after administration of investigational product.
Time Frame
2 years
Title
Primary mother outcome 4
Description
4. Occurrence of SAEs, MAEs, and obstetric complications (peripartum, intrapartum, and postpartum) throughout the study (Visit 1 through the 12 month postdelivery study visit) and any unsolicited events leading to study withdrawal.
Time Frame
2 years
Title
Primary Infant outcome 1
Description
1. Occurrence of unsolicited adverse events from birth to 6 weeks of age
Time Frame
2 years
Title
Primary Infant outcome 2
Description
2. Occurrence of SAEs, AEs of special interest (major congenital anomalies, developmental delay, and suspected or confirmed GBS infection), and MAEs through 12 months of age and any unsolicited events leading to study withdrawal.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Secondary mother Outcome 1
Description
1. GBS serotype specific IgG antibody titres measured at baseline, 2 weeks, 1 month after vaccination, at delivery and 6 weeks after delivery in HIV positive and HIV negative women.
Time Frame
2 years
Title
Secondary Mother Objective 2
Description
2. GBS serotype specific OPA titres measured at baseline, and at delivery in HIV positive and HIV negative women.
Time Frame
2 years
Title
Secondary infant Objective 1
Description
1. GBS serotype specific IgG antibody titres in HIV-exposed and unexposed infant participants measured at birth, 18 weeks and 12 months of life.
Time Frame
2 years
Title
Secondary infant Objective 2
Description
2. GBS serotype specific OPA titres in HIV-exposed and unexposed infant participants measured at 18 weeks of life.
Time Frame
2 years
Title
Secondary infant Objective 3
Description
3. Placental transfer ratio of GBS-specific antibodies in HIV-exposed and unexposed pregnancies.
Time Frame
2 years
Other Pre-specified Outcome Measures:
Title
Mother Exploratory outcome 1
Description
1. Fold increase in GBS serotype specific IgG antibody titres over baseline measured before vaccination through 12 months after delivery in HIV positive and HIV negative women.
Time Frame
2 years
Title
Mother Exploratory outcome 2
Description
2. Serotype specific GBS positive vaginal and/or rectal culture(s) before vaccination, at delivery, and 6 weeks after delivery in HIV positive and HIV negative women.
Time Frame
2 years
Title
Mother Exploratory outcome 3
Description
3. GBS serotype specific IgG and IgA antibody titres in breast milk following vaccination of women living with HIV and their unexposed counterparts in colostrum (within 72 hours of delivery) and breast milk at 6 and 18 weeks after delivery.
Time Frame
2 years
Title
Infant Exploratory outcome 1
Description
IgG antibody titres to vaccines included in the extended programme of vaccination administered to HIV-exposed and unexposed infant participants as part of at 18 weeks and 12 months of age.
Time Frame
2 years
Title
Infant Exploratory outcome 2
Description
2. Serotype specific GBS positive nasal/rectal cultures at delivery, 6 weeks and 18 weeks after delivery in infant participants.
Time Frame
2 years
Title
Infant Exploratory outcome 3
Description
3. GBS serotype specific IgG antibody titres measured from dried blood spots in infant participants at birth.
Time Frame
2 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Inclusion criteria for Maternal Participants Age ≥ 18 to ≤ 40 years of age, inclusive at day of signing the ICF. Pregnant at ≥ 27 0/7 to ≤35 6/7 gestation on the day of planned vaccination, verified by ultrasound scan (U/S). Low risk, singleton pregnancy, as assessed by the study physician based on ultra-sound scan and previous obstetric history. Documented negative HBV surface antigen, HCV antibody, and syphilis tests at screening. Documented HIV test during pregnancy undertaken as per the national guidelines. If HIV infected pregnant women, stable on ART for at least 3 months prior to study start Determined by medical history, physical examination, screening laboratory assessment, and clinical judgment to be appropriate for inclusion in the study. Receiving prenatal standard of care including HIV care if applicable at the clin-ics/physician offices/hospital network affiliated with the clinical study site. Willing to give birth at Kawempe Specialised National Referral Hospital, or Kisenyi Health center IV, Uganda. Willing and able to participate for the duration of the study visits and follow-up until 12-months post-delivery. Willing and able to be contacted by telephone for the full duration of the study, and to give informed consent for their infant participant to participate in the study. Inclusion criteria for Infants Inclusion criteria for Infants 1. Parent(s) willing and able to comply with scheduled visits, investigational plan, laboratory tests, and other study procedures. Exclusion Criteria: Exclusion criteria for Maternal Participants Any of the following: Investigator site staff members directly involved in the conduct of the study and their family members, site staff members otherwise supervised by the investigator, or participants who are Pfizer employees, including their family members, directly involved in the conduct of the study. Participants whose unborn baby have been fathered by investigational site staff members directly involved in the conduct of the study or their family members, site staff members otherwise supervised by the investigator, or Pfizer employees directly involved in the conduct of the study. Participation in other studies involving investigational drug(s), vaccines, or medical devices within 28 days prior to study entry and/or during study participation. Previous vaccination with any licensed or investigational GBS vaccine. History of severe adverse reaction associated with a vaccine and/or severe allergic reaction (e.g., anaphylaxis) to any component of the investigational product. History of microbiologically proven invasive disease caused by GBS, or history of an infant with GBS disease. Current alcohol abuse or illicit drug use. Body mass index (BMI) of ≥40 kg/m2 at the time of the screening visit. Clinical history of primary genital herpes simplex virus (HSV) infection during the current pregnancy. A prior history of or current pregnancy complications or abnormalities that will increase the risk associated with the participant's participation in, and completion of, the study, including but not limited to the following (refer to the SRM) for further details): Gestational hypertension or preeclampsia eclampsia Placental abnormality Polyhydramnios or oligohydramnios Significant bleeding or blood clotting disorder Gestational diabetes Any signs of premature labour with the current pregnancy Prior late stillbirth (defined as loss of pregnancy at any time after 28 weeks gestation) or neonatal death (defined as death of an infant within the first 28 days of life), prior low birth weight baby (defined as infant <2500 g) or premature delivery (defined as delivery before 37 0/7 weeks gestation), prior history of at least 3 miscarriages, prior pregnancies numbering greater than 5, or previous infant with a known or suspected genetic disorder or major congenital anomaly Confirmed GBS bacteriuria during the current pregnancy Major illness of the mother (outside of HIV serostatus) or conditions of the foetus that, in the investigator's judgment, will substantially increase the risk associated with the participant's participation in, and completion of, the study or could preclude the evaluation of the participant's response, including but not limited to the following (refer to the SRM) for further details): g. hypertension requiring treatment h. heart disease i. lung disease j. neurological disorders including a history of epilepsy or recurrent afebrile seizures k. kidney disease l. liver disease m. haematological disorders (including sickle cell disease) n. severe anaemia (less than 7.0g/dL) o. significant bleeding or blood clotting disorder p. endocrine disorders including known diabetes mellitus Participants with known or suspected immunodeficiency (outside of HIV positive sero-status). Participants who receive treatment with immunosuppressive therapy including cytotoxic agents or systemic corticosteroids, e.g., for cancer or an autoimmune disease, or planned receipt through the postvaccination blood draw. Inhaled/nebulised, intra articular, intra-bursal, or topical (skin or eyes) corticosteroids are permitted. Receipt of blood/plasma products or immunoglobulin, from 60 days before investigational product administration, or planned receipt through delivery. Known to be Rhesus Negative Psychiatric condition including recent (within the last year) or active suicidal ideation or behaviour or laboratory abnormalities that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study. Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalised involuntarily.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kirsty Le Doare, Prof
Phone
020 8672 9944
Email
Kiledoar@sgul.ac.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Rakan Musleh, MSc
Phone
020 8672 9944
Email
Rmusleh@sgul.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Musa sekikubo, Prof
Organizational Affiliation
Makerere University - John Hopkins University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Makerere University, John Hopkins University
City
Kawempe
Country
Uganda
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robert Mboizi
Email
rmboizi@mujhu.org

12. IPD Sharing Statement

Learn more about this trial

A Placebo Controlled Clinical Trial Investigating the Safety and Immunogenicity of GBS6 in Pregnant Women

We'll reach out to this number within 24 hrs