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A Phase 1 Ascending Dose Study to Assess the Safety and Immunogenicity of Adenovirus Anthrax Vector Candidate Vaccines

Primary Purpose

Anthrax Infection

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AVA
Ad4-PA-1
Ad4-PA-GPI-1
Sponsored by
Emergent BioSolutions
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Anthrax Infection focused on measuring Anthrax vaccine

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Able to understand the study and give written informed consent.
  • Healthy men or women aged 18-40 years old,
  • BMI between 18 to 36 kg/m2
  • Women of child bearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test prior to vaccination on all vaccination days; they must also be willing to use adequate birth control for the duration of the study and have additional pregnancy tests if indicated.
  • Intact upper arms with sufficient muscular tissue in the deltoid region for IM vaccine administration.
  • Subject must be available for the study duration
  • Subject must avoid strenuous exercise for at least 72 hours prior to each study vaccine administration.

Exclusion Criteria:

  • Subject is a healthcare worker who has direct contact with patients or has an household contact (HHC) who is immunodeficient or HIV-positive, pregnant, has an unstable medical condition, or is under the age of 18.
  • Subject is a childcare worker or a parent who has direct contact with children 5 years old and younger.
  • Subject directly prepares food in the food industry.
  • Pregnant or breastfeeding throughout the duration of the study until the final visit
  • Military service between 1971 and 1999, or after 2012 when Ad4 vaccine was/is routinely given
  • Employment in an industry involved in contact with ruminant animals, veterinary sciences, or other potential exposure to B. anthracis
  • Received previous Ad4 vaccination or experimental Ad4 vector vaccines
  • Received previous anthrax vaccine
  • Received or plans to receive any other approved or investigational vaccines from 30 days prior to the first study vaccination until 30 days after the final study vaccination for live attenuated vaccines and from 15 days prior to the first study vaccination until 15 days after the final study vaccination for inactivated vaccines
  • HIV or Hepatitis B or C positive
  • Immunodeficient or has an unstable medical condition including psychiatric conditions
  • Active or past history of acute or chronic gastrointestinal conditions
  • Active or past history of cancer except basal cell carcinoma
  • Recipient of bone marrow or solid organ transplant
  • Received or plans to receive systemic antiviral medication, within 30 days prior to the first study vaccination
  • Known allergy to any component of the study vaccine
  • Known allergy to, or known medical condition that precludes use of any systemic antiviral medication
  • Received or plans to receive medications indicated for decreasing acidity of stomach including:
  • Proton pump inhibitors or antacids or histamine 2-receptor antagonists
  • Received or plans to receive immunoglobulin or other blood products within 60 days prior to the first study vaccination
  • Received or plans to receive other investigational drugs within 30 days prior to the first study vaccination
  • Received or plans to receive systemic immunosuppressive therapy, radiation therapy, or inhaled steroids within 30 days prior to the first study vaccination
  • Asthmatic or requires asthmatic medications on a daily basis
  • Use of systemic chemotherapy within 5 years prior to study
  • Body temperature >38.1°C or acute illness within 3 days prior to vaccination
  • History of excessive alcohol consumption, drug abuse, or significant psychiatric illness
  • History of Guillain-Barré Syndrome
  • Blood donation within 2 months prior to first study vaccination
  • Expected to be noncompliant with study visits or plans to move away or be living with different HHCs during the next 8 months
  • Drinks more than 1200 mL of tea/coffee/cocoa/cola or other caffeinated beverage per day.
  • Any condition or finding that in the view of the primary investigator would impede full study participation

Sites / Locations

  • The Center for Pharmaceutical Research
  • Walter Reed Army Institute for Research
  • St. Louis University
  • Coastal Carolina Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Active Comparator

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

AVA

Ad4-PA-1

Ad4-PA-2

Ad4-PA-3

Ad4-PA-GPI-1

Ad4 PA-GPI-2

Ad4-PA-GPI -3

Arm Description

Anthrax Vaccine Adsorbed (0.5 mL) as the placebo control on Days 1, 15 and 29

Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Day 1 + oral placebo on Day 15 + AVA boost at Day 29

Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Days 1, 15 and 29

Ad4 given at 10^9, 10^10 and 10^11 vp Ad4 PA-GPI at Day 1 + AVA boost at Day 15 + placebo on Day 29

Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + oral placebo on Day 29 + AVA boost at Day 15

Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + placebo on Day 15 + AVA boost at Day 29

Given at 10^9, 10^10 and 10^11 viral particles Ad4-PA-GPI at Days 1, 15 and 29

Outcomes

Primary Outcome Measures

The safety, tolerability and immunogenicity of the Ad4 PA and Ad4 PA GPI vaccines across a range of dosages and schedules.
Safety will be measured by looking at safety labs, Adverse Events (AEs) and vaccine reactogenicity data from Baseline through Day 211. Immunogenicity will be measured by the peak serum antibody response to the PA transgene defined as the highest toxin-neutralizing antibody (TNA) titer achieved by a subject at any time between the first post-vaccination visit though Day 85 (and Day 211 if Day 85 is positive).

Secondary Outcome Measures

Antibody response of the Ad4-PA formulation to Ad4 PA GPI
Antibody response will be tested via enzyme-linked immunosorbent assay (ELISA) and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85
Antibody response of the Ad4-PA and Ad4-PA-GPI vaccination regimens to the anticipated AVA PEP regimen.
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85.
Antibody response induced by 3 different dosages of Ad4 PA and Ad4 PA GPI.
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85 and titers will be compared across the 3 different dosages of Ad4 PA and Ad4 PA GPI (10^9, 10^10, 10^11).
TNA and antibody response induced by Ad4 PA and Ad4 PA GPI on 3 different vaccination schedules.
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85, and compared among 3 vaccine schedules: Day 1: Ad4-PA or Ad4-PA-GPI, Day 15 placebo Day 29 AVA boost; Day 1:Ad4-PA or Ad4-PA-GPI, Day 15 AVA boost + Placebo; and Days 1, 15 and 29: Ad4-PA or Ad4-PA-GPI
Pre-existing Ad4 immunity on TNA and PA-ELISA response induced by Ad4 PA and Ad4 PA GPI.
Antibody response will be tested via ELISA and the impact of pre-existing Ad4 serostatus (positive/negative) on TNA and PA-ELISA will be evaluated
Evaluate the kinetics of the TNA and PA-ELISA antibody response induced by 3 different doses of Ad4 PA and Ad4 PA GPI on 3 different administration schedules.
TNA and PA-ELISA titer at each post-vaccination visit as measured by ELISA will be compared across each dose group (10^9, 10^10 and 10^11 vp) and dosing schedule. In addition, the time to peak pre-boost TNA titer and to peak pre-boost PA-ELISA titer will be compared across each dose group and dosing schedule. Cumulative TNA and PA-ELISA seroconversion through each post-vaccination visit and through Day 85
In vivo replication/excretion of the Ad4 PA and Ad4 PA GPI vaccines
The duration of in vivo replication/excretion will be measured by the Ad4 MN seroconversion and titer measured via ELISA testing. Vaccine take defined as either Ad4 micro-neutralizing (MN) seroconversion and/or detection of vaccine shedding measured by polymerase chain reaction (PCR) and confirmed by culture at any time point from Day 1 through Day 211

Full Information

First Posted
October 16, 2013
Last Updated
March 3, 2020
Sponsor
Emergent BioSolutions
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1. Study Identification

Unique Protocol Identification Number
NCT01979406
Brief Title
A Phase 1 Ascending Dose Study to Assess the Safety and Immunogenicity of Adenovirus Anthrax Vector Candidate Vaccines
Official Title
A Phase 1 Randomized Double-Blind Positive-Controlled Ascending Dose Study to Evaluate the Safety and Immunogenicity of a Replication-Competent Adenovirus Serotype 4 Anthrax Vector Candidate Vaccines - Ad4-PA (Protective Antigen)and Ad4-PA-GPI (Glycosylphosphatidylinositol)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
November 2013 (undefined)
Primary Completion Date
October 2014 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Emergent BioSolutions

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate 2 vaccine candidates against anthrax compared to the positive (vaccine) control as studied in normal healthy volunteers.
Detailed Description
A Phase 1, randomized, double-blind, positive controlled, increasing dose clinical trial in healthy adult subjects at multiple sites. The study will assess safety and immunogenicity of two adenovirus vaccine candidates against anthrax compared to the positive control, Anthrax Vaccine Adsorbed (AVA). The trial will enroll 108 subjects in the anthrax vector vaccine arms and 12 subjects in the AVA positive control subjects. The study will look at three different dose of oral dosages of Ad4-PA (protective antigen) and Ad4-PA-GPI (10^9, 10^10, 10^11 vp/dose)as well as 3 vaccine administration schedules (1 and 15 days; 1 and 29 days; 1, 15, and 29 days); 2 of 3 schedules will include an intramuscular (IM) AVA booster immunization, 1 schedule will include 3 vaccine administrations of Ad4-PA or Ad4-PA-GPI (glycosylphosphatidylinositol) alone, and 1 schedule will include 3 vaccine administrations of AVA alone.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anthrax Infection
Keywords
Anthrax vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AVA
Arm Type
Active Comparator
Arm Description
Anthrax Vaccine Adsorbed (0.5 mL) as the placebo control on Days 1, 15 and 29
Arm Title
Ad4-PA-1
Arm Type
Experimental
Arm Description
Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Day 1 + oral placebo on Day 15 + AVA boost at Day 29
Arm Title
Ad4-PA-2
Arm Type
Experimental
Arm Description
Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Days 1, 15 and 29
Arm Title
Ad4-PA-3
Arm Type
Experimental
Arm Description
Ad4 given at 10^9, 10^10 and 10^11 vp Ad4 PA-GPI at Day 1 + AVA boost at Day 15 + placebo on Day 29
Arm Title
Ad4-PA-GPI-1
Arm Type
Experimental
Arm Description
Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + oral placebo on Day 29 + AVA boost at Day 15
Arm Title
Ad4 PA-GPI-2
Arm Type
Experimental
Arm Description
Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + placebo on Day 15 + AVA boost at Day 29
Arm Title
Ad4-PA-GPI -3
Arm Type
Experimental
Arm Description
Given at 10^9, 10^10 and 10^11 viral particles Ad4-PA-GPI at Days 1, 15 and 29
Intervention Type
Biological
Intervention Name(s)
AVA
Other Intervention Name(s)
Anthrax vaccine adsorbed (BioThrax)
Intervention Description
Anthrax Vaccine Adsorbed (0.5 mL) as the placebo control on Days 1, 15 and 29
Intervention Type
Biological
Intervention Name(s)
Ad4-PA-1
Other Intervention Name(s)
Adenovirus serotype 4 vector vaccine against anthrax PA
Intervention Description
Ad4-PA will be given at 10^9, 10^10 and 10^11 on Day, followed by an oral placebo on Day 15 and an AVA boost on Day 29
Intervention Type
Biological
Intervention Name(s)
Ad4-PA-GPI-1
Other Intervention Name(s)
Adenovirus anthrax vaccine serotype 4 against anthrax PA
Intervention Description
Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + oral placebo on Day 29 + AVA boost at Day 15
Primary Outcome Measure Information:
Title
The safety, tolerability and immunogenicity of the Ad4 PA and Ad4 PA GPI vaccines across a range of dosages and schedules.
Description
Safety will be measured by looking at safety labs, Adverse Events (AEs) and vaccine reactogenicity data from Baseline through Day 211. Immunogenicity will be measured by the peak serum antibody response to the PA transgene defined as the highest toxin-neutralizing antibody (TNA) titer achieved by a subject at any time between the first post-vaccination visit though Day 85 (and Day 211 if Day 85 is positive).
Time Frame
Day 1 through Day 211
Secondary Outcome Measure Information:
Title
Antibody response of the Ad4-PA formulation to Ad4 PA GPI
Description
Antibody response will be tested via enzyme-linked immunosorbent assay (ELISA) and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85
Time Frame
Day 1 through Day 85 (Day 211 if Day 85 is positive)
Title
Antibody response of the Ad4-PA and Ad4-PA-GPI vaccination regimens to the anticipated AVA PEP regimen.
Description
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85.
Time Frame
Days 1 through 85 (Day 211 if Day 85 is positive)
Title
Antibody response induced by 3 different dosages of Ad4 PA and Ad4 PA GPI.
Description
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85 and titers will be compared across the 3 different dosages of Ad4 PA and Ad4 PA GPI (10^9, 10^10, 10^11).
Time Frame
Days 1 through 85 (Day 211 if Day 85 is positive)
Title
TNA and antibody response induced by Ad4 PA and Ad4 PA GPI on 3 different vaccination schedules.
Description
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85, and compared among 3 vaccine schedules: Day 1: Ad4-PA or Ad4-PA-GPI, Day 15 placebo Day 29 AVA boost; Day 1:Ad4-PA or Ad4-PA-GPI, Day 15 AVA boost + Placebo; and Days 1, 15 and 29: Ad4-PA or Ad4-PA-GPI
Time Frame
Days 1 through 85 (Day 211 if Day 85 is positive)
Title
Pre-existing Ad4 immunity on TNA and PA-ELISA response induced by Ad4 PA and Ad4 PA GPI.
Description
Antibody response will be tested via ELISA and the impact of pre-existing Ad4 serostatus (positive/negative) on TNA and PA-ELISA will be evaluated
Time Frame
Days 1 through 85 (Day 211 if Day 85 is positive)
Title
Evaluate the kinetics of the TNA and PA-ELISA antibody response induced by 3 different doses of Ad4 PA and Ad4 PA GPI on 3 different administration schedules.
Description
TNA and PA-ELISA titer at each post-vaccination visit as measured by ELISA will be compared across each dose group (10^9, 10^10 and 10^11 vp) and dosing schedule. In addition, the time to peak pre-boost TNA titer and to peak pre-boost PA-ELISA titer will be compared across each dose group and dosing schedule. Cumulative TNA and PA-ELISA seroconversion through each post-vaccination visit and through Day 85
Time Frame
Days 1 through 85 (Day 211 if Day 85 is positive)
Title
In vivo replication/excretion of the Ad4 PA and Ad4 PA GPI vaccines
Description
The duration of in vivo replication/excretion will be measured by the Ad4 MN seroconversion and titer measured via ELISA testing. Vaccine take defined as either Ad4 micro-neutralizing (MN) seroconversion and/or detection of vaccine shedding measured by polymerase chain reaction (PCR) and confirmed by culture at any time point from Day 1 through Day 211
Time Frame
Days 1 through 211
Other Pre-specified Outcome Measures:
Title
Systemic PA-specific cellular immune response induced by Ad4-PA and Ad4-PA-GPI
Description
The systemic PA-specific cellular immune response induced by Ad4-PA and Ad4-PA-GPI will be measured via cell-based assay on peripheral blood mononuclear cells(PBMCs). The tests will be performed on Days 1, 15, 29 and 43.
Time Frame
Days 1 through 43
Title
Mucosal PA-ELISA antibody responses induced by Ad4-PA and Ad4 PA-GPI
Description
PA antibody titers from mucosal samples will be obtained on Days 1 and 29 and titers will be compared among the 2 vaccine candidates.
Time Frame
Days 1 through 29

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Able to understand the study and give written informed consent. Healthy men or women aged 18-40 years old, BMI between 18 to 36 kg/m2 Women of child bearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test prior to vaccination on all vaccination days; they must also be willing to use adequate birth control for the duration of the study and have additional pregnancy tests if indicated. Intact upper arms with sufficient muscular tissue in the deltoid region for IM vaccine administration. Subject must be available for the study duration Subject must avoid strenuous exercise for at least 72 hours prior to each study vaccine administration. Exclusion Criteria: Subject is a healthcare worker who has direct contact with patients or has an household contact (HHC) who is immunodeficient or HIV-positive, pregnant, has an unstable medical condition, or is under the age of 18. Subject is a childcare worker or a parent who has direct contact with children 5 years old and younger. Subject directly prepares food in the food industry. Pregnant or breastfeeding throughout the duration of the study until the final visit Military service between 1971 and 1999, or after 2012 when Ad4 vaccine was/is routinely given Employment in an industry involved in contact with ruminant animals, veterinary sciences, or other potential exposure to B. anthracis Received previous Ad4 vaccination or experimental Ad4 vector vaccines Received previous anthrax vaccine Received or plans to receive any other approved or investigational vaccines from 30 days prior to the first study vaccination until 30 days after the final study vaccination for live attenuated vaccines and from 15 days prior to the first study vaccination until 15 days after the final study vaccination for inactivated vaccines HIV or Hepatitis B or C positive Immunodeficient or has an unstable medical condition including psychiatric conditions Active or past history of acute or chronic gastrointestinal conditions Active or past history of cancer except basal cell carcinoma Recipient of bone marrow or solid organ transplant Received or plans to receive systemic antiviral medication, within 30 days prior to the first study vaccination Known allergy to any component of the study vaccine Known allergy to, or known medical condition that precludes use of any systemic antiviral medication Received or plans to receive medications indicated for decreasing acidity of stomach including: Proton pump inhibitors or antacids or histamine 2-receptor antagonists Received or plans to receive immunoglobulin or other blood products within 60 days prior to the first study vaccination Received or plans to receive other investigational drugs within 30 days prior to the first study vaccination Received or plans to receive systemic immunosuppressive therapy, radiation therapy, or inhaled steroids within 30 days prior to the first study vaccination Asthmatic or requires asthmatic medications on a daily basis Use of systemic chemotherapy within 5 years prior to study Body temperature >38.1°C or acute illness within 3 days prior to vaccination History of excessive alcohol consumption, drug abuse, or significant psychiatric illness History of Guillain-Barré Syndrome Blood donation within 2 months prior to first study vaccination Expected to be noncompliant with study visits or plans to move away or be living with different HHCs during the next 8 months Drinks more than 1200 mL of tea/coffee/cocoa/cola or other caffeinated beverage per day. Any condition or finding that in the view of the primary investigator would impede full study participation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc Gurwith, MD
Organizational Affiliation
Emergent BioSolutions
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jakub Simon, MD
Organizational Affiliation
Emergent BioSolutions
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Mo Elsafy, MD, MSc
Organizational Affiliation
National Institutes of Health (NIH)
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Center for Pharmaceutical Research
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
64114
Country
United States
Facility Name
Walter Reed Army Institute for Research
City
Silver Spring
State/Province
Maryland
ZIP/Postal Code
20910
Country
United States
Facility Name
St. Louis University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63104
Country
United States
Facility Name
Coastal Carolina Research Center
City
Mount Pleasant
State/Province
South Carolina
ZIP/Postal Code
29464
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase 1 Ascending Dose Study to Assess the Safety and Immunogenicity of Adenovirus Anthrax Vector Candidate Vaccines

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