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A Phase I Study to Evaluate Safety and Immunogenicity of AERAS 404 (C-011-404) (C-011-404)

Primary Purpose

Tuberculosis

Status
Completed
Phase
Phase 1
Locations
South Africa
Study Type
Interventional
Intervention
AERAS-404 (mcg H4/nmol IC31)
Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl
Sponsored by
Aeras
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Tuberculosis

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria

Subjects must have met all of the following criteria:

  1. Had completed written informed consent
  2. Was male or female
  3. Was age 18 through 50 years on Study Day 0
  4. Had BCG vaccination at least 5 years ago, documented through medical history or presence of scar
  5. Had general good health, confirmed by medical history and physical examination
  6. Had a Body Mass Index (BMI) between 19 and 33 (weight in kg/[height in m]2)
  7. Agreed to complete a follow-up period of 182 days as required by the protocol
  8. Females: Agreed to avoid pregnancy from 28 days prior to Study Day 0 through the follow-up period of 182 days.
  9. Agreed to avoid elective surgery for the duration of the study
  10. Agreed to stay in contact with the investigative site for the duration of the study
  11. Had completed simultaneous enrollment in Aeras Vaccine Development Registry protocol

Exclusion Criteria

Subjects must not have:

  1. Acute illness on Study Day 0
  2. Oral temperature equal to or greater than 37.5 degrees C on Study Day 0
  3. Evidence of significant active infection
  4. Used immunosuppressive medication within 42 days before Study Day 0 (inhaled and topical corticosteroids are permitted)
  5. Received immunoglobulin or blood products within 42 days before Study Day 0
  6. Received any investigational drug therapy or investigational vaccine within 182 days before Study Day 0
  7. Received inactivated influenza vaccine or inactivated tick-borne encephalitis vaccine within 14 days before entry into the study, or any other standard vaccine within 42 days before Study Day 0 (the use of licensed drugs or vaccines medically indicated during the study interval was permitted)
  8. Current chronic drug therapy including hormone replacement such as thyroxin, insulin, etc. Estrogen and progesterone replacement and contraceptives were acceptable.
  9. History or laboratory evidence of any past, present or future possible immunodeficiency state which included (but was not limited to) any laboratory indication of HIV infection
  10. History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the study vaccine
  11. Previous medical history that may have compromised the safety of the subject in the study
  12. Evidence of a new acute illness that may have compromised the safety of the subject in the study
  13. Evidence of chronic hepatitis (e.g., hepatitis B core antibody or hepatitis C antibody)
  14. Inability to discontinue daily medications except contraceptives during the study period
  15. History of alcohol or drug abuse within the past 2 years
  16. Tobacco or cannabis smoking 3 or more days per week
  17. Positive urine test for illicit drugs (opiates, cocaine, amphetamines)
  18. History or evidence of any systemic disease on physical examination or any acute or chronic illness that, in the opinion of the investigator, may have interfered with the evaluation of the safety or immunogenicity of the vaccine, including axillary lymphadenopathy
  19. History or evidence (including chest X-ray) of active tuberculosis
  20. Shared a residence within the last year with an individual on anti-tuberculosis treatment or with culture or smear positive tuberculosis
  21. All females: Positive urine pregnancy test during screening; positive serum pregnancy test on the day of study vaccination; were nursing
  22. Abnormal (per local laboratory parameters) chemistry, hematology or urinalysis obtained within 36 hours prior to randomization.
  23. Laboratory evidence of Mtb infection, defined as a positive QuantiFERON-TB Gold (QFT-G) test.
  24. History of a positive tuberculin skin test within the past ten years (defined according to local guidelines).
  25. Received a tuberculin skin test within 3 months (90 days) prior to Study Day 0.

Sites / Locations

  • South African Tuberculosis Vaccine Institute; Brewelskloof Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

AERAS-404 (mcg H4/nmol IC31) 5/500

AERAS-404 (mcg H4/nmol IC31) 15/500

AERAS-404 (mcg H4/nmol IC31) 50/500

AERAS-404 (mcg H4/nmol IC31) 150/500

Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl

Arm Description

H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl

H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl

H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl

H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl

Placebo: Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl. This is the identical buffer solution in which IC31 is formulated.

Outcomes

Primary Outcome Measures

Evaluate the safety of two injections of AERAS 404 prepared with four escalating amounts of antigen in healthy adult subjects. Safety will be measured by number (percentage) and severity of SAEs.
The safety profile will be described by treatment regimen. Serious adverse events (SAE) will be collected on subjects throughout their participation in the study. Solicited and unsolicited adverse events will be captured for 28 days after each vaccination. The number (percentage) of subjects with any adverse events (including solicited, unsolicited and serious adverse events) will be summarized by MedRA system organ class (SOC) and preferred term (PT). Additional summaries will present the number (percentage) of subjects with any adverse events by severity and by relationship to study vaccine. The number (percentage) of subjects with post-vaccination clinical laboratory values or vital sign values recorded as newly abnormal following study vaccination and meeting toxicity criteria will be tabulated at each post-vaccination point and overall.

Secondary Outcome Measures

Evaluate the immunogenicity of two injections of AERAS 404 prepared with four escalating amounts of antigen in healthy adult subjects. Immune response will be based on percentage of CD4+ and CD8+ cells.
The primary response will be measured by flow cytometry in the Intracellular cytokine staining (ICS) assay. Immune responses will be based on percentage of CD4+ and CD8+ T cells that produced one, two, or three cytokines (IFN-gamma, TNF, and/or IL-2) in response to stimulation with one of the 2 antigenic peptide pool (Ag85B and TB10.4) derived from and representing the entire amino acid sequences of teh mycobacterial antigens Ag85B and TB10.4.

Full Information

First Posted
March 28, 2014
Last Updated
April 25, 2016
Sponsor
Aeras
Collaborators
Statens Serum Institut
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1. Study Identification

Unique Protocol Identification Number
NCT02109874
Brief Title
A Phase I Study to Evaluate Safety and Immunogenicity of AERAS 404 (C-011-404)
Acronym
C-011-404
Official Title
A Phase I Randomized Placebo-Controlled, Double-Blind Study to Evaluate Safety and Immunogenicity of AERAS 404 When Administered as a Single Adjuvant Amount With Different Antigen Amounts in HIV-Negative BCG-Vaccinated Adults Without Evidence of Tuberculosis Infection
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
September 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aeras
Collaborators
Statens Serum Institut

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase I study will be conducted as a randomized, placebo-controlled, double-blind, dose-escalation study in four groups of healthy adult male and female subjects who are BCG-vaccinated, HIV-negative, and have no evidence of tuberculosis infection. The study will be conducted at one or two sites located in South Africa. The purpose is to evaluate the safety and immunogenicity of two injections of AERAS 404 prepared with four escalating amounts of antigen in healthy adult male and female subjects who are BCG-vaccinated, HIV-negative, and have no evidence of tuberculosis infection.
Detailed Description
This Phase I study will be conducted as a randomized, placebo-controlled, double-blind, dose-escalation study in four groups of healthy adult male and female subjects who are BCG-vaccinated, HIV-negative, and have no evidence of tuberculosis infection. The study will be conducted at one or two sites located in South Africa. Forty subjects will be sequentially enrolled into one of four study groups (i.e., Group 1, Group 2, Group 3, or Group 4) based on time of completion of screening, with 10 subjects enrolled into each group. Within each study group, subjects will be randomized to a treatment regimen of either AERAS-404 or placebo control administered by intramuscular injection on Study Day 0 and Study Day 56. All subjects will receive the same treatment on Study Day 0 as they receive on Study Day 56. The dose of antigen will increase between study groups. All subjects will be followed for safety and immunogenicity evaluations for 182 days. A total of eleven clinic visits are planned (excluding screening) for all subjects.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AERAS-404 (mcg H4/nmol IC31) 5/500
Arm Type
Experimental
Arm Description
H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl
Arm Title
AERAS-404 (mcg H4/nmol IC31) 15/500
Arm Type
Experimental
Arm Description
H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl
Arm Title
AERAS-404 (mcg H4/nmol IC31) 50/500
Arm Type
Experimental
Arm Description
H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl
Arm Title
AERAS-404 (mcg H4/nmol IC31) 150/500
Arm Type
Experimental
Arm Description
H4 antigen (supplied in 4 different concentrations): 1.0 mL containing H4 antigen at 50, 150, 500, or 1500 mcg/mL in 10 mmol/L tris and 5% glycerol IC31 Adjuvant (supplied in 1 concentration): 0.8 mL containing IC31 adjuvant at 1250 nmol/mL, in 10 mmol/L tris and 169 mmol/L NaCl
Arm Title
Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl
Arm Type
Placebo Comparator
Arm Description
Placebo: Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl. This is the identical buffer solution in which IC31 is formulated.
Intervention Type
Biological
Intervention Name(s)
AERAS-404 (mcg H4/nmol IC31)
Other Intervention Name(s)
H4, AERAS-404
Intervention Description
Dose escalation
Intervention Type
Biological
Intervention Name(s)
Sterile buffer containing 10 mmol/L tris and 169 mmol/L NaCl
Primary Outcome Measure Information:
Title
Evaluate the safety of two injections of AERAS 404 prepared with four escalating amounts of antigen in healthy adult subjects. Safety will be measured by number (percentage) and severity of SAEs.
Description
The safety profile will be described by treatment regimen. Serious adverse events (SAE) will be collected on subjects throughout their participation in the study. Solicited and unsolicited adverse events will be captured for 28 days after each vaccination. The number (percentage) of subjects with any adverse events (including solicited, unsolicited and serious adverse events) will be summarized by MedRA system organ class (SOC) and preferred term (PT). Additional summaries will present the number (percentage) of subjects with any adverse events by severity and by relationship to study vaccine. The number (percentage) of subjects with post-vaccination clinical laboratory values or vital sign values recorded as newly abnormal following study vaccination and meeting toxicity criteria will be tabulated at each post-vaccination point and overall.
Time Frame
Solicited and unsolicited AEs until study day 182
Secondary Outcome Measure Information:
Title
Evaluate the immunogenicity of two injections of AERAS 404 prepared with four escalating amounts of antigen in healthy adult subjects. Immune response will be based on percentage of CD4+ and CD8+ cells.
Description
The primary response will be measured by flow cytometry in the Intracellular cytokine staining (ICS) assay. Immune responses will be based on percentage of CD4+ and CD8+ T cells that produced one, two, or three cytokines (IFN-gamma, TNF, and/or IL-2) in response to stimulation with one of the 2 antigenic peptide pool (Ag85B and TB10.4) derived from and representing the entire amino acid sequences of teh mycobacterial antigens Ag85B and TB10.4.
Time Frame
182 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria Subjects must have met all of the following criteria: Had completed written informed consent Was male or female Was age 18 through 50 years on Study Day 0 Had BCG vaccination at least 5 years ago, documented through medical history or presence of scar Had general good health, confirmed by medical history and physical examination Had a Body Mass Index (BMI) between 19 and 33 (weight in kg/[height in m]2) Agreed to complete a follow-up period of 182 days as required by the protocol Females: Agreed to avoid pregnancy from 28 days prior to Study Day 0 through the follow-up period of 182 days. Agreed to avoid elective surgery for the duration of the study Agreed to stay in contact with the investigative site for the duration of the study Had completed simultaneous enrollment in Aeras Vaccine Development Registry protocol Exclusion Criteria Subjects must not have: Acute illness on Study Day 0 Oral temperature equal to or greater than 37.5 degrees C on Study Day 0 Evidence of significant active infection Used immunosuppressive medication within 42 days before Study Day 0 (inhaled and topical corticosteroids are permitted) Received immunoglobulin or blood products within 42 days before Study Day 0 Received any investigational drug therapy or investigational vaccine within 182 days before Study Day 0 Received inactivated influenza vaccine or inactivated tick-borne encephalitis vaccine within 14 days before entry into the study, or any other standard vaccine within 42 days before Study Day 0 (the use of licensed drugs or vaccines medically indicated during the study interval was permitted) Current chronic drug therapy including hormone replacement such as thyroxin, insulin, etc. Estrogen and progesterone replacement and contraceptives were acceptable. History or laboratory evidence of any past, present or future possible immunodeficiency state which included (but was not limited to) any laboratory indication of HIV infection History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the study vaccine Previous medical history that may have compromised the safety of the subject in the study Evidence of a new acute illness that may have compromised the safety of the subject in the study Evidence of chronic hepatitis (e.g., hepatitis B core antibody or hepatitis C antibody) Inability to discontinue daily medications except contraceptives during the study period History of alcohol or drug abuse within the past 2 years Tobacco or cannabis smoking 3 or more days per week Positive urine test for illicit drugs (opiates, cocaine, amphetamines) History or evidence of any systemic disease on physical examination or any acute or chronic illness that, in the opinion of the investigator, may have interfered with the evaluation of the safety or immunogenicity of the vaccine, including axillary lymphadenopathy History or evidence (including chest X-ray) of active tuberculosis Shared a residence within the last year with an individual on anti-tuberculosis treatment or with culture or smear positive tuberculosis All females: Positive urine pregnancy test during screening; positive serum pregnancy test on the day of study vaccination; were nursing Abnormal (per local laboratory parameters) chemistry, hematology or urinalysis obtained within 36 hours prior to randomization. Laboratory evidence of Mtb infection, defined as a positive QuantiFERON-TB Gold (QFT-G) test. History of a positive tuberculin skin test within the past ten years (defined according to local guidelines). Received a tuberculin skin test within 3 months (90 days) prior to Study Day 0.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhongkai Shi, MD
Organizational Affiliation
Aeras
Official's Role
Study Director
Facility Information:
Facility Name
South African Tuberculosis Vaccine Institute; Brewelskloof Hospital
City
Worcester
Country
South Africa

12. IPD Sharing Statement

Citations:
PubMed Identifier
26048780
Citation
Geldenhuys H, Mearns H, Miles DJ, Tameris M, Hokey D, Shi Z, Bennett S, Andersen P, Kromann I, Hoff ST, Hanekom WA, Mahomed H, Hatherill M, Scriba TJ; H4:IC31 Trial Study Group; van Rooyen M, Bruce McClain J, Ryall R, de Bruyn G; H4:IC31 Trial Study Groupa. The tuberculosis vaccine H4:IC31 is safe and induces a persistent polyfunctional CD4 T cell response in South African adults: A randomized controlled trial. Vaccine. 2015 Jul 9;33(30):3592-9. doi: 10.1016/j.vaccine.2015.05.036. Epub 2015 Jun 3.
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A Phase I Study to Evaluate Safety and Immunogenicity of AERAS 404 (C-011-404)

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