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A Phase II Study of H56:IC31 in Healthy Adolescents (A-043)

Primary Purpose

Tuberculosis Infection

Status
Withdrawn
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
H56:IC31
Placebo
Sponsored by
Aeras
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Tuberculosis Infection

Eligibility Criteria

12 Years - 17 Years (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Has completed the written informed consent and assent process
  2. Is age ≥12 years and ≤17 years on Study Day 0
  3. Agrees to stay in contact with the study site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study
  4. For female participants: agrees to avoid pregnancy from 21 days prior to Study Day 0 through 6 months after the last study vaccination. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, or intrauterine device (IUD)
  5. Has general good health, confirmed by medical history and physical examination
  6. Had BCG vaccination at least 5 years ago documented by confirmation of parent/guardian that the participant received all childhood vaccines or by presence of healed BCG scar
  7. Tests ESAT-6 free IGRA and QFT-Plus negative at screening, using a pre-determined threshold for ESAT-6 free IGRA and the manufacturer's recommended threshold for QFT-Plus of 0.35 IU/mL in either of the TB antigen tubes after nil-subtraction

Exclusion Criteria:

  1. Acute illness on Study Day 0
  2. Axillary temperature ≥37.5 °C on Study Day 0
  3. Abnormal laboratory values from the most recent blood collected prior to randomization as follows (abnormal results may be repeated once and if found to be resolved the participant will not be excluded):

    • Laboratory evidence of hematologic disease (white blood cell count <3000/mm^3 or >11,500/mm^3; hemoglobin <0.9 times the lower limit of normal of the testing laboratory, by age and gender; absolute neutrophil count <1300/mm^3; absolute lymphocyte count <1000/mm^3).
    • ALT, AST, alkaline phosphatase, total bilirubin, creatinine, blood urea nitrogen (BUN) >1.25 times the ULN
  4. Urinalysis abnormality greater than Grade 1 on the Toxicity Scale (with the exception of hematuria in a menstruating female), or urinalysis abnormality judged clinically significant by the investigator
  5. History or evidence of any clinically significant systemic disease, or any acute or chronic illness that might affect the safety, immunogenicity, or efficacy of investigational product in the opinion of the investigator
  6. History of treatment for active TB disease or latent Mtb infection
  7. History or evidence, including chest X-ray, of active TB disease
  8. Shared household with an individual receiving anti-TB treatment, or known to have incompletely treated culture or smear positive TB, at screening
  9. History of autoimmune disease or immunosuppression
  10. Used immunosuppressive medication within 42 days before Study Day 0 (inhaled and topical corticosteroids are permitted)
  11. Received immunoglobulin or blood products within 42 days before Study Day 0
  12. Received any investigational drug or investigational vaccine within 180 days before Study Day 0, or planned participation in any other clinical trial during the study period
  13. Received investigational TB vaccine at any time prior to Study Day 0
  14. Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after each dose of investigational product
  15. History or laboratory evidence of any past or present possible immunodeficiency state including, but not limited to, any laboratory indication of HIV 1 infection
  16. History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the investigational product
  17. History of alcohol or drug abuse
  18. Any female currently pregnant or lactating/nursing, or positive urine pregnancy test during screening or Study Day 0
  19. Received a tuberculin skin test (TST) within 3 months (90 days) prior to Study Day 0.
  20. Any current medical, psychiatric, occupational, or substance abuse problems that, in the opinion of the investigator, will make it unlikely that the participant will comply with the protocol.

Sites / Locations

  • Aurum Institute - Klerksdorp
  • Aurum Institute - Rustenburg
  • Aurum Institute - Tembisa
  • National Institute for Medical Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

H56:IC31

Placebo

Arm Description

5 ug H56/500 nmol IC31, 0.5 mL Intramuscular (IM), Days 0 and 56

Normal saline, 0.5 mL IM, Days 0 and 56

Outcomes

Primary Outcome Measures

Frequency and severity of adverse events
To evaluate the safety profile of H56:IC31 compared to placebo in HIV-uninfected, previously BCG vaccinated adolescents.
ESAT-6 free IGRA conversion from a negative to positive test at any time point after Day 84 and through end of follow-up for the primary endpoint.
To evaluate prevention of Mtb infection by H56:IC31 compared to placebo, as measured by rates of conversion using an ESAT-6 free IGRA.

Secondary Outcome Measures

Primary ESAT-6 free IGRA conversion from a negative to a positive test
Primary ESAT-6 free IGRA conversion from a negative to a positive test at any time point after Day 84 and through end of follow up for the primary endpoint, AND persisting without ESAT-6 free IGRA reversion from a positive to a negative test through 6 months after ESAT-6 free IGRA conversion.
Primary ESAT-6 free IGRA conversion from a negative to a positive test
Primary ESAT-6 free IGRA conversion from a negative to a positive test at any time point after randomization and through end of follow up for the primary endpoint, AND persisting without ESAT-6 free IGRA reversion from a positive to a negative test through 6 months after ESAT-6 free IGRA conversion.
Initial ESAT-6 free IGRA reversion from a positive to a negative test at any time point after primary ESAT-6 free IGRA conversion through the end of follow up.
To evaluate trends in ESAT-6 free IGRA prolonged/sustained conversions and late reversions (i.e., through more than 6 months post initial conversion) in ESAT-6 free IGRA converters.
Percentage of CD4+ and CD8+ T cells that express IFN-γ, TNF, and/or IL-2 alone or in combination in response to stimulation with peptide pools representing the entire amino acid sequence of the vaccine antigens.
Immunogenicity of H56:IC31 in HIV-uninfected, previously BCG vaccinated adolescents.

Full Information

First Posted
August 24, 2017
Last Updated
April 6, 2018
Sponsor
Aeras
Collaborators
Statens Serum Institut, Aurum Institute, South African Tuberculosis Vaccine Initiative, Oslo University Hospital, University of Copenhagen, University of Bergen, National Institute for Medical Research, Tanzania
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1. Study Identification

Unique Protocol Identification Number
NCT03265977
Brief Title
A Phase II Study of H56:IC31 in Healthy Adolescents
Acronym
A-043
Official Title
A Randomized, Placebo Controlled, Double-Blind Phase II Study to Evaluate Safety, Immunogenicity, and Prevention of Infection With Mycobacterium Tuberculosis (Mtb) of H56:IC31 in Healthy Adolescents
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Design, sponsorship changed prior to initiation. No study procedures done.
Study Start Date
June 2018 (Anticipated)
Primary Completion Date
April 30, 2021 (Anticipated)
Study Completion Date
June 30, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aeras
Collaborators
Statens Serum Institut, Aurum Institute, South African Tuberculosis Vaccine Initiative, Oslo University Hospital, University of Copenhagen, University of Bergen, National Institute for Medical Research, Tanzania

4. Oversight

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

5. Study Description

Brief Summary
This clinical trial will evaluate safety, immunogenicity, and efficacy (prevention of Mtb infection as measured by IGRA conversions) of H56:IC31 in remotely BCG vaccinated adolescents.
Detailed Description
This clinical trial will evaluate safety, immunogenicity, and prevention of Mtb infection, (measured by IGRA conversion) of H56:IC31 in remotely BCG vaccinated adolescents. A TB vaccination strategy incorporating H56:IC31 in adolescents or young adults, if found to prevent Mtb infection, would likely have a major impact on TB disease, TB transmission, and control of the epidemic. If vaccination with H56:IC31 is shown to prevent infection with Mtb in this proof of concept study in adolescents, additional larger scale studies examining the impact on TB disease in more diverse populations would be warranted. Primary objectives To evaluate the safety profile of H56:IC31 compared to placebo in HIV-uninfected, remotely BCG vaccinated adolescents. To evaluate prevention of Mtb infection by H56:IC31 compared to placebo, as measured by rates of conversion using an ESAT-6 free IGRA. Secondary objectives To evaluate prevention of Mtb infection by H56:IC31 compared to placebo, as measured by rates of sustained conversion using an ESAT-6 free IGRA. To evaluate trends in ESAT-6 free IGRA prolonged/sustained conversions and late reversions (i.e., through more than 6 months post initial conversion) in ESAT-6 free IGRA converters. To investigate the immunogenicity of H56:IC31 in HIV-uninfected, remotely BCG vaccinated adolescents.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Participants will be enrolled in two cohorts. Within each cohort participants will be randomized in a 1:1 ratio to receive either H56:IC31 (5 ug H56/500 nmol IC31) or placebo intramuscularly (IM) on Days 0 and 56.
Masking
ParticipantCare ProviderInvestigator
Masking Description
Random numbers generated by IWRS; Stratified by site. Syringes are masked with a translucent colored label, in order to maintain the study blind.
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
H56:IC31
Arm Type
Experimental
Arm Description
5 ug H56/500 nmol IC31, 0.5 mL Intramuscular (IM), Days 0 and 56
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Normal saline, 0.5 mL IM, Days 0 and 56
Intervention Type
Biological
Intervention Name(s)
H56:IC31
Intervention Description
The H56 antigen is a fusion protein created from 3 Mtb antigens: antigen 85B (Ag85B), ESAT-6, and Rv2660c.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Normal saline
Primary Outcome Measure Information:
Title
Frequency and severity of adverse events
Description
To evaluate the safety profile of H56:IC31 compared to placebo in HIV-uninfected, previously BCG vaccinated adolescents.
Time Frame
Day 0 through month 24
Title
ESAT-6 free IGRA conversion from a negative to positive test at any time point after Day 84 and through end of follow-up for the primary endpoint.
Description
To evaluate prevention of Mtb infection by H56:IC31 compared to placebo, as measured by rates of conversion using an ESAT-6 free IGRA.
Time Frame
Day 84 through month 24
Secondary Outcome Measure Information:
Title
Primary ESAT-6 free IGRA conversion from a negative to a positive test
Description
Primary ESAT-6 free IGRA conversion from a negative to a positive test at any time point after Day 84 and through end of follow up for the primary endpoint, AND persisting without ESAT-6 free IGRA reversion from a positive to a negative test through 6 months after ESAT-6 free IGRA conversion.
Time Frame
Day 84 through month 24
Title
Primary ESAT-6 free IGRA conversion from a negative to a positive test
Description
Primary ESAT-6 free IGRA conversion from a negative to a positive test at any time point after randomization and through end of follow up for the primary endpoint, AND persisting without ESAT-6 free IGRA reversion from a positive to a negative test through 6 months after ESAT-6 free IGRA conversion.
Time Frame
Day 84 through end of study (approximately 24 months)
Title
Initial ESAT-6 free IGRA reversion from a positive to a negative test at any time point after primary ESAT-6 free IGRA conversion through the end of follow up.
Description
To evaluate trends in ESAT-6 free IGRA prolonged/sustained conversions and late reversions (i.e., through more than 6 months post initial conversion) in ESAT-6 free IGRA converters.
Time Frame
Day 84 through month 24
Title
Percentage of CD4+ and CD8+ T cells that express IFN-γ, TNF, and/or IL-2 alone or in combination in response to stimulation with peptide pools representing the entire amino acid sequence of the vaccine antigens.
Description
Immunogenicity of H56:IC31 in HIV-uninfected, previously BCG vaccinated adolescents.
Time Frame
Day 0 through month 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Has completed the written informed consent and assent process Is age ≥12 years and ≤17 years on Study Day 0 Agrees to stay in contact with the study site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study For female participants: agrees to avoid pregnancy from 21 days prior to Study Day 0 through 6 months after the last study vaccination. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, or intrauterine device (IUD) Has general good health, confirmed by medical history and physical examination Had BCG vaccination at least 5 years ago documented by confirmation of parent/guardian that the participant received all childhood vaccines or by presence of healed BCG scar Tests ESAT-6 free IGRA and QFT-Plus negative at screening, using a pre-determined threshold for ESAT-6 free IGRA and the manufacturer's recommended threshold for QFT-Plus of 0.35 IU/mL in either of the TB antigen tubes after nil-subtraction Exclusion Criteria: Acute illness on Study Day 0 Axillary temperature ≥37.5 °C on Study Day 0 Abnormal laboratory values from the most recent blood collected prior to randomization as follows (abnormal results may be repeated once and if found to be resolved the participant will not be excluded): Laboratory evidence of hematologic disease (white blood cell count <3000/mm^3 or >11,500/mm^3; hemoglobin <0.9 times the lower limit of normal of the testing laboratory, by age and gender; absolute neutrophil count <1300/mm^3; absolute lymphocyte count <1000/mm^3). ALT, AST, alkaline phosphatase, total bilirubin, creatinine, blood urea nitrogen (BUN) >1.25 times the ULN Urinalysis abnormality greater than Grade 1 on the Toxicity Scale (with the exception of hematuria in a menstruating female), or urinalysis abnormality judged clinically significant by the investigator History or evidence of any clinically significant systemic disease, or any acute or chronic illness that might affect the safety, immunogenicity, or efficacy of investigational product in the opinion of the investigator History of treatment for active TB disease or latent Mtb infection History or evidence, including chest X-ray, of active TB disease Shared household with an individual receiving anti-TB treatment, or known to have incompletely treated culture or smear positive TB, at screening History of autoimmune disease or immunosuppression 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 or investigational vaccine within 180 days before Study Day 0, or planned participation in any other clinical trial during the study period Received investigational TB vaccine at any time prior to Study Day 0 Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after each dose of investigational product History or laboratory evidence of any past or present possible immunodeficiency state including, but not limited to, any laboratory indication of HIV 1 infection History of allergic disease or reactions, including eczema, likely to be exacerbated by any component of the investigational product History of alcohol or drug abuse Any female currently pregnant or lactating/nursing, or positive urine pregnancy test during screening or Study Day 0 Received a tuberculin skin test (TST) within 3 months (90 days) prior to Study Day 0. Any current medical, psychiatric, occupational, or substance abuse problems that, in the opinion of the investigator, will make it unlikely that the participant will comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dereck Tait, MD
Organizational Affiliation
Aeras
Official's Role
Study Director
Facility Information:
Facility Name
Aurum Institute - Klerksdorp
City
Klerksdorp
ZIP/Postal Code
2571
Country
South Africa
Facility Name
Aurum Institute - Rustenburg
City
Rustenburg
ZIP/Postal Code
0300
Country
South Africa
Facility Name
Aurum Institute - Tembisa
City
Tembisa
ZIP/Postal Code
1632
Country
South Africa
Facility Name
National Institute for Medical Research
City
Mwanza
State/Province
Isamilo Area
Country
Tanzania

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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A Phase II Study of H56:IC31 in Healthy Adolescents

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