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A Phase I/IIa Study of the Safety, Immunogenicity and Efficacy of FMP2.1/AS01B, an Asexual Blood-Stage Vaccine for Plasmodium Falciparum Malaria

Primary Purpose

Plasmodium Falciparum Malaria

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
FMP2.1/AS01B
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Plasmodium Falciparum Malaria focused on measuring Plasmodium Falciparum, Malaria, Vaccine, Plasmodium, Falciparum

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy, male or non-pregnant female adults aged 18 - 45 years
  • Subject is willing and able to give written informed consent for participation in the study
  • Resident in or near Oxford for the duration of the challenge part of the study. Or for volunteers not living in Oxford: agreement to stay in arranged accommodation close to the trial centre during a part of the study (from the day before challenge until anti-malarial treatment is completed).
  • Female subjects of child bearing potential must be willing to ensure that they practice continuous effective contraception for the duration of the study
  • Able (in the Investigator's opinion) and willing to comply with all study requirements
  • Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the study
  • Agreement to permanently refrain from blood donation, as per current UK Blood Transfusion and Tissue Transplantation Services guidelines (73).
  • Reachable (24 hours a day) by mobile phone during the period between CHMI and completion of antimalarial treatment.
  • Willingness to take a curative anti-malaria regimen following CHMI.
  • Answer all questions on the informed consent questionnaire correctly.

Exclusion Criteria:

  • History of clinical malaria (any species).
  • Travel to a malaria endemic region during the study period or within the preceding six months with significant risk of malaria exposure.
  • Use of systemic antibiotics with known antimalarial activity within 30 days of CHMI (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin).
  • Prior receipt of an investigational malaria vaccine or any other investigational vaccine likely to impact on interpretation of the trial data.
  • Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
  • History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection.
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • Use of immunoglobulins or blood products within 3 months prior to enrolment or previous severe adverse reaction to a blood transfusion.
  • History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (or malaria infection).
  • Any history of anaphylaxis post vaccination.
  • Pregnancy, lactation or intention to become pregnant during the study.
  • Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone.
  • Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone.
  • Contraindications to the use of all three proposed anti-malarial medications; Riamet, Malarone and Chloroquine.
  • Any clinical condition known to prolong the QT interval.
  • Family history of congenital QT prolongation or sudden death.
  • Positive family history in 1st and 2nd degree relatives < 50 years old for cardiac disease.
  • History of cardiac arrhythmia, including clinically relevant bradycardia.
  • An estimated, ten year risk of fatal cardiovascular disease of ≥5%, as estimated by the Systematic Coronary Risk Evaluation (SCORE) system.
  • Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests may be requested at the discretion of the Investigator. Absolute values for exclusion for confirmed abnormal results are shown in Appendix A.
  • History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
  • History of serious psychiatric condition that may affect participation in the study.
  • Any other serious chronic illness requiring hospital specialist supervision.
  • Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 42 standard UK units every week.
  • Suspected or known injecting drug abuse in the 5 years preceding enrolment.
  • Seropositive for hepatitis B surface antigen (HBsAg).
  • Seropositive for hepatitis C virus (antibodies to HCV) at screening.
  • Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.
  • Volunteers unable to be closely followed for social, geographic or psychological reasons.

Sites / Locations

  • NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton
  • Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford
  • NIHR Wellcome Trust Clinical Research Facility (NIHR WTCRF), Hammersmith Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

Group 1 - FMP2.1/AS01B vaccine

Group 2 - control

Arm Description

FMP2.1/AS01B vaccine administered at days 0, 28 and 56. Blood-stage controlled human malaria infection (CHMI) at day 70.

Group 2 is an infectivity-control group for the malaria infection challenge procedures; these volunteers will not be vaccinated. Blood-stage controlled human malaria infection (CHMI) at day 70.

Outcomes

Primary Outcome Measures

PCR-derived parasite multiplication rate (PMR)
PCR-derived parasite multiplication rate (PMR) will be the primary study endpoint, and comparison of the endpoint between the two study groups will constitute the primary analysis for efficacy.

Secondary Outcome Measures

Full Information

First Posted
January 21, 2014
Last Updated
January 8, 2015
Sponsor
University of Oxford
Collaborators
The PATH Malaria Vaccine Initiative (MVI), National Institute for Health Research, United Kingdom
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1. Study Identification

Unique Protocol Identification Number
NCT02044198
Brief Title
A Phase I/IIa Study of the Safety, Immunogenicity and Efficacy of FMP2.1/AS01B, an Asexual Blood-Stage Vaccine for Plasmodium Falciparum Malaria
Official Title
A Phase I/IIa Study of the Safety, Immunogenicity and Efficacy of FMP2.1/AS01B, an Asexual Blood-Stage Vaccine for Plasmodium Falciparum Malaria
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
December 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford
Collaborators
The PATH Malaria Vaccine Initiative (MVI), National Institute for Health Research, United Kingdom

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate an experimental malaria vaccine for its ability to prevent malaria infection or disease in a blood-stage challenge model (when volunteers are infected with malaria parasites using malaria-infected red blood cells). The vaccine being testing is a protein called FMP2.1, which is given with an adjuvant (a substance to improve the body's response to a vaccination) called AS01B. The aim is to use this protein and adjuvant to help the body make an immune response against parts of the malaria parasite. This study will enable assessment of: The ability of the vaccine to prevent malaria infection. The safety of the vaccine in healthy participants. The response of the human immune system to the vaccine. This will be done by giving participants three vaccinations and then exposing them to malaria infection by transfusing a small number of red blood cells infected with malaria under carefully regulated conditions. Participants will be followed closely to observe if and when they develop malaria. If the vaccine provides some protection against malaria, participants will take longer to develop malaria than usual or will not develop malaria at all. The study will enrol 15 participants to be vaccinated and then challenged with malaria in addition to recruit 15 individuals to be control subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Falciparum Malaria
Keywords
Plasmodium Falciparum, Malaria, Vaccine, Plasmodium, Falciparum

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Non-Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1 - FMP2.1/AS01B vaccine
Arm Type
Active Comparator
Arm Description
FMP2.1/AS01B vaccine administered at days 0, 28 and 56. Blood-stage controlled human malaria infection (CHMI) at day 70.
Arm Title
Group 2 - control
Arm Type
No Intervention
Arm Description
Group 2 is an infectivity-control group for the malaria infection challenge procedures; these volunteers will not be vaccinated. Blood-stage controlled human malaria infection (CHMI) at day 70.
Intervention Type
Biological
Intervention Name(s)
FMP2.1/AS01B
Other Intervention Name(s)
FMP2.1, AS01B
Intervention Description
50 µg FMP2.1 in 0.5 mL of the adjuvant AS01B (containing 50 mcg MPL + 50 mcg QS21) is administered via intramuscular (IM) injection in the deltoid region of the non-dominant arm
Primary Outcome Measure Information:
Title
PCR-derived parasite multiplication rate (PMR)
Description
PCR-derived parasite multiplication rate (PMR) will be the primary study endpoint, and comparison of the endpoint between the two study groups will constitute the primary analysis for efficacy.
Time Frame
From the day before CHMI until 23 days after the challenge

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy, male or non-pregnant female adults aged 18 - 45 years Subject is willing and able to give written informed consent for participation in the study Resident in or near Oxford for the duration of the challenge part of the study. Or for volunteers not living in Oxford: agreement to stay in arranged accommodation close to the trial centre during a part of the study (from the day before challenge until anti-malarial treatment is completed). Female subjects of child bearing potential must be willing to ensure that they practice continuous effective contraception for the duration of the study Able (in the Investigator's opinion) and willing to comply with all study requirements Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the study Agreement to permanently refrain from blood donation, as per current UK Blood Transfusion and Tissue Transplantation Services guidelines (73). Reachable (24 hours a day) by mobile phone during the period between CHMI and completion of antimalarial treatment. Willingness to take a curative anti-malaria regimen following CHMI. Answer all questions on the informed consent questionnaire correctly. Exclusion Criteria: History of clinical malaria (any species). Travel to a malaria endemic region during the study period or within the preceding six months with significant risk of malaria exposure. Use of systemic antibiotics with known antimalarial activity within 30 days of CHMI (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin). Prior receipt of an investigational malaria vaccine or any other investigational vaccine likely to impact on interpretation of the trial data. Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period. History of sickle cell anaemia, sickle cell trait, thalassaemia or thalassaemia trait or any haematological condition that could affect susceptibility to malaria infection. Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed). Use of immunoglobulins or blood products within 3 months prior to enrolment or previous severe adverse reaction to a blood transfusion. History of allergic disease or reactions likely to be exacerbated by any component of the vaccine (or malaria infection). Any history of anaphylaxis post vaccination. Pregnancy, lactation or intention to become pregnant during the study. Use of medications known to cause prolongation of the QT interval and existing contraindication to the use of Malarone. Use of medications known to have a potentially clinically significant interaction with Riamet and Malarone. Contraindications to the use of all three proposed anti-malarial medications; Riamet, Malarone and Chloroquine. Any clinical condition known to prolong the QT interval. Family history of congenital QT prolongation or sudden death. Positive family history in 1st and 2nd degree relatives < 50 years old for cardiac disease. History of cardiac arrhythmia, including clinically relevant bradycardia. An estimated, ten year risk of fatal cardiovascular disease of ≥5%, as estimated by the Systematic Coronary Risk Evaluation (SCORE) system. Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. In the event of abnormal test results, confirmatory repeat tests may be requested at the discretion of the Investigator. Absolute values for exclusion for confirmed abnormal results are shown in Appendix A. History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ). History of serious psychiatric condition that may affect participation in the study. Any other serious chronic illness requiring hospital specialist supervision. Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 42 standard UK units every week. Suspected or known injecting drug abuse in the 5 years preceding enrolment. Seropositive for hepatitis B surface antigen (HBsAg). Seropositive for hepatitis C virus (antibodies to HCV) at screening. Any other significant disease, disorder, or finding which may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data. Volunteers unable to be closely followed for social, geographic or psychological reasons.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Simon J Draper
Organizational Affiliation
University of Oxford
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Saul N Faust
Organizational Affiliation
University of Southampton
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Graham S Cooke
Organizational Affiliation
Imperial College London
Official's Role
Principal Investigator
Facility Information:
Facility Name
NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton
City
Southampton
State/Province
Hampshire
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford
City
Oxford
State/Province
Oxfordshire
ZIP/Postal Code
OX3 7LE
Country
United Kingdom
Facility Name
NIHR Wellcome Trust Clinical Research Facility (NIHR WTCRF), Hammersmith Hospital
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
26908756
Citation
Payne RO, Milne KH, Elias SC, Edwards NJ, Douglas AD, Brown RE, Silk SE, Biswas S, Miura K, Roberts R, Rampling TW, Venkatraman N, Hodgson SH, Labbe GM, Halstead FD, Poulton ID, Nugent FL, de Graaf H, Sukhtankar P, Williams NC, Ockenhouse CF, Kathcart AK, Qabar AN, Waters NC, Soisson LA, Birkett AJ, Cooke GS, Faust SN, Woods C, Ivinson K, McCarthy JS, Diggs CL, Vekemans J, Long CA, Hill AV, Lawrie AM, Dutta S, Draper SJ. Demonstration of the Blood-Stage Plasmodium falciparum Controlled Human Malaria Infection Model to Assess Efficacy of the P. falciparum Apical Membrane Antigen 1 Vaccine, FMP2.1/AS01. J Infect Dis. 2016 Jun 1;213(11):1743-51. doi: 10.1093/infdis/jiw039. Epub 2016 Feb 4. Erratum In: J Infect Dis. 2016 Sep 15;214(6):978.
Results Reference
derived

Learn more about this trial

A Phase I/IIa Study of the Safety, Immunogenicity and Efficacy of FMP2.1/AS01B, an Asexual Blood-Stage Vaccine for Plasmodium Falciparum Malaria

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