search
Back to results

A Study of the Efficacy and Safety of the LEISH-F2 + MPL-SE Vaccine for Treatment of Cutaneous Leishmaniasis

Primary Purpose

Cutaneous Leishmaniasis

Status
Completed
Phase
Phase 2
Locations
Peru
Study Type
Interventional
Intervention
LEISH-F2 + MPL-SE
Sodium stibogluconate
Sponsored by
Access to Advanced Health Institute (AAHI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cutaneous Leishmaniasis focused on measuring Leishmaniasis, vaccine, immunotherapy

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males and females ≥ 12 years and < 70 years of age. In the first stage of the study, only patients aged ≥ 18 years and < 70 years will be enrolled. In the second stage, enrollment will also include adolescent patients aged ≥ 12 - < 18 years.
  • Must have a clinical diagnosis of cutaneous leishmaniasis confirmed by positive identification of Leishmania parasite and identification of L. peruviana by PCR.
  • Lesions must be clear of any superinfection prior to enrollment.
  • Female patients of childbearing age must have a negative serum pregnancy test at screening, a negative urine pregnancy test within 24 hours before the first vaccination or initiation of chemotherapy, must not be breast-feeding, and are required to use adequate contraception through Day 84 of the study. These precautions are necessary due to unknown effects that LEISH-F2 + MPL SE, sodium stibogluconate might have in a fetus or newborn infant.
  • The following laboratory blood tests must have values within the normal ranges at screening: sodium, potassium, urea, total bilirubin, ALT, AST, glucose, creatinine, alkaline phosphatase, total WBC count and platelet count. Hemoglobin may exceed the ULN since patients reside in the Andes at very high altitude (up to 20 g/dL)
  • The following serology tests must be negative at screening: HIV-1/2, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) antibody. All patients (or their parents) will receive HIV-related counseling prior to testing. Patients with positive HIV test results will be referred for counseling and treatment as appropriate.
  • Potential study patients (or their guardians) must give written informed consent, be willing to be housed in Lima for a minimum of 20 days and up to 63 days, able to attend all required follow-up visits, have a permanent address, and be reachable by study site personnel.

Exclusion Criteria:

  • Infection with species other than L.peruviana as confirmed by PCR.
  • Presence of eleven or more active cutaneous leishmaniasis lesions.
  • The diameter of the ulcerated area of any single lesion is >60 mm.
  • Presence of lesions with superinfection at time of enrollment.
  • History of mucocutaneous leishmaniasis or diagnosis of mucocutaneous leishmaniasis at screening.
  • History of previous exposure to Leishmania vaccines.
  • Known use of injected or oral corticosteroids within 6 weeks prior to the first vaccination or initiation of chemotherapy.
  • Participation in another experimental protocol or receipt of any investigational products within 30 days prior to the first vaccination or initiation of chemotherapy.
  • History of autoimmune disease or other causes of immunosuppressive states.
  • History or evidence of any acute or chronic illness that, in the opinion of the study clinician, may interfere with the evaluation of the safety or the immunogenicity of the vaccine. (Patients presenting with concomitant illness will be referred for standard clinical care).
  • History of use of any medication that, in the opinion of the study clinician, may interfere with the evaluation of the safety or the immunogenicity of the vaccine.
  • History of significant psychiatric illness.
  • Drug addiction including alcohol abuse.
  • Patients with a history of previous anaphylaxis, severe allergic reaction to vaccines or unknown allergens, or allergic reaction to eggs.
  • Patients who are unlikely to cooperate with the requirements of the study protocol.
  • ECG with evidence of ventricular arrythmias ≥ 4 extra systoles per minute.
  • Known allergy or contraindication to chemotherapy (e.g., known reaction to pentavalent antimonials, cardiopathy, myocarditis).

Sites / Locations

  • Instituto de Medicina Tropical"Alexander von Humboldt"

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

LEISH-F2 + MPL-SE vaccine

Sodium stibogluconate (SSG)

Arm Description

Recombinant three antigen Leishmania polyprotein + MPL-SE adjuvant

20 mg/kg/day IV for 20 days

Outcomes

Primary Outcome Measures

Date of Clinical Cure
Efficacy of immunotherapy with the LEISH-F2 + MPL-SE vaccine was compared to the efficacy of chemotherapy with sodium stibogluconate in the treatment of CL. Efficacy is measured by the date of clinical cure.
Adverse Events of Grade 1 Severity or Higher Occurring in ≥ 3 Patients During Active Treatment Phase of the Study.
Safety of immunotherapy with the vaccine was compared to the safety of chemotherapy with sodium stibogluconate. All adverse events are listed regardless of relatedness.

Secondary Outcome Measures

IgG Antibodies and T-cell Cytokine Responses (IFN-g and IL-10)
Immunogenicity of the vaccine was evaluated by measuring IgG antibody and T-cell responses to the LEISH-F2 protein and soluble Leishmania antigen (SLA). IgG antibodies were measured by ELISA and T-cell cytokine responses (IFN-g and IL-10) were measured by Luminex. Data is presented as median Post:Pre ratios comparing Days 56/84 or 168 to baseline at Day 0.

Full Information

First Posted
November 9, 2009
Last Updated
November 15, 2013
Sponsor
Access to Advanced Health Institute (AAHI)
search

1. Study Identification

Unique Protocol Identification Number
NCT01011309
Brief Title
A Study of the Efficacy and Safety of the LEISH-F2 + MPL-SE Vaccine for Treatment of Cutaneous Leishmaniasis
Official Title
A Phase 2, Randomized, Open-Label, Controlled Study to Evaluate the Efficacy, Safety, and Immunogenicity of the LEISH-F2 + MPL-SE Vaccine in the Treatment of Patients With Cutaneous Leishmaniasis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2013
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
December 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Access to Advanced Health Institute (AAHI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the efficacy, safety, and immunogenicity of an investigational vaccine being developed for the treatment of leishmaniasis, including cutaneous leishmaniasis (CL). The vaccine, identified as LEISH-F2 + MPL-SE, consists of a Leishmania protein (LEISH-F2) together with an adjuvant MPL-SE.
Detailed Description
A phase 2, randomized, open-label, controlled study to evaluate the efficacy, safety, and immunogenicity of the vaccine administered three times (10 μg LEISH-F2 + 25 μg MPL-SE on Days 0, 28 and 56) in the treatment of adults and adolescents with CL compared to treatment with standard chemotherapy (20 mg/kg/day sodium stibogluconate for 20 days). The proportion cured in each group will be determined using clinical criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cutaneous Leishmaniasis
Keywords
Leishmaniasis, vaccine, immunotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LEISH-F2 + MPL-SE vaccine
Arm Type
Experimental
Arm Description
Recombinant three antigen Leishmania polyprotein + MPL-SE adjuvant
Arm Title
Sodium stibogluconate (SSG)
Arm Type
Active Comparator
Arm Description
20 mg/kg/day IV for 20 days
Intervention Type
Biological
Intervention Name(s)
LEISH-F2 + MPL-SE
Other Intervention Name(s)
There are no other names for the vaccine.
Intervention Description
10 μg LEISH-F2 + 25 μg MPL-SE on Days 0, 28 and 56
Intervention Type
Drug
Intervention Name(s)
Sodium stibogluconate
Other Intervention Name(s)
Marfan SSG
Intervention Description
20 mg/kg/day IV daily for 20 days
Primary Outcome Measure Information:
Title
Date of Clinical Cure
Description
Efficacy of immunotherapy with the LEISH-F2 + MPL-SE vaccine was compared to the efficacy of chemotherapy with sodium stibogluconate in the treatment of CL. Efficacy is measured by the date of clinical cure.
Time Frame
Day 84
Title
Adverse Events of Grade 1 Severity or Higher Occurring in ≥ 3 Patients During Active Treatment Phase of the Study.
Description
Safety of immunotherapy with the vaccine was compared to the safety of chemotherapy with sodium stibogluconate. All adverse events are listed regardless of relatedness.
Time Frame
Day 0 through Day 84
Secondary Outcome Measure Information:
Title
IgG Antibodies and T-cell Cytokine Responses (IFN-g and IL-10)
Description
Immunogenicity of the vaccine was evaluated by measuring IgG antibody and T-cell responses to the LEISH-F2 protein and soluble Leishmania antigen (SLA). IgG antibodies were measured by ELISA and T-cell cytokine responses (IFN-g and IL-10) were measured by Luminex. Data is presented as median Post:Pre ratios comparing Days 56/84 or 168 to baseline at Day 0.
Time Frame
Days 0, 56 or 84, and 168

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females ≥ 12 years and < 70 years of age. In the first stage of the study, only patients aged ≥ 18 years and < 70 years will be enrolled. In the second stage, enrollment will also include adolescent patients aged ≥ 12 - < 18 years. Must have a clinical diagnosis of cutaneous leishmaniasis confirmed by positive identification of Leishmania parasite and identification of L. peruviana by PCR. Lesions must be clear of any superinfection prior to enrollment. Female patients of childbearing age must have a negative serum pregnancy test at screening, a negative urine pregnancy test within 24 hours before the first vaccination or initiation of chemotherapy, must not be breast-feeding, and are required to use adequate contraception through Day 84 of the study. These precautions are necessary due to unknown effects that LEISH-F2 + MPL SE, sodium stibogluconate might have in a fetus or newborn infant. The following laboratory blood tests must have values within the normal ranges at screening: sodium, potassium, urea, total bilirubin, ALT, AST, glucose, creatinine, alkaline phosphatase, total WBC count and platelet count. Hemoglobin may exceed the ULN since patients reside in the Andes at very high altitude (up to 20 g/dL) The following serology tests must be negative at screening: HIV-1/2, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) antibody. All patients (or their parents) will receive HIV-related counseling prior to testing. Patients with positive HIV test results will be referred for counseling and treatment as appropriate. Potential study patients (or their guardians) must give written informed consent, be willing to be housed in Lima for a minimum of 20 days and up to 63 days, able to attend all required follow-up visits, have a permanent address, and be reachable by study site personnel. Exclusion Criteria: Infection with species other than L.peruviana as confirmed by PCR. Presence of eleven or more active cutaneous leishmaniasis lesions. The diameter of the ulcerated area of any single lesion is >60 mm. Presence of lesions with superinfection at time of enrollment. History of mucocutaneous leishmaniasis or diagnosis of mucocutaneous leishmaniasis at screening. History of previous exposure to Leishmania vaccines. Known use of injected or oral corticosteroids within 6 weeks prior to the first vaccination or initiation of chemotherapy. Participation in another experimental protocol or receipt of any investigational products within 30 days prior to the first vaccination or initiation of chemotherapy. History of autoimmune disease or other causes of immunosuppressive states. History or evidence of any acute or chronic illness that, in the opinion of the study clinician, may interfere with the evaluation of the safety or the immunogenicity of the vaccine. (Patients presenting with concomitant illness will be referred for standard clinical care). History of use of any medication that, in the opinion of the study clinician, may interfere with the evaluation of the safety or the immunogenicity of the vaccine. History of significant psychiatric illness. Drug addiction including alcohol abuse. Patients with a history of previous anaphylaxis, severe allergic reaction to vaccines or unknown allergens, or allergic reaction to eggs. Patients who are unlikely to cooperate with the requirements of the study protocol. ECG with evidence of ventricular arrythmias ≥ 4 extra systoles per minute. Known allergy or contraindication to chemotherapy (e.g., known reaction to pentavalent antimonials, cardiopathy, myocarditis).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Franco Piazza, MD, MPH
Organizational Affiliation
Access to Advanced Health Institute (AAHI)
Official's Role
Study Director
Facility Information:
Facility Name
Instituto de Medicina Tropical"Alexander von Humboldt"
City
Lima
Country
Peru

12. IPD Sharing Statement

Learn more about this trial

A Study of the Efficacy and Safety of the LEISH-F2 + MPL-SE Vaccine for Treatment of Cutaneous Leishmaniasis

We'll reach out to this number within 24 hrs