A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL) (LEISH3)
Primary Purpose
Post-kala-azar Dermal Leishmaniasis
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Vaccine
Placebo
Sponsored by
About this trial
This is an interventional prevention trial for Post-kala-azar Dermal Leishmaniasis
Eligibility Criteria
Inclusion Criteria:
The patient volunteer must be:
- Aged 12 to 50 years on the day of screening
- Have had VL and have been cured following a standard regimen of SSG / PM
- Females must be unmarried, single, or widowed
- Willing and able to give written informed consent
- For adolescents aged 12 to 17 years on the day of screening written informed consent from a parent must be obtained.
All Participants
- Uncomplicated VL responsive to SSG / PM treatment
- Have relatively normal blood values in the setting of VL, defined as hemoglobin >5.0 g/dL, white blood cells >1.0 x10(9)/L, platelets >40 x10(9)/L, liver function tests < x5 normal, Creatinine <1.5 mg/dL
- Available for the duration of the study
- Without any other significant health problems as determined by medical history, physical examination, results of screening tests and the clinical judgment of a medically qualified Clinical Investigator
- Negative for malaria on blood smear
- Judged, in the opinion of a medically qualified Clinical Investigator, to be able and likely to comply with all study requirements as set out in the protocol
- Negative for human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C
- For females only, willing to undergo urinary pregnancy tests on the day of screening, on the day of vaccination (prior to vaccination) and 3, 6, 9 and 12 months after vaccination.
Exclusion Criteria:
The volunteer may not enter the study if any of the following apply:
- Has HIV/VL coinfection
- Has had previous treatment for VL with relapse
- Receipt of a live attenuated vaccine within 60 days or other vaccine within 14 days of screening
- Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
- History of allergic disease or reactions likely to be exacerbated by any component of the vaccine or a history of severe or multiple allergies to drugs or pharmaceutical agents
- Any history of severe local or general reaction to vaccination as defined as
- Local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the major circumference of the arm, not resolving within 72 hours
- General: fever ≥ 39.5°C within 48 hours, anaphylaxis, bronchospasm, laryngeal oedema, collapse, convulsions or encephalopathy within 48 hours
- Females - pregnancy, less than 12 weeks postpartum, lactating or willingness/intention to become pregnant during the study and for 3 months following vaccination.
- Seropositive for hepatitis B surface antigen (HBsAg) or Hepatitis C (antibodies to hepatitis C virus)
- Significant abnormal finding (in the setting of VL, see definitions in Inclusion criteria) on entry biochemistry or haematology blood tests or urinalysis
- 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
- Tuberculosis, leprosy, or malnutrition (malnutrition in adults defined as a BMI <18.5, and in adolescents (12-17yrs) as a Z score cut-off value of <-2 SD).
- Any other significant disease, disorder or finding, which, in the opinion of a medically qualified Clinical Investigator, may either put the volunteer at risk because of participation in the study, or may influence the result of the study, or the volunteer's ability to participate in the study
- Unlikely to comply with the study protocol
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Vaccine arm
Placebo
Arm Description
Vaccine in 1 ml, single dose
1 ml normal saline , single dose
Outcomes
Primary Outcome Measures
Safety of single dose vaccination with ChAd63-KH
Treatment-related adverse events as defined in the clinical trial protocol (median no. events)
Efficacy of single dose vaccination with ChAd63-KH
Frequency of occurrence of PKDL in patients completing treatment with SSG / PM.
Secondary Outcome Measures
Immunological response: T cells
To compare systemic immune responses in vaccine vs placebo arms by measurement of the frequency (median) of gamma-interferon producing T cells
Immunological response: transcriptomics
Comparing transcripts for differential expression in vaccine and placebo arms
Pathogenesis of PKDL comparing Leishmania parasite load pre-vaccination and at PKDL onset
Parasite detection using RNAscope / immunocytochemistry
Immunological response: B cells
Measurement of frequency in vaccinated and placebo groups of B cells by flow cytometry
Immunological response: antibody levels
To compare systemic immune responses in vaccine vs placebo arms by median optical density levels
Full Information
NCT ID
NCT04107961
First Posted
September 23, 2019
Last Updated
September 29, 2022
Sponsor
University of York
Collaborators
Wellcome Trust, European and Developing Countries Clinical Trials Partnership (EDCTP), European Vaccine Initiative
1. Study Identification
Unique Protocol Identification Number
NCT04107961
Brief Title
A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL)
Acronym
LEISH3
Official Title
A Phase II Study to Assess the Safety and Efficacy of the Leishmania Vaccine ChAd63-KH for the Prevention of Post-kala Azar Dermal Leishmaniasis
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Withdrawn
Why Stopped
The trial will be undertaken but the protocol will be substantially revised.
Study Start Date
October 1, 2023 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
July 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of York
Collaborators
Wellcome Trust, European and Developing Countries Clinical Trials Partnership (EDCTP), European Vaccine Initiative
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
The actual format of the anticipated LEISH3 trial is under review.
Detailed Description
The leishmaniases are poverty-related neglected diseases with a major impact on health worldwide. They affect the poorest of the poor and present a severe barrier to socio-economic development. Caused by infection with one of several species of Leishmania parasite, these diseases occur in 98 countries worldwide and can be broadly classified as tegumentary leishmaniases (TL; affecting the skin and mucosa) and visceral leishmaniasis (VL; affecting internal organs). Worldwide, over 1 million reported cases of TL and 0.5 million reported cases of VL occur each year. Whereas TL are chronic and non-life-threatening, VL is responsible for over 20,000 deaths per year, second only to malaria amongst parasites with regard to mortality. Collectively, approximately 2.4 million disability-adjusted life years are lost to the leishmaniases. No vaccines are currently licensed for any form of human leishmaniasis and the drug arsenal is limited and increasingly compromised by drug resistance.
.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Post-kala-azar Dermal Leishmaniasis
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomised placebo-controlled double-blind study
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Double blinded placebo controlled
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Vaccine arm
Arm Type
Experimental
Arm Description
Vaccine in 1 ml, single dose
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
1 ml normal saline , single dose
Intervention Type
Biological
Intervention Name(s)
Vaccine
Other Intervention Name(s)
ChAd63-KH
Intervention Description
Single intramuscular injection into the deltoid region
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Single intramuscular injection into the deltoid region
Primary Outcome Measure Information:
Title
Safety of single dose vaccination with ChAd63-KH
Description
Treatment-related adverse events as defined in the clinical trial protocol (median no. events)
Time Frame
12 months from vaccination
Title
Efficacy of single dose vaccination with ChAd63-KH
Description
Frequency of occurrence of PKDL in patients completing treatment with SSG / PM.
Time Frame
12 months from vaccination
Secondary Outcome Measure Information:
Title
Immunological response: T cells
Description
To compare systemic immune responses in vaccine vs placebo arms by measurement of the frequency (median) of gamma-interferon producing T cells
Time Frame
12 months from vaccination
Title
Immunological response: transcriptomics
Description
Comparing transcripts for differential expression in vaccine and placebo arms
Time Frame
12 months from vaccination
Title
Pathogenesis of PKDL comparing Leishmania parasite load pre-vaccination and at PKDL onset
Description
Parasite detection using RNAscope / immunocytochemistry
Time Frame
12 months from vaccination
Title
Immunological response: B cells
Description
Measurement of frequency in vaccinated and placebo groups of B cells by flow cytometry
Time Frame
12 months from vaccination
Title
Immunological response: antibody levels
Description
To compare systemic immune responses in vaccine vs placebo arms by median optical density levels
Time Frame
12 months from vaccination
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The patient volunteer must be:
Aged 12 to 50 years on the day of screening
Have had VL and have been cured following a standard regimen of SSG / PM
Females must be unmarried, single, or widowed
Willing and able to give written informed consent
For adolescents aged 12 to 17 years on the day of screening written informed consent from a parent must be obtained.
All Participants
Uncomplicated VL responsive to SSG / PM treatment
Have relatively normal blood values in the setting of VL, defined as hemoglobin >5.0 g/dL, white blood cells >1.0 x10(9)/L, platelets >40 x10(9)/L, liver function tests < x5 normal, Creatinine <1.5 mg/dL
Available for the duration of the study
Without any other significant health problems as determined by medical history, physical examination, results of screening tests and the clinical judgment of a medically qualified Clinical Investigator
Negative for malaria on blood smear
Judged, in the opinion of a medically qualified Clinical Investigator, to be able and likely to comply with all study requirements as set out in the protocol
Negative for human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C
For females only, willing to undergo urinary pregnancy tests on the day of screening, on the day of vaccination (prior to vaccination) and 3, 6, 9 and 12 months after vaccination.
Exclusion Criteria:
The volunteer may not enter the study if any of the following apply:
Has HIV/VL coinfection
Has had previous treatment for VL with relapse
Receipt of a live attenuated vaccine within 60 days or other vaccine within 14 days of screening
Administration of immunoglobulins and/or any blood products within the three months preceding the planned administration of the vaccine candidate
History of allergic disease or reactions likely to be exacerbated by any component of the vaccine or a history of severe or multiple allergies to drugs or pharmaceutical agents
Any history of severe local or general reaction to vaccination as defined as
Local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the major circumference of the arm, not resolving within 72 hours
General: fever ≥ 39.5°C within 48 hours, anaphylaxis, bronchospasm, laryngeal oedema, collapse, convulsions or encephalopathy within 48 hours
Females - pregnancy, less than 12 weeks postpartum, lactating or willingness/intention to become pregnant during the study and for 3 months following vaccination.
Seropositive for hepatitis B surface antigen (HBsAg) or Hepatitis C (antibodies to hepatitis C virus)
Significant abnormal finding (in the setting of VL, see definitions in Inclusion criteria) on entry biochemistry or haematology blood tests or urinalysis
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
Tuberculosis, leprosy, or malnutrition (malnutrition in adults defined as a BMI <18.5, and in adolescents (12-17yrs) as a Z score cut-off value of <-2 SD).
Any other significant disease, disorder or finding, which, in the opinion of a medically qualified Clinical Investigator, may either put the volunteer at risk because of participation in the study, or may influence the result of the study, or the volunteer's ability to participate in the study
Unlikely to comply with the study protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul M Kaye, PhD
Organizational Affiliation
University of York
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Study to Assess Safety and Efficacy of a Leishmania Vaccine to Prevent Post Kala Azar Dermal Leishmaniasis (PKDL)
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