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Anti-malaria MAb in Mali

Primary Purpose

Plasmodium Falciparum Infection, Malaria

Status
Active
Phase
Phase 2
Locations
Mali
Study Type
Interventional
Intervention
VRC-MALMAB0100-00-AB (CIS43LS)
Normal saline
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Plasmodium Falciparum Infection

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Aged ≥18 and ≤55 years.
  • Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process.
  • In good general health and without clinically significant medical history.
  • Able to provide informed consent.
  • Willing to have blood samples and data stored for future research.
  • Resides in or near Kalifabougou or Torodo, Mali, and available for the duration of the study.
  • Females of childbearing potential must be willing to use reliable contraception from 21 days prior to study day 0 through the final study visit as described below.

    • Reliable methods of birth control include 1 of the following: confirmed pharmacologic contraceptives via parenteral delivery or intrauterine or implantable device.
    • Nonchildbearing women will be required to report date of last menstrual period, history of surgical sterility (i.e., tubal ligation, hysterectomy) or premature ovarian insufficiency, and will have urine or serum pregnancy test performed per protocol.

Exclusion Criteria:

  • Pregnancy, as determined by a positive urine or serum beta-human choriogonadotropin (β-hCG) test (if female).
  • Currently breastfeeding.
  • Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and comply with the study protocol.
  • Study comprehension examination score of <80% correct or per investigator discretion.
  • Hemoglobin, white blood cell, absolute neutrophil, or platelet count outside the local laboratory-defined limits of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.)
  • Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.)
  • Infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV).
  • Known or documented sickle cell disease by history. (Note: Known sickle cell trait is NOT exclusionary.)
  • Clinically significant abnormal electrocardiogram (ECG; corrected QT interval [QTc] >460 or other significant abnormal findings, including unexplained tachycardia or bradycardia).
  • Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, oncologic, or renal disease by history, physical examination, and/or laboratory studies including urinalysis.
  • Receipt of any investigational product within the past 30 days.
  • Participation or planned participation in an interventional trial with an investigational product until the last required protocol visit. (Note: Past, current, or planned participation in observational studies is NOT exclusionary.)
  • Medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
  • History of a severe allergic reaction or anaphylaxis.
  • Severe asthma (defined as asthma that is unstable or required emergent care, urgent care, hospitalization, or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years).
  • Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjögren's syndrome, or autoimmune thrombocytopenia.
  • Known immunodeficiency syndrome.
  • Known asplenia or functional asplenia.
  • Use of chronic (≥14 days) oral or IV corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone >10 mg/day) or immunosuppressive drugs within 30 days of day 0.
  • Receipt of a live vaccine within the past 4 weeks or a killed vaccine within the past 2 weeks prior to study agent administration.
  • Receipt of immunoglobulins and/or blood products within the past 6 months.
  • Previous receipt of an investigational malaria vaccine in the last 5 years.
  • Known allergies or contraindication against artemether-lumefantrine.
  • Other condition(s) that, in the opinion of the investigator, would jeopardize the safety or rights of a subject participating in the trial, interfere with the evaluation of the study objectives, or render the subject unable to comply with the protocol.

Sites / Locations

  • Kalifabougou MRTC Clinic
  • Torodo MRTC Clinic

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Dose-escalation study: Arm 1: 5 mg/kg of CIS43LS

Dose-escalation study: Arm 2: 10 mg/kg of CIS43LS

Dose-escalation study: Arm 3: 40 mg/kg of CIS43LS

Efficacy study: Arm 1: 10 mg/kg of CIS43LS

Efficacy study: Arm 2: 40 mg/kg of CIS43LS

Efficacy study: Arm 3: Placebo

Arm Description

Participants will receive 5 mg/kg of CIS43LS on Day 0. Once all participants in Arm 1 reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin for Arm 2.

Participants will receive 10 mg/kg of CIS43LS on Day 0. Once all participants in Arm 2 reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin for Arm 3.

Participants will receive 40 mg/kg of CIS43LS on Day 0. After the last participant in Arm 3 reaches Day 7 safety follow-up, an interim safety evaluation will be performed before enrollment begins for the Efficacy study.

Participants will receive 10 mg/kg of CIS43LS on Day 0

Participants will receive 40 mg/kg of CIS43LS on Day 0.

Participants will receive placebo on Day 0.

Outcomes

Primary Outcome Measures

Incidence of local AEs occurring within 7 days after the administration of CIS43LS.
Dose escalation study only.
Severity of local AEs occurring within 7 days after the administration of CIS43LS.
Dose escalation study only.
Incidence of systemic AEs occurring within 7 days after the administration of CIS43LS.
Dose escalation study only.
Severity of systemic AEs occurring within 7 days after the administration of CIS43LS.
Dose escalation study only.
Occurrence of Plasmodium falciparum (Pf) blood stage infection
Detected by microscopic examination of thick blood smear for 24 weeks after administration of CIS43LS or placebo. Efficacy study only.

Secondary Outcome Measures

Dose escalation study: measurement of CIS43LS in sera of recipients
Occurrence of Pf blood stage infection
Detected by PCR for 24 weeks after administration of CIS43LS or placebo. Efficacy study only.
Efficacy study: measurement of CIS43LS in sera of recipients

Full Information

First Posted
March 30, 2020
Last Updated
September 20, 2022
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Malaria Research and Training Center; Faculté de Médecine Pharmacie d'Odontostomatologie; University of Sciences, Techniques, & Technologies of Bamako (USTTB), Vaccine Research Center (VRC), NIAID, University of Washington, Harvard School of Public Health (HSPH)
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1. Study Identification

Unique Protocol Identification Number
NCT04329104
Brief Title
Anti-malaria MAb in Mali
Official Title
Safety and Efficacy of VRC-MALMAB0100-00-AB (CIS43LS), a Human Monoclonal Antibody Against Plasmodium Falciparum, in a Dose-Escalation Trial and a Randomized, Double-Blind Trial of Adults in Mali
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 15, 2021 (Actual)
Primary Completion Date
January 26, 2022 (Actual)
Study Completion Date
July 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Malaria Research and Training Center; Faculté de Médecine Pharmacie d'Odontostomatologie; University of Sciences, Techniques, & Technologies of Bamako (USTTB), Vaccine Research Center (VRC), NIAID, University of Washington, Harvard School of Public Health (HSPH)

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety, tolerability, and efficacy of VRC MALMAB0100-00-AB (CIS43LS), a human monoclonal antibody, against naturally occurring Plasmodium falciparum (Pf) infection.
Detailed Description
This study will evaluate the safety, tolerability, and efficacy of VRC MALMAB0100-00-AB (CIS43LS), a human monoclonal antibody, against naturally occurring Plasmodium falciparum (Pf) infection. The first part of the study is an open-label dose-escalation study for safety and tolerability. Participants will be assigned to one of three dose arms. Dosing will begin in the lowest dose arm. Once all participants in that arm reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin at the subsequent dose level. This process will be repeated until participants complete the third dose arm. Participants will be followed for safety to assess adverse events (AEs) at study visits 1, 3, 7, 14, 21, and 28 days after administration, then monthly through 24 weeks after administration. After the last subject in the highest dose arm reaches Day 7 safety follow-up, an interim safety evaluation will be performed before enrollment begins for the second part of the study. The second part of the study is a randomized, double-blind, placebo-controlled trial to assess safety and protective efficacy of CIS43LS and placebo. Participants in the efficacy study will receive the study agent and be followed at study visits 1, 3, 7, 14, 21, and 28 days later, and once every 2 weeks thereafter through 24 weeks. Primary study assessments include physical examinations and blood collection for identification of Pf infection and other research laboratory evaluations.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
348 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose-escalation study: Arm 1: 5 mg/kg of CIS43LS
Arm Type
Experimental
Arm Description
Participants will receive 5 mg/kg of CIS43LS on Day 0. Once all participants in Arm 1 reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin for Arm 2.
Arm Title
Dose-escalation study: Arm 2: 10 mg/kg of CIS43LS
Arm Type
Experimental
Arm Description
Participants will receive 10 mg/kg of CIS43LS on Day 0. Once all participants in Arm 2 reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin for Arm 3.
Arm Title
Dose-escalation study: Arm 3: 40 mg/kg of CIS43LS
Arm Type
Experimental
Arm Description
Participants will receive 40 mg/kg of CIS43LS on Day 0. After the last participant in Arm 3 reaches Day 7 safety follow-up, an interim safety evaluation will be performed before enrollment begins for the Efficacy study.
Arm Title
Efficacy study: Arm 1: 10 mg/kg of CIS43LS
Arm Type
Experimental
Arm Description
Participants will receive 10 mg/kg of CIS43LS on Day 0
Arm Title
Efficacy study: Arm 2: 40 mg/kg of CIS43LS
Arm Type
Experimental
Arm Description
Participants will receive 40 mg/kg of CIS43LS on Day 0.
Arm Title
Efficacy study: Arm 3: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo on Day 0.
Intervention Type
Biological
Intervention Name(s)
VRC-MALMAB0100-00-AB (CIS43LS)
Intervention Description
Administered via one-time IV infusion
Intervention Type
Other
Intervention Name(s)
Normal saline
Intervention Description
Administered via one-time IV infusion
Primary Outcome Measure Information:
Title
Incidence of local AEs occurring within 7 days after the administration of CIS43LS.
Description
Dose escalation study only.
Time Frame
Measured through Day 7
Title
Severity of local AEs occurring within 7 days after the administration of CIS43LS.
Description
Dose escalation study only.
Time Frame
Measured through Day 7
Title
Incidence of systemic AEs occurring within 7 days after the administration of CIS43LS.
Description
Dose escalation study only.
Time Frame
Measured through Day 7
Title
Severity of systemic AEs occurring within 7 days after the administration of CIS43LS.
Description
Dose escalation study only.
Time Frame
Measured through Day 7
Title
Occurrence of Plasmodium falciparum (Pf) blood stage infection
Description
Detected by microscopic examination of thick blood smear for 24 weeks after administration of CIS43LS or placebo. Efficacy study only.
Time Frame
Measured through Week 24
Secondary Outcome Measure Information:
Title
Dose escalation study: measurement of CIS43LS in sera of recipients
Time Frame
Measured through Week 24
Title
Occurrence of Pf blood stage infection
Description
Detected by PCR for 24 weeks after administration of CIS43LS or placebo. Efficacy study only.
Time Frame
Measured through Week 24
Title
Efficacy study: measurement of CIS43LS in sera of recipients
Time Frame
Measured through Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Aged ≥18 and ≤55 years. Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process. In good general health and without clinically significant medical history. Able to provide informed consent. Willing to have blood samples and data stored for future research. Resides in or near Kalifabougou or Torodo, Mali, and available for the duration of the study. Females of childbearing potential must be willing to use reliable contraception from 21 days prior to study day 0 through the final study visit as described below. Reliable methods of birth control include 1 of the following: confirmed pharmacologic contraceptives via parenteral delivery or intrauterine or implantable device. Nonchildbearing women will be required to report date of last menstrual period, history of surgical sterility (i.e., tubal ligation, hysterectomy) or premature ovarian insufficiency, and will have urine or serum pregnancy test performed per protocol. Exclusion Criteria: Pregnancy, as determined by a positive urine or serum beta-human choriogonadotropin (β-hCG) test (if female). Currently breastfeeding. Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and comply with the study protocol. Study comprehension examination score of <80% correct or per investigator discretion. Hemoglobin, white blood cell, absolute neutrophil, or platelet count outside the local laboratory-defined limits of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.) Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.) Infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV). Known or documented sickle cell disease by history. (Note: Known sickle cell trait is NOT exclusionary.) Clinically significant abnormal electrocardiogram (ECG; corrected QT interval [QTc] >460 or other significant abnormal findings, including unexplained tachycardia or bradycardia). Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, oncologic, or renal disease by history, physical examination, and/or laboratory studies including urinalysis. Receipt of any investigational product within the past 30 days. Participation or planned participation in an interventional trial with an investigational product until the last required protocol visit. (Note: Past, current, or planned participation in observational studies is NOT exclusionary.) Medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months. History of a severe allergic reaction or anaphylaxis. Severe asthma (defined as asthma that is unstable or required emergent care, urgent care, hospitalization, or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years). Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjögren's syndrome, or autoimmune thrombocytopenia. Known immunodeficiency syndrome. Known asplenia or functional asplenia. Use of chronic (≥14 days) oral or IV corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone >10 mg/day) or immunosuppressive drugs within 30 days of day 0. Receipt of a live vaccine within the past 4 weeks or a killed vaccine within the past 2 weeks prior to study agent administration. Receipt of immunoglobulins and/or blood products within the past 6 months. Previous receipt of an investigational malaria vaccine in the last 5 years. Known allergies or contraindication against artemether-lumefantrine. Other condition(s) that, in the opinion of the investigator, would jeopardize the safety or rights of a subject participating in the trial, interfere with the evaluation of the study objectives, or render the subject unable to comply with the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kassoum Kayentao, MD, MPH, PhD
Organizational Affiliation
Faculté de Médecine Pharmacie d'Odontostomatologie (FMPOS)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Peter D. Crompton, MD, MPH
Organizational Affiliation
National Institutes of Health (NIH)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kalifabougou MRTC Clinic
City
Kalifabougou
State/Province
Région De Koulikoro
Country
Mali
Facility Name
Torodo MRTC Clinic
City
Torodo
State/Province
Région De Koulikoro
Country
Mali

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36317783
Citation
Kayentao K, Ongoiba A, Preston AC, Healy SA, Doumbo S, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Kisalu NK, Carlton K, Serebryannyy L, Narpala S, McDermott AB, Gaudinski M, Traore S, Cisse H, Keita M, Skinner J, Hu Z, Zeguime A, Ouattara A, Doucoure M, Dolo A, Djimde A, Traore B, Seder RA, Crompton PD; Mali Malaria mAb Trial Team. Safety and Efficacy of a Monoclonal Antibody against Malaria in Mali. N Engl J Med. 2022 Nov 17;387(20):1833-1842. doi: 10.1056/NEJMoa2206966. Epub 2022 Oct 31.
Results Reference
derived

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Anti-malaria MAb in Mali

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