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Bacille Calmette Guerin (BCG) Revaccination of Healthy Adolescents for the Prevention of Mycobacterium Tuberculosis Sustained Infection

Primary Purpose

Tuberculosis

Status
Active
Phase
Phase 2
Locations
South Africa
Study Type
Interventional
Intervention
BCG vaccine SSI
Placebo
Sponsored by
Bill & Melinda Gates Medical Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Tuberculosis focused on measuring Mycobacterium tuberculosis infection, Healthy adolescents, Healthy participants, BCG vaccine

Eligibility Criteria

10 Years - 18 Years (Child, Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Participant between ≥ 10 years and ≤ 18 years on Study Day 1
  • General good health, confirmed by medical history and physical examination
  • Vaccinated with Bacille Calmette Guerin (BCG) at least 5 years ago, documented through medical history or by presence of healed BCG scar
  • Tests QuantiFERON®-TB Gold Plus Assay (QFT) negative at screening, using the manufacturer's recommended threshold of 0.35 international units per milliliter
  • For female participants: not pregnant and agrees to avoid pregnancy throughout the first 12 months of the study. Women physically capable of pregnancy must agree to use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include sexual abstinence (not engaging in sexual intercourse), a confirmed sterile partner, or at least 2 contraception methods from the following list: male or female condom, diaphragm, intrauterine devices (IUDs), hormonal contraceptive (oral, injection, transdermal patch, or implant).
  • 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
  • Capable of giving signed informed consent/assent and completes the written informed consent/assent process.

Exclusion Criteria:

  • Acute illness on Study Day 1 . NOTE: This is a temporary exclusion for which the participant may be re-evaluated
  • Body temperature ≥37.5 degree Celsius on Study Day 1. NOTE: This is a temporary exclusion for which the participant may be re-evaluated
  • History or evidence of any clinically significant disease, including severe eczema and severe asthma, or any acute or chronic illness that might affect the safety, immunogenicity, or efficacy of study vaccine in the opinion of the investigator
  • 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
  • History of autoimmune disease
  • History or evidence of active tuberculosis (TB) disease
  • History or laboratory evidence of any past or present possible immunodeficiency state including, but not limited to, any laboratory indication of human immunodeficiency virus - 1 (HIV-1) infection
  • History of allergic disease that is likely to be exacerbated by any component of the study vaccine
  • History of treatment for active TB disease or history of latent Mycobacterium tuberculosis infection
  • Received a tuberculin skin test within 6 months prior to Study Day 1
  • Received immunosuppressive treatment, e.g., chemotherapy, biologics or radiation therapy, or used immunosuppressive medication (daily steroid equivalent of ≥5 milligrams prednisone) within 42 days before Study Day 1. Inhaled and topical corticosteroids are permitted.
  • Received immunoglobulin or blood products within 42 days before Study Day 1
  • Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after Study Day 1
  • Received investigational TB vaccine at any time prior to Study Day 1
  • Received any investigational drug therapy or investigational vaccine within 180 days before Study Day 1, or planned participation in any other clinical trial using investigational product during the study period
  • Laboratory values from the most recent blood collected prior to randomization outside the normal range that are suggestive of a disease state. Grade 1 abnormalities (as per Division of Acquired Immunodeficiency Syndrome toxicity table version 2.1) do not lead to exclusion if the investigator considers them not clinically significant
  • 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
  • Shared residence with an individual who is receiving TB treatment or with someone who is known to have incompletely treated TB. e.g., polymerase chain reaction-positive, culture-positive, smear-positive TB, or clinically diagnosed unconfirmed TB
  • Child in Care
  • Female participants currently pregnant or lactating/nursing; or positive serum pregnancy test during screening or on Day 1, prior to vaccination, or planning a pregnancy within the first 12 months after study intervention

Sites / Locations

  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Bacille Calmette Guerin (BCG) group

Placebo group

Arm Description

Outcomes

Primary Outcome Measures

Number of Participants With Sustained QuantiFERON®-TB Gold Plus Assay (QFT) Conversion From a Negative to Positive Test Based on positive QFT test results
Sustained Conversion means initial conversion and QFT Positive 3 and 6 months later.

Secondary Outcome Measures

Number of Participants with Sustained QFT Conversion From a Negative to Positive Test Based on positive QFT test results
Number of Participants With Solicited Adverse Events (AEs)
Number of Participants With Unsolicited AEs
Number of Participants With Serious Adverse Events
Number of Participants With AEs of Special Interest
Number of Participants With Serious Adverse Drug Reactions

Full Information

First Posted
October 22, 2019
Last Updated
October 4, 2023
Sponsor
Bill & Melinda Gates Medical Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT04152161
Brief Title
Bacille Calmette Guerin (BCG) Revaccination of Healthy Adolescents for the Prevention of Mycobacterium Tuberculosis Sustained Infection
Official Title
A Randomized, Placebo Controlled, Observer-Blind, Phase IIb Study to Evaluate the Efficacy, Safety, and Immunogenicity of BCG Revaccination in Healthy Adolescents for the Prevention of Sustained Infection With Mycobacterium Tuberculosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 16, 2019 (Actual)
Primary Completion Date
September 1, 2025 (Anticipated)
Study Completion Date
September 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bill & Melinda Gates Medical Research Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to demonstrate the efficacy of Bacille Calmette Guerin (BCG) revaccination against sustained Mycobacterium tuberculosis infection versus placebo in previously BCG vaccinated QuantiFERON®-TB Gold Plus Assay (QFT) negative, healthy adolescents.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis
Keywords
Mycobacterium tuberculosis infection, Healthy adolescents, Healthy participants, BCG vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1836 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bacille Calmette Guerin (BCG) group
Arm Type
Experimental
Arm Title
Placebo group
Arm Type
Placebo Comparator
Intervention Type
Biological
Intervention Name(s)
BCG vaccine SSI
Intervention Description
Participants will receive a single 0.1 milliliter (mL) volume of BCG vaccine SSI, administered intradermally in deltoid region of the upper arm.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Participants will receive a single 0.1 mL volume of normal saline, administered intradermally in deltoid region of the upper arm.
Primary Outcome Measure Information:
Title
Number of Participants With Sustained QuantiFERON®-TB Gold Plus Assay (QFT) Conversion From a Negative to Positive Test Based on positive QFT test results
Description
Sustained Conversion means initial conversion and QFT Positive 3 and 6 months later.
Time Frame
Up to 48 months
Secondary Outcome Measure Information:
Title
Number of Participants with Sustained QFT Conversion From a Negative to Positive Test Based on positive QFT test results
Time Frame
Initial conversion and QFT-positive at 3- and 6-months post conversion, with a minimum follow-up of 36- and 48-months post vaccination
Title
Number of Participants With Solicited Adverse Events (AEs)
Time Frame
Day 1 through 7 days post vaccination
Title
Number of Participants With Unsolicited AEs
Time Frame
Day 1 through 28 days post vaccination
Title
Number of Participants With Serious Adverse Events
Time Frame
Day 1 through Month 6
Title
Number of Participants With AEs of Special Interest
Time Frame
Day 1 through Month 6
Title
Number of Participants With Serious Adverse Drug Reactions
Time Frame
Day 1 through end of study participation i.e. approximately 48 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
10 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participant between ≥ 10 years and ≤ 18 years on Study Day 1 General good health, confirmed by medical history and physical examination Vaccinated with Bacille Calmette Guerin (BCG) at least 5 years ago, documented through medical history or by presence of healed BCG scar Tests QuantiFERON®-TB Gold Plus Assay (QFT) negative at screening. For female participants: not pregnant and agrees to avoid pregnancy throughout the first 12 months of the study. Women physically capable of pregnancy must agree to use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include sexual abstinence (not engaging in sexual intercourse), a confirmed sterile partner, or at least 2 contraception methods from the following list: male or female condom, diaphragm, intrauterine devices (IUDs), hormonal contraceptive (oral, injection, transdermal patch, or implant). 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 Capable of giving signed informed consent/assent and completes the written informed consent/assent process. Exclusion Criteria: Acute illness on Study Day 1. NOTE: This is a temporary exclusion for which the participant may be re-evaluated Body temperature ≥37.5 degree Celsius on Study Day 1. NOTE: This is a temporary exclusion for which the participant may be re-evaluated History or evidence of any clinically significant disease, including severe eczema and severe asthma, or any acute or chronic illness that might affect the safety, immunogenicity, or efficacy of study vaccine in the opinion of the investigator 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 History of autoimmune disease History or evidence of active tuberculosis (TB) disease History or laboratory evidence of any past or present possible immunodeficiency state including, but not limited to, any laboratory indication of human immunodeficiency virus - 1 (HIV-1) infection History of allergic disease that is likely to be exacerbated by any component of the study vaccine History of treatment for active TB disease or history of latent Mycobacterium tuberculosis infection Received a tuberculin skin test within 6 months prior to Study Day 1 Received immunosuppressive treatment, e.g., chemotherapy, biologics or radiation therapy, or used immunosuppressive medication (daily steroid equivalent of ≥5 milligrams prednisone) within 42 days before Study Day 1. Inhaled and topical corticosteroids are permitted. Received immunoglobulin or blood products within 42 days before Study Day 1 Planned administration/administration of a licensed vaccine in the period starting 28 days before and ending 28 days after Study Day 1 Received investigational TB vaccine at any time prior to Study Day 1 Received any investigational drug therapy or investigational vaccine within 180 days before Study Day 1, or planned participation in any other clinical trial using investigational product during the study period Laboratory values from the most recent blood collected prior to randomization outside the normal range that are suggestive of a disease state. Grade 1 abnormalities (as per Division of Acquired Immunodeficiency Syndrome toxicity table version 2.1) do not lead to exclusion if the investigator considers them not clinically significant 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 Shared residence with an individual who is receiving TB treatment or with someone who is known to have incompletely treated TB. e.g., Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF) assay-positive, polymerase chain reaction-positive, culture-positive, smear-positive TB, or clinically diagnosed unconfirmed TB Child in Care Female participants currently pregnant or lactating/nursing; or positive serum pregnancy test during screening or on Day 1, prior to vaccination, or planning a pregnancy within the first 12 months after study intervention
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gates MRI
Organizational Affiliation
Bill & Melinda Gates Medical Research Institute
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site
City
Klipfontein
State/Province
Cape Town
ZIP/Postal Code
7750
Country
South Africa
Facility Name
Investigational Site
City
Berea
State/Province
Durban
ZIP/Postal Code
4001
Country
South Africa
Facility Name
Investigational Site
City
Hillbrow
State/Province
Johannesburg
ZIP/Postal Code
2001
Country
South Africa
Facility Name
Investigational Site
City
Paarl
State/Province
Western Cape
ZIP/Postal Code
7626
Country
South Africa
Facility Name
Investigational Site
City
Worcester
State/Province
Western Cape
ZIP/Postal Code
6850
Country
South Africa

12. IPD Sharing Statement

Plan to Share IPD
Yes

Learn more about this trial

Bacille Calmette Guerin (BCG) Revaccination of Healthy Adolescents for the Prevention of Mycobacterium Tuberculosis Sustained Infection

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