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Clinical Trial for the Evaluation of Three Regimens of Influenza Vaccination in Kidney Transplant Recipients

Primary Purpose

Human Influenza

Status
Completed
Phase
Phase 4
Locations
Brazil
Study Type
Interventional
Intervention
Trivalent influenza vaccine (inactivated and fragmented).
Sponsored by
Butantan Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Human Influenza focused on measuring Influenza vaccine

Eligibility Criteria

18 Years - 59 Years (Adult)All SexesAccepts Healthy Volunteers

Kidney Transplant Recipients

Inclusion Criteria:

  • Kidney transplant for more than 30 days;
  • 18 to 59 years of age;
  • Functioning graft (patients without an indication for dialysis at the time, regardless of the glomerular filtration rate);
  • Ability to understand and engage with all procedures required for participation in the study;
  • Willingness to participate documented by the signature of the ICF.

Exclusion Criteria:

  • Double transplant (other organ besides the kidney);
  • Graft loss;
  • HIV infection or malignancy;
  • Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product;
  • Any acute condition and/or fever within 7 days prior to vaccination or axillary temperature greater than 37,8°C on the day of vaccination;
  • Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 21 days after inclusion in the study;
  • Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements;
  • Use of any investigational product within 42 days prior to the inclusion in the study (visit V0) or scheduled to receive it after the inclusion in the study (visit V0);
  • Inclusion in another clinical trial six months prior to vaccination;
  • Denies permission for biological material storage for future research as defined in ICF;
  • Any other condition that, in the investigator's opinion or of his representative, might put at risk the safety/rights of a potential participant or could hamper his/her compliance with the protocol.

Healthy Adults

Inclusion Criteria:

  • Healthy adults of both sexes with 18 to 59 years of age;
  • Be available to participate during the entire study period;
  • Demonstrate intent to participate in the study, documented by signing the IC.

Exclusion Criteria:

  • Evidence of active neurological, cardiac, pulmonary, hepatic or renal disease as clinical history, physical examination and/or laboratory results;
  • Compromised immune system diseases including: diabetes mellitus, cancer (except basal cell carcinoma) and autoimmune diseases;
  • Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements;
  • Abusive usage of alcohol or drugs in the past 12 months that has caused medical, professional or family problems, indicated by clinical history;
  • Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product;
  • Diagnosis of asthma with a history of hospitalization in the last six months due to illness;
  • Any acute illness and/or fever in the 7 days prior to study inclusion or axillary temperature greater than 37.8 ° C on the day of vaccination (visit V0);
  • Use of corticosteroids (except topical or nasal) or other immunosuppressive drugs within 42 days before study initiation/baseline. It will be considered immunosuppressive dose of corticosteroids the equivalent to a dose ≥10 mg of prednisone per day for over 14 days;
  • Use of anticoagulant medication;
  • Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 42 days after receiving the investigational product;
  • History of asplenia;
  • Have received blood products in the past six months, including transfusions or immunoglobulin, or scheduled administration of blood products or immunoglobulin for the first 42 days after vaccination; -Use of any investigational product within 42 days before or after receiving this - study vaccination;
  • Has participated in another clinical trial six months prior to vaccination;
  • Denies permission for biological material storage for future research as defined in ICF;
  • Any other condition that might put in risk the safety/rights of a potential participant or hurdle his/her compliance with this protocol in investigator's opinion or his representative physician.

Sites / Locations

  • Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Divisão de Clínica Urológica e Divisão de Moléstias Infecciosas

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Experimental

Experimental

Arm Label

Recommended dose (kidney transplant)

Healthy adults

Single double dose (kidney transplant)

Two sequential doses (kidney transplant)

Arm Description

Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 0.5 mL dose.

Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 0.5 mL dose.

Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 1.0 mL dose.

Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: two 0.5 mL doses 21 days apart.

Outcomes

Primary Outcome Measures

Percentage of Seroconversion.
Seroconversion will be defined as HI titers ≥1:40 post-vaccination among subjects with pre-vaccination HI titers <1:10, or as a 4-fold increase in post-vaccination HI titers among subjects with pre -vaccination HI titers ≥ 1:10.
Percentage of Seroprotection
Seroprotection will be defined as post-vaccinations HI titers ≥1:40.
Increase in the geometric mean titers of HI post-vaccination.

Secondary Outcome Measures

Solicited and unsolicited local and systemic adverse reactions.

Full Information

First Posted
April 2, 2014
Last Updated
July 20, 2015
Sponsor
Butantan Institute
Collaborators
Fundação de Amparo à Pesquisa do Estado de São Paulo
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1. Study Identification

Unique Protocol Identification Number
NCT02104869
Brief Title
Clinical Trial for the Evaluation of Three Regimens of Influenza Vaccination in Kidney Transplant Recipients
Official Title
Open Label Parallel Randomized Clinical Trial to Evaluate the Immunogenicity of Three Regimens of the Trivalent Influenza Vaccine (Inactivated and Fragmented) in Kidney Transplant Recipients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2015
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Butantan Institute
Collaborators
Fundação de Amparo à Pesquisa do Estado de São Paulo

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This will be an open label, parallel, randomized clinical trial that will evaluate the immunogenicity and safety of the trivalent influenza vaccine (inactivated and fragmented) produced by Instituto Butantan among adult kidney transplant recipients, when administered in three vaccination regimens: i) the recommended dose; ii) a single double dose; iii) two doses administered with a 21 day interval. The randomization ratio among the three groups of kidney transplant recipients will be 1:1, and 60 participants will be included in each group. After vaccination all participants will be followed for 26 weeks. In addition, 15 healthy adults will be included as a control group, and will receive the recommended dose. The study hypothesis is that a different vaccination regimen can improve the immune response of kidney transplant recipients after vaccination with the trivalent influenza vaccine (inactivated and fragmented).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Human Influenza
Keywords
Influenza vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
195 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Recommended dose (kidney transplant)
Arm Type
Active Comparator
Arm Description
Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 0.5 mL dose.
Arm Title
Healthy adults
Arm Type
Active Comparator
Arm Description
Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 0.5 mL dose.
Arm Title
Single double dose (kidney transplant)
Arm Type
Experimental
Arm Description
Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: single 1.0 mL dose.
Arm Title
Two sequential doses (kidney transplant)
Arm Type
Experimental
Arm Description
Intervention: trivalent influenza vaccine (inactivated and fragmented). Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg). Dose: two 0.5 mL doses 21 days apart.
Intervention Type
Biological
Intervention Name(s)
Trivalent influenza vaccine (inactivated and fragmented).
Primary Outcome Measure Information:
Title
Percentage of Seroconversion.
Description
Seroconversion will be defined as HI titers ≥1:40 post-vaccination among subjects with pre-vaccination HI titers <1:10, or as a 4-fold increase in post-vaccination HI titers among subjects with pre -vaccination HI titers ≥ 1:10.
Time Frame
21 days (+7 days) after vaccination.
Title
Percentage of Seroprotection
Description
Seroprotection will be defined as post-vaccinations HI titers ≥1:40.
Time Frame
21 days (+7 days) after vaccination.
Title
Increase in the geometric mean titers of HI post-vaccination.
Time Frame
21 days (+7 days) after vaccination.
Secondary Outcome Measure Information:
Title
Solicited and unsolicited local and systemic adverse reactions.
Time Frame
Until day 3 post-vaccination.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Kidney Transplant Recipients Inclusion Criteria: Kidney transplant for more than 30 days; 18 to 59 years of age; Functioning graft (patients without an indication for dialysis at the time, regardless of the glomerular filtration rate); Ability to understand and engage with all procedures required for participation in the study; Willingness to participate documented by the signature of the ICF. Exclusion Criteria: Double transplant (other organ besides the kidney); Graft loss; HIV infection or malignancy; Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product; Any acute condition and/or fever within 7 days prior to vaccination or axillary temperature greater than 37,8°C on the day of vaccination; Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 21 days after inclusion in the study; Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements; Use of any investigational product within 42 days prior to the inclusion in the study (visit V0) or scheduled to receive it after the inclusion in the study (visit V0); Inclusion in another clinical trial six months prior to vaccination; Denies permission for biological material storage for future research as defined in ICF; Any other condition that, in the investigator's opinion or of his representative, might put at risk the safety/rights of a potential participant or could hamper his/her compliance with the protocol. Healthy Adults Inclusion Criteria: Healthy adults of both sexes with 18 to 59 years of age; Be available to participate during the entire study period; Demonstrate intent to participate in the study, documented by signing the IC. Exclusion Criteria: Evidence of active neurological, cardiac, pulmonary, hepatic or renal disease as clinical history, physical examination and/or laboratory results; Compromised immune system diseases including: diabetes mellitus, cancer (except basal cell carcinoma) and autoimmune diseases; Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements; Abusive usage of alcohol or drugs in the past 12 months that has caused medical, professional or family problems, indicated by clinical history; Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product; Diagnosis of asthma with a history of hospitalization in the last six months due to illness; Any acute illness and/or fever in the 7 days prior to study inclusion or axillary temperature greater than 37.8 ° C on the day of vaccination (visit V0); Use of corticosteroids (except topical or nasal) or other immunosuppressive drugs within 42 days before study initiation/baseline. It will be considered immunosuppressive dose of corticosteroids the equivalent to a dose ≥10 mg of prednisone per day for over 14 days; Use of anticoagulant medication; Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 42 days after receiving the investigational product; History of asplenia; Have received blood products in the past six months, including transfusions or immunoglobulin, or scheduled administration of blood products or immunoglobulin for the first 42 days after vaccination; -Use of any investigational product within 42 days before or after receiving this - study vaccination; Has participated in another clinical trial six months prior to vaccination; Denies permission for biological material storage for future research as defined in ICF; Any other condition that might put in risk the safety/rights of a potential participant or hurdle his/her compliance with this protocol in investigator's opinion or his representative physician.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexander R Precioso, MD, PhD
Organizational Affiliation
Instituto Butantan
Official's Role
Study Director
Facility Information:
Facility Name
Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Divisão de Clínica Urológica e Divisão de Moléstias Infecciosas
City
São Paulo
ZIP/Postal Code
05403-010
Country
Brazil

12. IPD Sharing Statement

Citations:
PubMed Identifier
33988337
Citation
Odongo FCA, Braga PE, Palacios R, Miraglia JL, Sartori AMC, Ibrahim KY, Lopes MH, Caiaffa-Filho HH, Timenetsky MDCST, Agena F, Fonseca de Azevedo LS, David-Neto E, Precioso AR, Pierrotti LC. An Open-label Randomized Controlled Parallel-group Pilot Study Comparing the Immunogenicity of a Standard-, Double-, and Booster-dose Regimens of the 2014 Seasonal Trivalent Inactivated Influenza Vaccine in Kidney Transplant Recipients. Transplantation. 2022 Jan 1;106(1):210-220. doi: 10.1097/TP.0000000000003702.
Results Reference
derived

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Clinical Trial for the Evaluation of Three Regimens of Influenza Vaccination in Kidney Transplant Recipients

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