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Evaluate a New Shigella Sonnei Vaccine Administered Either by Intradermal, Intranasal or Intramuscular Route in Healthy Adults

Primary Purpose

Shigellosis

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
S. sonnei 1790GAHB
Placebo
Sponsored by
GSK Vaccines Institute For Global Health S.r.l.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Shigellosis focused on measuring prevention, Shigella sonnei

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Males and females of age ≥18 years to ≤45 years.
  2. Individuals who, after the nature of the study have been explained to them, have given written consent according to local regulatory requirements.
  3. Individuals in good health as determined by the outcome of medical history, physical examination, hematology, renal, bone and liver panels (including negative for agglutination testing of S. sonnei), urinalysis and clinical judgment of the investigator.
  4. If women of childbearing potential, have a negative pregnancy test prior to study vaccination and willingness to use acceptable contraceptive measures for the entire study duration.
  5. Individuals available for follow-up for the duration of the study.
  6. Individuals registered with a general practitioner.

Exclusion Criteria:

  1. Individuals with a history of recurrent wheezing, asthma, respiratory allergies, allergic rhinitis, nasal surgery or significant nasal abnormalities (e.g. polyps), and Bell's palsy. Presence of nasal piercings. Symptoms of upper respiratory tract infection within 3 days of intended study vaccination is a temporary exclusion criterion.
  2. Individuals unwilling to abstain from medications or other agents that are applied via the nasal route from 24 hours prior to each nasal dosing through to the safety assessment 1 week later.
  3. Individuals with behavioral or cognitive impairment or psychiatric disease that, in the opinion of the investigator, may interfere with the subject's ability to participate in the study.
  4. Individuals with any progressive or severe neurological disorder, seizure disorder or Guillain-Barré syndrome.
  5. Individuals who are not able to understand and to follow all required study procedures for the whole period of the study.
  6. Individuals with history of any illness that, in the opinion of the investigator, might interfere with the results of the study or pose additional risk to the subjects due to participation in the study.
  7. Individuals with human leukocyte antigen (HLA) -B27 positive and/or with history of reactive arthritis
  8. Individuals with known HIV, HBV and HCV infection or HIV related disease, with history of an autoimmune disorder or any other known or suspected impairment /alteration of the immune system, or under immunosuppressive therapy including use of systemic corticosteroids or chronic use of inhaled high-potency corticosteroids within the previous 30 days, or were in chemotherapy treatment within the past 6 months.
  9. Individuals with a known bleeding diathesis, or any condition that may be associated with a prolonged bleeding time.
  10. Individuals with any serious chronic or progressive disease according to judgment of the investigator (e.g., neoplasm, insulin dependent diabetes, cardiac, renal or hepatic disease).
  11. Individuals who have any malignancy or lymphoproliferative disorder.
  12. Individuals with history of allergy to vaccine components.
  13. Individuals participating in any clinical trial with another investigational product 90 days prior to first study visit or intent to participate in another clinical study at any time during the conduct of this study.
  14. Individuals who received any other vaccines within 4 weeks prior to enrollment in this study or who are planning to receive any vaccine within the entire study duration except influenza vaccination, which is not allowed within the period included between 4 weeks before 1st vaccination and 4 weeks after 3rd vaccination
  15. Individuals who have received blood, blood products and/or plasma derivatives including parenteral immunoglobulin preparations in the past 12 weeks.
  16. Individuals who are part of study personnel or close family members to the personnel conducting this study or employees of the clinical trial site institution.
  17. Individuals with body temperature > 38.0 degrees Celsius within 3 days of intended study vaccination.
  18. BMI > 30 kg/m2.
  19. Individuals with history of substance or alcohol abuse within the past 2 years.
  20. Women who are pregnant or breast-feeding or of childbearing age who have not used or do not plan to use acceptable birth control measures, for the duration of the study.
  21. Females with history of stillbirth, neonatal loss, or previous infant with anomaly.
  22. Individuals who have a previously ascertained or suspected disease caused by S. sonnei or positive S. sonnei serology at screening
  23. Individuals who have had household contact with/and or intimate exposure to an individual with laboratory confirmed S. sonnei
  24. Any condition, which, in the opinion of the investigator may pose an increased and unreasonable safety risk to the subject if participating to the present study

Sites / Locations

  • Surrey Clinical Research Center (Surrey CRC)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Placebo Comparator

Placebo Comparator

Arm Label

S. sonnei 1790GAHB - 0.1 mcg - ID

S. sonnei 1790GAHB - 1 mcg - ID

S. sonnei 1790GAHB - 10 mcg - ID

S. sonnei 1790GAHB - 5 mcg - IN

S. sonnei 1790GAHB - 20 mcg - IN

S. sonnei 1790GAHB - 80 mcg - IN

S. sonnei 1790GAHB - 5 mcg - IM

Placebo - ID

Placebo - IN

Placebo - IM

Arm Description

Subjects enrolled in COHORT A receiving 3 injections of S. sonnei 1790GAHB - 0.1 mcg intradermally (ID)

Subjects enrolled in COHORT B receiving 3 injections of S. sonnei 1790GAHB - 1 mcg intradermally (ID)

Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 10 mcg intradermally (ID)

Subjects enrolled in COHORT A receiving 3 injections of S. sonnei 1790GAHB - 5 mcg intranasally (IN)

Subjects enrolled in COHORT B receiving 3 injections of S. sonnei 1790GAHB - 20 mcg intranasally (IN)

Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 80 mcg intranasally (IN)

Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 5 mcg intramuscularly (IM)

2 subjects enrolled in each COHORT A, B and C receiving 3 injections of Placebo intradermally (ID). These were pooled in one Placebo group in the analyses

2 subjects enrolled in each COHORT A, B and C receiving 3 injections of Placebo intranasally (IN). These were pooled in one Placebo group in the analyses

2 subjects enrolled in COHORT C receiving 3 injections of Placebo intramuscularly (IM)

Outcomes

Primary Outcome Measures

Number of subjects with solicited local reaction after any vaccination
Any erythema/induration/swelling refers to: ≥25 mm in diameter. Grade 3 (severe) refers to erythema/induration/swelling >100 mm in diameter. Grade 3 (severe) for injection site pain/nasal pain/facial edema/rhinorrhea refers to: prevents daily activity
Number of subjects with solicited systemic reaction after any vaccination
Any= Incidence of any symptom regardless of intensity grade. Grade 3 = symptom that prevented daily activities
Number of subjects with Neutrophils results below and above the normal ranges
Day 8: VISIT 2 (D7 post 1st vac)
Number of subjects with Neutrophils results below and above the normal
Day 36: VISIT 3.1 (D7 post 2nd vac)
Number of subjects with Neutrophils results below and above the normal
Day 57: VISIT 4 (3rd vac.)
Number of subjects with Neutrophils results below and above the normal
Day 64: VISIT 4.1 (D7 post 3rd vac.)
Number of subjects with Neutrophils results below and above the normal
Day 85: VISIT 5 (1 month post 3rd vac.)
Number of subjects with Neutrophils results below and above the normal
Day 225: VISIT 6 (6 months post 3rd vac.)

Secondary Outcome Measures

Anti-LPS S. sonnei serum IgG Geometric mean concentration (GMCs)
Number of subjects with seroresponse for anti-LPS S. sonnei
Seroresponse is defined as: If half of the baseline value is greater than 25 ELISA Unit (EU) then an increase of at least 50% in the post-vaccination sample as compared to baseline [i.e. ((Post-vac minus baseline)/baseline)100% ≥ 50%]. If half of the baseline value is less or equal to 25 EU then an increase of at least 25 EU in the post-vaccination sample as compared to baseline (i.e. [post-vac minus baseline] ≥25 EU)
Number of subjects with high seroresponse for anti-LPS S. sonnei (IgG ELISA ≥121 EU)
High seroresponse is defined as a post vaccination titer ≥X anti-LPS serum IgG units in the GSK (former Novartis) ELISA that correspond to a titer of 1:800 in the ELISA method used by Cohen et al. (1989 J. Clin. Microbiol. 27:162). To determine the value for 'X' the GSK (former Novartis) anti-LPS ELISA was calibrated against the Cohen ELISA and it was found that a concentration of 121 EU EU/mL corresponds to a titer of 1:800 in the Cohen assay

Full Information

First Posted
January 2, 2014
Last Updated
June 20, 2016
Sponsor
GSK Vaccines Institute For Global Health S.r.l.
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1. Study Identification

Unique Protocol Identification Number
NCT02034500
Brief Title
Evaluate a New Shigella Sonnei Vaccine Administered Either by Intradermal, Intranasal or Intramuscular Route in Healthy Adults
Official Title
A Phase 1, Randomized, Placebo Controlled, Single Center, Dose Escalation Study to Evaluate the Safety and Immunogenicity of 3 Vaccinations With Shigella Sonnei Vaccine (1790GAHB) Administered Either by Intradermal, Intranasal or Intramuscular Route in Healthy Adults.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2016
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
April 2015 (Actual)
Study Completion Date
April 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GSK Vaccines Institute For Global Health S.r.l.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase 1 clinical trial is aimed to evaluate the safety and immunogenicity of 3 doses of a candidate vaccine against Shigella sonnei (1790GAHB vaccine) when administered at different dosages by different routes (intradermally, intranasally or intramuscularly) in healthy adults (18 to 45 years of age at enrollment). The safety profile of the 1790GAHB vaccine is evaluated in comparison to that of placebo (GAHB-Placebo), constituted by an aluminum hydroxide suspension having the same concentration as study vaccine formulations. A total of 52 eligible subjects will be assigned to one of three sequential cohorts as follows: Cohort A) 0.1 μg ID and 5 μg IN Cohort B) 1 μg ID and 20 μg IN Cohort C) 10 μg ID, 80 μg IN and 5 μg IM Within each cohort, in an observer-blind fashion, subjects will be randomized to receive three vaccinations, four weeks apart, of either 1790GAHB vaccine (at five antigen concentrations) or GAHB placebo. Specifically for IN and ID administration routes, a Data Safety Monitoring Board will be in place to receive a summary of all safety data obtained during one week follow-up post-first vaccination with the lower dose. Based on evaluation of the safety data, the Data Safety Monitoring Board will make a recommendation, as to whether the next cohort should be vaccinated with higher antigen concentration or not. Expected duration of the study for an individual subject is 9 months. Each subject will be followed-up for 6 months after the 3rd vaccination

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Shigellosis
Keywords
prevention, Shigella sonnei

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
52 (Actual)

8. Arms, Groups, and Interventions

Arm Title
S. sonnei 1790GAHB - 0.1 mcg - ID
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT A receiving 3 injections of S. sonnei 1790GAHB - 0.1 mcg intradermally (ID)
Arm Title
S. sonnei 1790GAHB - 1 mcg - ID
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT B receiving 3 injections of S. sonnei 1790GAHB - 1 mcg intradermally (ID)
Arm Title
S. sonnei 1790GAHB - 10 mcg - ID
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 10 mcg intradermally (ID)
Arm Title
S. sonnei 1790GAHB - 5 mcg - IN
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT A receiving 3 injections of S. sonnei 1790GAHB - 5 mcg intranasally (IN)
Arm Title
S. sonnei 1790GAHB - 20 mcg - IN
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT B receiving 3 injections of S. sonnei 1790GAHB - 20 mcg intranasally (IN)
Arm Title
S. sonnei 1790GAHB - 80 mcg - IN
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 80 mcg intranasally (IN)
Arm Title
S. sonnei 1790GAHB - 5 mcg - IM
Arm Type
Experimental
Arm Description
Subjects enrolled in COHORT C receiving 3 injections of S. sonnei 1790GAHB - 5 mcg intramuscularly (IM)
Arm Title
Placebo - ID
Arm Type
Placebo Comparator
Arm Description
2 subjects enrolled in each COHORT A, B and C receiving 3 injections of Placebo intradermally (ID). These were pooled in one Placebo group in the analyses
Arm Title
Placebo - IN
Arm Type
Placebo Comparator
Arm Description
2 subjects enrolled in each COHORT A, B and C receiving 3 injections of Placebo intranasally (IN). These were pooled in one Placebo group in the analyses
Arm Title
Placebo - IM
Arm Type
Placebo Comparator
Arm Description
2 subjects enrolled in COHORT C receiving 3 injections of Placebo intramuscularly (IM)
Intervention Type
Biological
Intervention Name(s)
S. sonnei 1790GAHB
Other Intervention Name(s)
Shigella sonnei vaccine
Intervention Type
Biological
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Number of subjects with solicited local reaction after any vaccination
Description
Any erythema/induration/swelling refers to: ≥25 mm in diameter. Grade 3 (severe) refers to erythema/induration/swelling >100 mm in diameter. Grade 3 (severe) for injection site pain/nasal pain/facial edema/rhinorrhea refers to: prevents daily activity
Time Frame
During a 7-day (Days 1-7) post vaccination period following any injection
Title
Number of subjects with solicited systemic reaction after any vaccination
Description
Any= Incidence of any symptom regardless of intensity grade. Grade 3 = symptom that prevented daily activities
Time Frame
During a 7-day (Days 1 to 7) post vaccination period following any injection
Title
Number of subjects with Neutrophils results below and above the normal ranges
Description
Day 8: VISIT 2 (D7 post 1st vac)
Time Frame
At Day 8
Title
Number of subjects with Neutrophils results below and above the normal
Description
Day 36: VISIT 3.1 (D7 post 2nd vac)
Time Frame
At Day 36
Title
Number of subjects with Neutrophils results below and above the normal
Description
Day 57: VISIT 4 (3rd vac.)
Time Frame
At Day 57
Title
Number of subjects with Neutrophils results below and above the normal
Description
Day 64: VISIT 4.1 (D7 post 3rd vac.)
Time Frame
At Day 64
Title
Number of subjects with Neutrophils results below and above the normal
Description
Day 85: VISIT 5 (1 month post 3rd vac.)
Time Frame
At Day 85
Title
Number of subjects with Neutrophils results below and above the normal
Description
Day 225: VISIT 6 (6 months post 3rd vac.)
Time Frame
At Day 225
Secondary Outcome Measure Information:
Title
Anti-LPS S. sonnei serum IgG Geometric mean concentration (GMCs)
Time Frame
At baseline, at 28 days after each vaccination and at 168 days after last vaccination
Title
Number of subjects with seroresponse for anti-LPS S. sonnei
Description
Seroresponse is defined as: If half of the baseline value is greater than 25 ELISA Unit (EU) then an increase of at least 50% in the post-vaccination sample as compared to baseline [i.e. ((Post-vac minus baseline)/baseline)100% ≥ 50%]. If half of the baseline value is less or equal to 25 EU then an increase of at least 25 EU in the post-vaccination sample as compared to baseline (i.e. [post-vac minus baseline] ≥25 EU)
Time Frame
At 28 days after each vaccination and 168 days after last vaccination
Title
Number of subjects with high seroresponse for anti-LPS S. sonnei (IgG ELISA ≥121 EU)
Description
High seroresponse is defined as a post vaccination titer ≥X anti-LPS serum IgG units in the GSK (former Novartis) ELISA that correspond to a titer of 1:800 in the ELISA method used by Cohen et al. (1989 J. Clin. Microbiol. 27:162). To determine the value for 'X' the GSK (former Novartis) anti-LPS ELISA was calibrated against the Cohen ELISA and it was found that a concentration of 121 EU EU/mL corresponds to a titer of 1:800 in the Cohen assay
Time Frame
At baseline, at 28 days after each vaccination and at 168 days after last vaccination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males and females of age ≥18 years to ≤45 years. Individuals who, after the nature of the study have been explained to them, have given written consent according to local regulatory requirements. Individuals in good health as determined by the outcome of medical history, physical examination, hematology, renal, bone and liver panels (including negative for agglutination testing of S. sonnei), urinalysis and clinical judgment of the investigator. If women of childbearing potential, have a negative pregnancy test prior to study vaccination and willingness to use acceptable contraceptive measures for the entire study duration. Individuals available for follow-up for the duration of the study. Individuals registered with a general practitioner. Exclusion Criteria: Individuals with a history of recurrent wheezing, asthma, respiratory allergies, allergic rhinitis, nasal surgery or significant nasal abnormalities (e.g. polyps), and Bell's palsy. Presence of nasal piercings. Symptoms of upper respiratory tract infection within 3 days of intended study vaccination is a temporary exclusion criterion. Individuals unwilling to abstain from medications or other agents that are applied via the nasal route from 24 hours prior to each nasal dosing through to the safety assessment 1 week later. Individuals with behavioral or cognitive impairment or psychiatric disease that, in the opinion of the investigator, may interfere with the subject's ability to participate in the study. Individuals with any progressive or severe neurological disorder, seizure disorder or Guillain-Barré syndrome. Individuals who are not able to understand and to follow all required study procedures for the whole period of the study. Individuals with history of any illness that, in the opinion of the investigator, might interfere with the results of the study or pose additional risk to the subjects due to participation in the study. Individuals with human leukocyte antigen (HLA) -B27 positive and/or with history of reactive arthritis Individuals with known HIV, HBV and HCV infection or HIV related disease, with history of an autoimmune disorder or any other known or suspected impairment /alteration of the immune system, or under immunosuppressive therapy including use of systemic corticosteroids or chronic use of inhaled high-potency corticosteroids within the previous 30 days, or were in chemotherapy treatment within the past 6 months. Individuals with a known bleeding diathesis, or any condition that may be associated with a prolonged bleeding time. Individuals with any serious chronic or progressive disease according to judgment of the investigator (e.g., neoplasm, insulin dependent diabetes, cardiac, renal or hepatic disease). Individuals who have any malignancy or lymphoproliferative disorder. Individuals with history of allergy to vaccine components. Individuals participating in any clinical trial with another investigational product 90 days prior to first study visit or intent to participate in another clinical study at any time during the conduct of this study. Individuals who received any other vaccines within 4 weeks prior to enrollment in this study or who are planning to receive any vaccine within the entire study duration except influenza vaccination, which is not allowed within the period included between 4 weeks before 1st vaccination and 4 weeks after 3rd vaccination Individuals who have received blood, blood products and/or plasma derivatives including parenteral immunoglobulin preparations in the past 12 weeks. Individuals who are part of study personnel or close family members to the personnel conducting this study or employees of the clinical trial site institution. Individuals with body temperature > 38.0 degrees Celsius within 3 days of intended study vaccination. BMI > 30 kg/m2. Individuals with history of substance or alcohol abuse within the past 2 years. Women who are pregnant or breast-feeding or of childbearing age who have not used or do not plan to use acceptable birth control measures, for the duration of the study. Females with history of stillbirth, neonatal loss, or previous infant with anomaly. Individuals who have a previously ascertained or suspected disease caused by S. sonnei or positive S. sonnei serology at screening Individuals who have had household contact with/and or intimate exposure to an individual with laboratory confirmed S. sonnei Any condition, which, in the opinion of the investigator may pose an increased and unreasonable safety risk to the subject if participating to the present study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David JM Lewis, MD
Organizational Affiliation
University of Surrey, Guildford, GU2 7XP United Kingdom
Official's Role
Principal Investigator
Facility Information:
Facility Name
Surrey Clinical Research Center (Surrey CRC)
City
Guildford
State/Province
Surrey
ZIP/Postal Code
GU2 7XP
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
28735965
Citation
Launay O, Lewis DJM, Anemona A, Loulergue P, Leahy J, Scire AS, Maugard A, Marchetti E, Zancan S, Huo Z, Rondini S, Marhaba R, Finco O, Martin LB, Auerbach J, Cohen D, Saul A, Gerke C, Podda A. Safety Profile and Immunologic Responses of a Novel Vaccine Against Shigella sonnei Administered Intramuscularly, Intradermally and Intranasally: Results From Two Parallel Randomized Phase 1 Clinical Studies in Healthy Adult Volunteers in Europe. EBioMedicine. 2017 Aug;22:164-172. doi: 10.1016/j.ebiom.2017.07.013. Epub 2017 Jul 15.
Results Reference
derived
PubMed Identifier
27490698
Citation
Muturi-Kioi V, Lewis D, Launay O, Leroux-Roels G, Anemona A, Loulergue P, Bodinham CL, Aerssens A, Groth N, Saul A, Podda A. Neutropenia as an Adverse Event following Vaccination: Results from Randomized Clinical Trials in Healthy Adults and Systematic Review. PLoS One. 2016 Aug 4;11(8):e0157385. doi: 10.1371/journal.pone.0157385. eCollection 2016.
Results Reference
derived

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Evaluate a New Shigella Sonnei Vaccine Administered Either by Intradermal, Intranasal or Intramuscular Route in Healthy Adults

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