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Immunisation, Treatment and Controlled Human Hookworm Infection (ITCHHI)

Primary Purpose

Necator Americanus Infection

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
3x 50 L3 larvae immunisation with albendazole treatment
3x placebo immunisation with albendazole treatment
2x 50 L3 larvae infection
Sponsored by
Leiden University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Necator Americanus Infection

Eligibility Criteria

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

Inclusion Criteria:

In order to be eligible to participate in this study, a subject must meet all of the following criteria:

  1. Subject is aged ≥ 18 and ≤ 45 years and in good health.
  2. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  3. Subject is able to communicate well with the investigator and is available to attend all study visits.
  4. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period.
  5. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study.
  6. Subject agrees to refrain from travel to a hookworm endemic area during the course of the trial.
  7. Subject has signed informed consent.

Exclusion Criteria:

  1. Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following:

    • positive HIV, HBV or HCV screening tests;
    • the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period;
    • having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <6.5 mmol/L for females or <7.5 mmol/L for males.
    • history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years;
    • any history of treatment for severe psychiatric disease by a psychiatrist in the past year;
    • history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset;
    • inflammmatory bowel syndrome;
    • regular constipation, resulting in bowel movements less than three times per week.
  2. Known hypersensitivity to or contra-indications for use of albendazole, including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone).
  3. Known allergy to amphotericin B or gentamicin.
  4. For female subjects: positive urine pregnancy test at screening.
  5. Positive faecal qPCR for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection.
  6. Being an employee or student of the department of Parasitology of the LUMC.
  7. Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application.

Sites / Locations

  • Leiden University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Intervention

Placebo

Arm Description

3x 50 L3 larvae immunisation with albendazole treatment and 2x 50 L3 larvae infection

3x placebo immunisation with albendazole treatment and 2x 50 L3 larvae infection

Outcomes

Primary Outcome Measures

Difference between egg counts between intervention and placebo group
Comparison of average egg counts from week 25-29 of the trial (which is week 12 to 16 after controlled human hookworm infection) by Kato-Katz between intervention group and placebo group

Secondary Outcome Measures

Frequency of adverse events
Comparison of frequency of adverse events collected during immunisation phase and after controlled human hookworm infection between intervention and placebo group
Severity of adverse events
Comparison of severity of adverse events collected during immunisation phase and after controlled human hookworm infection between intervention and placebo group

Full Information

First Posted
August 10, 2018
Last Updated
September 2, 2019
Sponsor
Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT03702530
Brief Title
Immunisation, Treatment and Controlled Human Hookworm Infection
Acronym
ITCHHI
Official Title
Immunisation, Treatment and Controlled Human Hookworm Infection
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
December 17, 2018 (Actual)
Primary Completion Date
September 2, 2019 (Actual)
Study Completion Date
September 2, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Leiden University Medical Center

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
24 healthy volunteers will be immunized with three times 50 L3 larvae or placebo followed by treatment with albendazol and subsequently challenged with twice 50 L3 larvae.
Detailed Description
24 healthy hookworm-naive volunteers will be randomized in a 2:1 allocation to either the intervention group or placebo. Volunteers in the intervention group will be immunized three times with 50 L3 larvae of Necator americanus with three-week intervals. Two weeks after each immunization, volunteers will be treated with albendazole. Four weeks after the last treatment all volunteers are challenged with controlled human hookworm infection consisting of two doses of 50 L3 larvae with a two week interval. 16 weeks after the first challenge all volunteers will be treated with albendazole, except up to four volunteers who will be asked to remain as chronic donors for future hookworm studies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Necator Americanus Infection

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Volunteers are randomized into either the intervention or the placebo group (2:1 allocation). The two groups run parallel in the trial. At the moments of immunization in the intervention group volunteers in the placebo group receive a mock infection with water to maintain blinding.
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Participant, clinical trial physicians and laboratory personnel are blinded for treatment allocation. Blinding is maintained by exposing the volunteers in the placebo group to a mock infection with water. During the trial clinical trial physicians are blinded to the outcome measures (i.e. Kato-Katz outcomes), laboratory staff are blinded for the study code of samples delivered.
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Description
3x 50 L3 larvae immunisation with albendazole treatment and 2x 50 L3 larvae infection
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
3x placebo immunisation with albendazole treatment and 2x 50 L3 larvae infection
Intervention Type
Biological
Intervention Name(s)
3x 50 L3 larvae immunisation with albendazole treatment
Intervention Description
Immunisation with 50 Necator americanus L3 larvae at week 0, 3 and 6 with albendazole treatment at week 2, 5 and 8
Intervention Type
Other
Intervention Name(s)
3x placebo immunisation with albendazole treatment
Intervention Description
Mock immunisation with water at week 0, 3 and 6 with albendazole treatment at week 2, 5 and 8
Intervention Type
Biological
Intervention Name(s)
2x 50 L3 larvae infection
Intervention Description
After (mock) immunisation, infection with 50 Necator americanus larvae at week 13 and 15
Primary Outcome Measure Information:
Title
Difference between egg counts between intervention and placebo group
Description
Comparison of average egg counts from week 25-29 of the trial (which is week 12 to 16 after controlled human hookworm infection) by Kato-Katz between intervention group and placebo group
Time Frame
week 25-29
Secondary Outcome Measure Information:
Title
Frequency of adverse events
Description
Comparison of frequency of adverse events collected during immunisation phase and after controlled human hookworm infection between intervention and placebo group
Time Frame
week 0-29
Title
Severity of adverse events
Description
Comparison of severity of adverse events collected during immunisation phase and after controlled human hookworm infection between intervention and placebo group
Time Frame
week 0-29

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: In order to be eligible to participate in this study, a subject must meet all of the following criteria: Subject is aged ≥ 18 and ≤ 45 years and in good health. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby. Subject is able to communicate well with the investigator and is available to attend all study visits. Subject agrees to refrain from blood donation to Sanquin or for other purposes throughout the study period. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study. Subject agrees to refrain from travel to a hookworm endemic area during the course of the trial. Subject has signed informed consent. Exclusion Criteria: Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following: positive HIV, HBV or HCV screening tests; the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period; having one of the following laboratory abnormalities: ferritine <10 ug/L, transferrine <2.04 g/L or Hb <6.5 mmol/L for females or <7.5 mmol/L for males. history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years; any history of treatment for severe psychiatric disease by a psychiatrist in the past year; history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset; inflammmatory bowel syndrome; regular constipation, resulting in bowel movements less than three times per week. Known hypersensitivity to or contra-indications for use of albendazole, including co-medication known to interact with albendazole metabolism (e.g. carbamazepine, phenobarbital, phenytoin, cimetidine, theophylline, dexamethasone). Known allergy to amphotericin B or gentamicin. For female subjects: positive urine pregnancy test at screening. Positive faecal qPCR for hookworm at screening, any known history of hookworm infection or treatment for hookworm infection. Being an employee or student of the department of Parasitology of the LUMC. Current or past scars, tattoos, or other disruptions of skin integrity at the intended site of larval application.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
M. Roestenberg, MD, PhD
Organizational Affiliation
Leiden University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No

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Immunisation, Treatment and Controlled Human Hookworm Infection

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