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PfSPZ Challenge in Non-immune Adults in Baltimore, USA

Primary Purpose

Plasmodium Falciparum Infection

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
PfSPZ (7G8) Challenge
PfSPZ (NF54) Challenge
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 focused on measuring 7G8 clone, NF54 strain, Non-immune, PCR, PfSPZ Challenge, Plasmodium falciparum, qPCR, Sporozoites

Eligibility Criteria

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

Inclusion Criteria:

1. Healthy adults between the ages of 18 and 45 years, inclusive 2. Able and willing to participate for the duration of the study 3. Able and willing to provide written (not proxy) informed consent 4. Provides informed consent and correctly answers greater than or equal to 70% on the post consent quiz before any study procedures, and is available for all study visits -Note: Two attempts permitted 5. Females of childbearing potential must agree to practice highly effective contraception -Note: Contraception must be practiced from 30 days before the time of enrollment until at least 30 days following inoculation (such as double barrier methods (condoms plus foam or spermicide, diaphragm plus foam or spermicide), licensed intrauterine devices (IUDs), intravaginal or intra/transdermal or oral hormonal methods initiated at least 30 days before inoculation or challenge, documented surgical sterilization via tubal ligation the essure procedure or hysterectomy, abstinence or a vasectomized partner). The contraceptive method should remain unchanged throughout the required period 6. Is in good health, as determined by vital signs (heart rate, blood pressure, oral temperature); medical history; normal laboratory ranges listed in Appendix C; and a physical examination -Note: hemoglobin, white blood cell count, platelet count, glucose (random), serum alanine aminotransferase (ALT), serum creatinine, urine protein and urine blood 7. Agree not to travel to a malaria endemic region during study days 1-29 8. Willing to avoid non-study related blood donation from screening until 3 years (45) following P. falciparum challenge 9. Able to understand and comply with planned study procedures including daily outpatient follow-up visits beginning 5 days after inoculation

Exclusion Criteria:

1. Any history of malaria infection, or travel to a malaria endemic region within 3 months before planned date of CHMI 2. History of long-term residence (>5 years) in an area known to have significant transmission of P. falciparum 3. Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg) 4. Positive sickle cell screening test or known hemoglobinopathy 5. Current or recent (within the last four weeks) treatment with parenteral or oral corticosteroids (intranasal or inhaled steroids are acceptable), or other immunosuppressive agents, or chemotherapy 6. Screening laboratory values outside protocol-specified acceptable normal ranges as noted in Appendix C, except hematuria>1+ detected during menses for females. Note: For females who are menstruating, urinalysis frequently tests positive for blood and is not an indicator of poor health status or increased risk; other exceptions include ALT and creatinine below the lower limit of the reference range 7. Known hypersensitivity to components of PfSPZ Challenge, atovaquone-proguanil or artemether-lumefantrine 8. History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, nervous system, or other metabolic or autoimmune/inflammatory conditions 9. History of anaphylaxis or severe hypersensitivity reaction 10. Receipt of an investigational product on study days -31 to -1 or planned receipt of an investigational product on study days 1-57. 11. Any condition that, in the opinion of the investigator, would affect a participant's ability to understand or comply with the study protocol or would jeopardize a participant's safety or rights 12. Use or planned use of any drug with anti-malarial activity 30 days before or after CHMI Note: Medications with antimalarial activity include trimethoprim-sulfamethoxazole, azithromycin, erythromycin, tetracycline, doxycycline, minocycline, clindamycin, ciprofloxacin, levofloxacin, norfloxacin and rifampin 13. Planned surgery 30 days before or after CHMI 14. History of drug or alcohol abuse within the last five years 15. Receipt of blood or blood products in the previous six months or donation of a unit of blood within two months before screening 16. History of schizophrenia, bipolar disorder or other psychiatric condition that makes study compliance difficult Note: Subjects with psychoses or history of suicide attempt or gesture in the 3 years before study entry, ongoing risk for suicide. 17. History of diabetes mellitus with the exception of pregnancy-induced diabetes that has resolved 18. Has evidence of increased cardiovascular disease risk (defined as > 10%, 5 year risk) as determined by the method of Gaziano (46) Note: Risk factors include sex, age (years), systolic blood pressure (mm Hg), smoking status, body mass index (BMI, kg/mm2), reported diabetes status, and blood pressure. 19. Abnormal screening ECG Note: Pathologic Q wave and significant ST-T wave changes, left ventricular hypertrophy, non-sinus rhythm except isolated premature atrial or ventricular contractions, right of left bundle branch block, advanced A-V heart block (secondary or tertiary), QT/QTc interval >450 ms 20. Body mass index (BMI) >40 21. Known hypersensitivity to atovaquone-proguanil or artemether-lumefantrine 22. Anticipated medication use during the 28-day post-challenge period known to interact with atovaquone-proguanil or artemether-lumefantrine Note: Such as rifampin, carbamazepine, phenytoin, St. John's wort, cimetidine, metoclopramide, antacids, and kaolin 23. Personal beliefs that prevent receipt of human serum albumin 24. Immunization with more than three other vaccines within the past month and through study day 57 after CHMI 25. Previous vaccination with a candidate malaria vaccine or participation in a CHMI study 26. History of splenectomy 27. Pregnant or lactating females

Sites / Locations

  • University of Maryland School of Medicine - Center for Vaccine Development - Baltimore

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

1600 7G8 PfSPZ

3200 7G8 PfSPZ

3200 NF54 PfSPZ

4800 7G8 PfSPZ

800 7G8 PfSPZ

Arm Description

N= 7-9 participants will receive 1600 7G8 PfSPZ DVI in a volume of 500mcL

N= 9 participants will receive 3200 7G8 PfSPZ DVI in a volume of 500mcL

N= 5-6 participants will receive 3200 NF54 PfSPZ DVI in a volume of 500mcL

N= 2-3 participants will receive 4800 7G8 PfSPZ DVI in a volume of 500mcL

N= 7-9 participants will receive 800 7G8 PfSPZ DVI in a volume of 500mcL

Outcomes

Primary Outcome Measures

The number and severity of local and systemic solicited and unsolicited reactogenicity symptoms related to PfSPZ Challenge for 7 days following DVI administration
The number of serious adverse events recorded from study

Secondary Outcome Measures

Percent infectivity of each PfSPZ dose regimen
Time to P. falciparum asexual parasitemia following experimental malaria challenge

Full Information

First Posted
May 12, 2016
Last Updated
January 24, 2019
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT02780154
Brief Title
PfSPZ Challenge in Non-immune Adults in Baltimore, USA
Official Title
A Phase 1 Trial to Evaluate the Safety and Infectivity of Direct Venous Inoculation of Aseptic, Purified, Cryopreserved Plasmodium Falciparum (7G8 and NF54) Sporozoites in Non-immune Adults in Baltimore, USA
Study Type
Interventional

2. Study Status

Record Verification Date
April 5, 2017
Overall Recruitment Status
Completed
Study Start Date
August 25, 2016 (Actual)
Primary Completion Date
December 15, 2016 (Actual)
Study Completion Date
December 15, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

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

5. Study Description

Brief Summary
This is a single center, randomized and controlled human study to optimize controlled human malaria infection (CHMI) administered by direct venous inoculation (DVI). 36 healthy adults aged between 18 and 45 years, will be randomized to one of five groups and will be inoculated with PfSPZ Challenge DVI. Participation duration is estimated to be 2 months, while the study duration is planned to be 4 months. The primary objective of this study is to assess the safety and reactogenicity of PfSPZ Challenge administered by DVI using 7G8 and NF54 P. falciparum strains.
Detailed Description
The proposed study is a single center, randomized and controlled human study to optimize controlled human malaria infection (CHMI) administered by direct venous inoculation (DVI). 30 to 36 participants will be randomized to one of five groups and will be inoculated with PfSPZ Challenge DVI. All participants recruited will be healthy adults aged between 18 and 45 years. The study duration is 4 months, participation duration is estimated to be 2 months. Safety and infectivity data will be collected for each study product and dose-level. Sera will be collected at baseline and at study day 29 for antibody assays. Participants, and clinical and laboratory investigators will be blinded to group allocation. The study primary endpoint will be reached at study day 29, at which time an interim study report will be generated. The investigators, the sponsor, the data and statistical analysis team, and Sanaria staff will meet in person or by teleconference on day 43 to review infection, pre-patent period, and adverse event results. These results will be made available to members of the International PfSPZ Consortium (I-PfSPZ-C) and if required, to regulatory authorities, including the FDA, to facilitate other PfSPZ Challenge CHMI studies with the appropriate disclaimers. Participants will be followed as outpatients for malaria diagnosis, treatment and follow-up to study day 57. Malaria positivity will be determined by qPCR diagnostics with microscopy as a backup. Participants who test positive for malaria and those who remain negative at study day 29 will be treated with oral atovaquone-proguanil. The primary objective of this study is to assess the safety and reactogenicity of PfSPZ Challenge administered by DVI using 7G8 and NF54 P. falciparum strains. Secondary objectives are to 1) assess the infectivity of four escalating doses of direct venous inoculation (DVI) of the 7G8 clone in comparison with an established dose (100% infective) DVI of the NF54 strain and 2) assess the time to malaria patency for escalating doses of the 7G8 clone compared to a single dose of the NF54 strain.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Falciparum Infection
Keywords
7G8 clone, NF54 strain, Non-immune, PCR, PfSPZ Challenge, Plasmodium falciparum, qPCR, Sporozoites

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1600 7G8 PfSPZ
Arm Type
Experimental
Arm Description
N= 7-9 participants will receive 1600 7G8 PfSPZ DVI in a volume of 500mcL
Arm Title
3200 7G8 PfSPZ
Arm Type
Experimental
Arm Description
N= 9 participants will receive 3200 7G8 PfSPZ DVI in a volume of 500mcL
Arm Title
3200 NF54 PfSPZ
Arm Type
Experimental
Arm Description
N= 5-6 participants will receive 3200 NF54 PfSPZ DVI in a volume of 500mcL
Arm Title
4800 7G8 PfSPZ
Arm Type
Experimental
Arm Description
N= 2-3 participants will receive 4800 7G8 PfSPZ DVI in a volume of 500mcL
Arm Title
800 7G8 PfSPZ
Arm Type
Experimental
Arm Description
N= 7-9 participants will receive 800 7G8 PfSPZ DVI in a volume of 500mcL
Intervention Type
Biological
Intervention Name(s)
PfSPZ (7G8) Challenge
Intervention Description
PfSPZ (7G8) is a candidate vaccine, it consists of a suspension of purified, live-attenuated cryopreserved Pf sporozoites in a cryoprotectant.
Intervention Type
Biological
Intervention Name(s)
PfSPZ (NF54) Challenge
Intervention Description
PfSPZ (NF54) is a candidate vaccine, it consists of a suspension of purified, live-attenuated cryopreserved Pf sporozoites in a cryoprotectant.
Primary Outcome Measure Information:
Title
The number and severity of local and systemic solicited and unsolicited reactogenicity symptoms related to PfSPZ Challenge for 7 days following DVI administration
Time Frame
Days 1-7
Title
The number of serious adverse events recorded from study
Time Frame
Days 1-57
Secondary Outcome Measure Information:
Title
Percent infectivity of each PfSPZ dose regimen
Time Frame
Days 1-57
Title
Time to P. falciparum asexual parasitemia following experimental malaria challenge
Time Frame
Days 1-57

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: 1. Healthy adults between the ages of 18 and 45 years, inclusive 2. Able and willing to participate for the duration of the study 3. Able and willing to provide written (not proxy) informed consent 4. Provides informed consent and correctly answers greater than or equal to 70% on the post consent quiz before any study procedures, and is available for all study visits -Note: Two attempts permitted 5. Females of childbearing potential must agree to practice highly effective contraception -Note: Contraception must be practiced from 30 days before the time of enrollment until at least 30 days following inoculation (such as double barrier methods (condoms plus foam or spermicide, diaphragm plus foam or spermicide), licensed intrauterine devices (IUDs), intravaginal or intra/transdermal or oral hormonal methods initiated at least 30 days before inoculation or challenge, documented surgical sterilization via tubal ligation the essure procedure or hysterectomy, abstinence or a vasectomized partner). The contraceptive method should remain unchanged throughout the required period 6. Is in good health, as determined by vital signs (heart rate, blood pressure, oral temperature); medical history; normal laboratory ranges listed in Appendix C; and a physical examination -Note: hemoglobin, white blood cell count, platelet count, glucose (random), serum alanine aminotransferase (ALT), serum creatinine, urine protein and urine blood 7. Agree not to travel to a malaria endemic region during study days 1-29 8. Willing to avoid non-study related blood donation from screening until 3 years (45) following P. falciparum challenge 9. Able to understand and comply with planned study procedures including daily outpatient follow-up visits beginning 5 days after inoculation Exclusion Criteria: 1. Any history of malaria infection, or travel to a malaria endemic region within 3 months before planned date of CHMI 2. History of long-term residence (>5 years) in an area known to have significant transmission of P. falciparum 3. Positive serology for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B surface antigen (HBsAg) 4. Positive sickle cell screening test or known hemoglobinopathy 5. Current or recent (within the last four weeks) treatment with parenteral or oral corticosteroids (intranasal or inhaled steroids are acceptable), or other immunosuppressive agents, or chemotherapy 6. Screening laboratory values outside protocol-specified acceptable normal ranges as noted in Appendix C, except hematuria>1+ detected during menses for females. Note: For females who are menstruating, urinalysis frequently tests positive for blood and is not an indicator of poor health status or increased risk; other exceptions include ALT and creatinine below the lower limit of the reference range 7. Known hypersensitivity to components of PfSPZ Challenge, atovaquone-proguanil or artemether-lumefantrine 8. History of acute or chronic medical conditions including, but not limited to, disorders of the liver, kidney, lung, heart, nervous system, or other metabolic or autoimmune/inflammatory conditions 9. History of anaphylaxis or severe hypersensitivity reaction 10. Receipt of an investigational product on study days -31 to -1 or planned receipt of an investigational product on study days 1-57. 11. Any condition that, in the opinion of the investigator, would affect a participant's ability to understand or comply with the study protocol or would jeopardize a participant's safety or rights 12. Use or planned use of any drug with anti-malarial activity 30 days before or after CHMI Note: Medications with antimalarial activity include trimethoprim-sulfamethoxazole, azithromycin, erythromycin, tetracycline, doxycycline, minocycline, clindamycin, ciprofloxacin, levofloxacin, norfloxacin and rifampin 13. Planned surgery 30 days before or after CHMI 14. History of drug or alcohol abuse within the last five years 15. Receipt of blood or blood products in the previous six months or donation of a unit of blood within two months before screening 16. History of schizophrenia, bipolar disorder or other psychiatric condition that makes study compliance difficult Note: Subjects with psychoses or history of suicide attempt or gesture in the 3 years before study entry, ongoing risk for suicide. 17. History of diabetes mellitus with the exception of pregnancy-induced diabetes that has resolved 18. Has evidence of increased cardiovascular disease risk (defined as > 10%, 5 year risk) as determined by the method of Gaziano (46) Note: Risk factors include sex, age (years), systolic blood pressure (mm Hg), smoking status, body mass index (BMI, kg/mm2), reported diabetes status, and blood pressure. 19. Abnormal screening ECG Note: Pathologic Q wave and significant ST-T wave changes, left ventricular hypertrophy, non-sinus rhythm except isolated premature atrial or ventricular contractions, right of left bundle branch block, advanced A-V heart block (secondary or tertiary), QT/QTc interval >450 ms 20. Body mass index (BMI) >40 21. Known hypersensitivity to atovaquone-proguanil or artemether-lumefantrine 22. Anticipated medication use during the 28-day post-challenge period known to interact with atovaquone-proguanil or artemether-lumefantrine Note: Such as rifampin, carbamazepine, phenytoin, St. John's wort, cimetidine, metoclopramide, antacids, and kaolin 23. Personal beliefs that prevent receipt of human serum albumin 24. Immunization with more than three other vaccines within the past month and through study day 57 after CHMI 25. Previous vaccination with a candidate malaria vaccine or participation in a CHMI study 26. History of splenectomy 27. Pregnant or lactating females
Facility Information:
Facility Name
University of Maryland School of Medicine - Center for Vaccine Development - Baltimore
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201-1509
Country
United States

12. IPD Sharing Statement

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PfSPZ Challenge in Non-immune Adults in Baltimore, USA

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