Phase 1 Clinical Trial of the Safety and Immunogenicity of an Adenovirus-based TB Vaccine Administered by Aerosol
Primary Purpose
Tuberculosis
Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
Ad5Ag85A
Sponsored by
About this trial
This is an interventional prevention trial for Tuberculosis focused on measuring Tuberculosis, Vaccine, Aerosol, Adenovirus, Immunogenicity
Eligibility Criteria
Inclusion Criteria:
- Healthy human subjects who are between 18 and 55 years of age with a history of BCG vaccination.
- HIV antibody negative
- Able to understand and comply with protocol requirements and instructions; able to attend scheduled study visits and complete required investigations.
- For women, negative pregnancy test and practicing two acceptable forms of contraception for the duration of the study (barrier contraceptive, birth control pill, surgically sterile, post-menopausal 2 years, abstinence)
- For men, using barrier contraception for the duration of the study
Exclusion Criteria:
- Pregnant or lactating women
- Subjects who have any acute or chronic illnesses including active tuberculosis, any relevant findings on physical examination or are receiving any drug treatment in the opinion of the investigator likely to affect the immune system including current use of inhaled or nasal steroids.
- Subjects with a history of any bleeding disorder or receiving any drug treatment that in the opinion of the investigator may increase the risk of bleeding
- Subjects with a history of respiratory disease, e.g. asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD).
- Current smokers, including e-cigarettes, and ex-smokers who have quit within the last year, as reported by the subject
- Subjects with clinically significant abnormality of baseline spirometry tests
- Any health-related condition for which study bronchoscopy is contraindicated
- Subjects who have a history of active or latent TB infection or whose PBMC's are responsive to ESAT6/CFP10 stimulation using a commercial interferon gamma release assay for TB [consistent with latent TB infection].
- Subjects whose baseline laboratory values are outside of the normal range unless the abnormality is considered not to be of clinical relevance by the Investigator. A single repeat test is allowed during the screening period.
- Subjects whose use of alcohol or drugs would, in the opinion of the investigator, interfere with adherence to the study protocol.
- Subjects who are using, or have a history of using, inhaled cocaine, metamphetamine or other inhaled or smoked recreational drugs. Subjects who give a history of last smoking marijuana more than a year ago may be enrolled, as long as they do not smoke marijuana for the duration of the study.
- Failure to provide written consent.
- Known allergy to vaccine components
- Previous vaccination with Ad5Ag85A or any other experimental TB vaccine
- Known exposure to active TB within past 6 months or subjects whose occupation puts them at increased risk of TB exposure (based on Hamilton Health Science/St Joseph Healthcare list of high risk personnel)
- Any abnormality on chest x-ray suggestive of active or remote tuberculosis infection or evidence on chest-x-ray of clinically significant respiratory disease.
- PPD skin test within last 12 months
Sites / Locations
- McMaster University Medical Centre
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Group 1 Aerosol
Group 2 Aerosol
Group 3 Intramuscular
Arm Description
Receive 10^6 Ad5Ag85A by aerosol at day 0
Receive 2x10^6 Ad5Ag85A by aerosol at day 0
Receive 10^8 Ad5Ag85A by intramuscular injection at day 0
Outcomes
Primary Outcome Measures
Number of participants reporting adverse events
Adverse events will be assessed according to the CTCAE Expanded Common Toxicity Criteria at 48-72 hours after vaccination, and at weeks 2, 4, 8, 12, 16 and 24
Secondary Outcome Measures
Immunogenicity of one of two doses of Ad5Ag85A administered by aerosol
Change from baseline in the immune responses of specific T-cells in bronchoalveolar lavage [BAL] fluid (mucosal) and blood (systemic). Immune responses measured will include interferon Elispot assay, cytokine production and intracellular cytokine staining
Immunogenicity of one of two doses of Ad5Ag85A administered by aerosol
Immunogenicity of inhaled administration of Ad5Ag85A compared with intramuscular administration
Immunogenicity of inhaled administration of Ad5Ag85A compared with intramuscular administration
Number of participants reporting adverse events with inhaled administration of Ad5Ag85A compared with intramuscular administration
Immune responses measured from induced sputum compared with bronchoalveolar lavage
For first cohort of 8 participants only
immune responses measured from induced sputum compared with bronchoalveolar lavage
For first cohort of 8 participants only
Number of participants developing a positive interferon release assay for TB after vaccination with Ad5Ag85A
For first cohort of 8 patients only
Number of participants reporting adverse events correlated with level of pre-existing anti-adenoviral antibodies
Immune response to vaccination correlated with pre-existing anti-adenoviral antibodies
Immune response to vaccination correlated with pre-existing anti-adenoviral antibodies
Number of participants reporting adverse effects correlated with dose of vaccine received by inhalation
Immune response to vaccine correlated with dose of vaccine received by inhalation
Immune response to vaccine correlated with dose of vaccine received by inhalation
Full Information
NCT ID
NCT02337270
First Posted
December 19, 2014
Last Updated
October 25, 2021
Sponsor
McMaster University
Collaborators
Canadian Institutes of Health Research (CIHR)
1. Study Identification
Unique Protocol Identification Number
NCT02337270
Brief Title
Phase 1 Clinical Trial of the Safety and Immunogenicity of an Adenovirus-based TB Vaccine Administered by Aerosol
Official Title
Phase 1, Open-label Clinical Trial to Evaluate the Safety and Immunogenicity of an Adenovirus-based Tuberculosis Vaccine Administered by Aerosol
Study Type
Interventional
2. Study Status
Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
September 5, 2017 (Actual)
Primary Completion Date
September 7, 2021 (Actual)
Study Completion Date
September 7, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
McMaster University
Collaborators
Canadian Institutes of Health Research (CIHR)
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
This is a phase 1 study, in healthy volunteers who have previously been immunized with bacilli Calmette Guerin (BCG), to evaluate the safety and immune responses that develop in the blood and lungs following the administration by aerosol of a new experimental adenovirus-based vaccine for tuberculosis (TB), Ad5Ag85A.
Detailed Description
This is a phase 1, open label study to evaluate the safety and immunogenicity of a single administration of one of two doses of a recombinant replication deficient human adenoviral (Ad5) TB vaccine containing the immunodominant antigen Ag85A delivered to the respiratory tract by aerosol in healthy volunteers with a history of BCG immunization.
28 healthy volunteers will be enrolled. The first cohort (n=8) will receive a lower dose of vaccine using the AeroNeb Solo Vibrating Mesh Nebulizer. For the second cohort (n=20) participants will be randomized to either a higher dose of vaccine by aerosol (n=10) or intramuscular administration (n=10). Cellular immune responses in the lung and peripheral blood will be evaluated
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberculosis
Keywords
Tuberculosis, Vaccine, Aerosol, Adenovirus, Immunogenicity
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
36 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group 1 Aerosol
Arm Type
Experimental
Arm Description
Receive 10^6 Ad5Ag85A by aerosol at day 0
Arm Title
Group 2 Aerosol
Arm Type
Experimental
Arm Description
Receive 2x10^6 Ad5Ag85A by aerosol at day 0
Arm Title
Group 3 Intramuscular
Arm Type
Experimental
Arm Description
Receive 10^8 Ad5Ag85A by intramuscular injection at day 0
Intervention Type
Biological
Intervention Name(s)
Ad5Ag85A
Intervention Description
Aerosol administration of Ad5Ag85A
Primary Outcome Measure Information:
Title
Number of participants reporting adverse events
Description
Adverse events will be assessed according to the CTCAE Expanded Common Toxicity Criteria at 48-72 hours after vaccination, and at weeks 2, 4, 8, 12, 16 and 24
Time Frame
Over 24 weeks
Secondary Outcome Measure Information:
Title
Immunogenicity of one of two doses of Ad5Ag85A administered by aerosol
Description
Change from baseline in the immune responses of specific T-cells in bronchoalveolar lavage [BAL] fluid (mucosal) and blood (systemic). Immune responses measured will include interferon Elispot assay, cytokine production and intracellular cytokine staining
Time Frame
Two weeks after vaccination
Title
Immunogenicity of one of two doses of Ad5Ag85A administered by aerosol
Time Frame
Eight (first cohort) or twelve (second cohort) weeks after vaccination
Title
Immunogenicity of inhaled administration of Ad5Ag85A compared with intramuscular administration
Time Frame
Two weeks after vaccination
Title
Immunogenicity of inhaled administration of Ad5Ag85A compared with intramuscular administration
Time Frame
Twelve weeks after vaccination
Title
Number of participants reporting adverse events with inhaled administration of Ad5Ag85A compared with intramuscular administration
Time Frame
Over 24 weeks
Title
Immune responses measured from induced sputum compared with bronchoalveolar lavage
Description
For first cohort of 8 participants only
Time Frame
Two weeks after vaccination
Title
immune responses measured from induced sputum compared with bronchoalveolar lavage
Description
For first cohort of 8 participants only
Time Frame
Eight weeks after vaccination
Title
Number of participants developing a positive interferon release assay for TB after vaccination with Ad5Ag85A
Description
For first cohort of 8 patients only
Time Frame
At 16 weeks
Title
Number of participants reporting adverse events correlated with level of pre-existing anti-adenoviral antibodies
Time Frame
Over 24 weeks
Title
Immune response to vaccination correlated with pre-existing anti-adenoviral antibodies
Time Frame
Two weeks after vaccination
Title
Immune response to vaccination correlated with pre-existing anti-adenoviral antibodies
Time Frame
Eight weeks after vaccination
Title
Number of participants reporting adverse effects correlated with dose of vaccine received by inhalation
Time Frame
Over 24 weeks
Title
Immune response to vaccine correlated with dose of vaccine received by inhalation
Time Frame
Two weeks after vaccination
Title
Immune response to vaccine correlated with dose of vaccine received by inhalation
Time Frame
Eight or 12 weeks after vaccination
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Healthy human subjects who are between 18 and 55 years of age with a history of BCG vaccination.
HIV antibody negative
Able to understand and comply with protocol requirements and instructions; able to attend scheduled study visits and complete required investigations.
For women, negative pregnancy test and practicing two acceptable forms of contraception for the duration of the study (barrier contraceptive, birth control pill, surgically sterile, post-menopausal 2 years, abstinence)
For men, using barrier contraception for the duration of the study
Exclusion Criteria:
Pregnant or lactating women
Subjects who have any acute or chronic illnesses including active tuberculosis, any relevant findings on physical examination or are receiving any drug treatment in the opinion of the investigator likely to affect the immune system including current use of inhaled or nasal steroids.
Subjects with a history of any bleeding disorder or receiving any drug treatment that in the opinion of the investigator may increase the risk of bleeding
Subjects with a history of respiratory disease, e.g. asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD).
Current smokers, including e-cigarettes, and ex-smokers who have quit within the last year, as reported by the subject
Subjects with clinically significant abnormality of baseline spirometry tests
Any health-related condition for which study bronchoscopy is contraindicated
Subjects who have a history of active or latent TB infection or whose PBMC's are responsive to ESAT6/CFP10 stimulation using a commercial interferon gamma release assay for TB [consistent with latent TB infection].
Subjects whose baseline laboratory values are outside of the normal range unless the abnormality is considered not to be of clinical relevance by the Investigator. A single repeat test is allowed during the screening period.
Subjects whose use of alcohol or drugs would, in the opinion of the investigator, interfere with adherence to the study protocol.
Subjects who are using, or have a history of using, inhaled cocaine, metamphetamine or other inhaled or smoked recreational drugs. Subjects who give a history of last smoking marijuana more than a year ago may be enrolled, as long as they do not smoke marijuana for the duration of the study.
Failure to provide written consent.
Known allergy to vaccine components
Previous vaccination with Ad5Ag85A or any other experimental TB vaccine
Known exposure to active TB within past 6 months or subjects whose occupation puts them at increased risk of TB exposure (based on Hamilton Health Science/St Joseph Healthcare list of high risk personnel)
Any abnormality on chest x-ray suggestive of active or remote tuberculosis infection or evidence on chest-x-ray of clinically significant respiratory disease.
PPD skin test within last 12 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fiona M Smaill, MB,ChB
Organizational Affiliation
McMaster University
Official's Role
Principal Investigator
Facility Information:
Facility Name
McMaster University Medical Centre
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
12. IPD Sharing Statement
Citations:
PubMed Identifier
34990408
Citation
Jeyanathan M, Fritz DK, Afkhami S, Aguirre E, Howie KJ, Zganiacz A, Dvorkin-Gheva A, Thompson MR, Silver RF, Cusack RP, Lichty BD, O'Byrne PM, Kolb M, Medina MFC, Dolovich MB, Satia I, Gauvreau GM, Xing Z, Smaill F. Aerosol delivery, but not intramuscular injection, of adenovirus-vectored tuberculosis vaccine induces respiratory-mucosal immunity in humans. JCI Insight. 2022 Feb 8;7(3):e155655. doi: 10.1172/jci.insight.155655.
Results Reference
derived
Links:
URL
https://www.medrxiv.org/content/10.1101/2021.09.09.21263339v1
Description
Safety and immunopotency of an adenovirus-vectored tuberculosis vaccine delivered via inhaled aerosol to healthy humans: a dose and route comparison phase 1b study
Learn more about this trial
Phase 1 Clinical Trial of the Safety and Immunogenicity of an Adenovirus-based TB Vaccine Administered by Aerosol
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