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Phase 1 Trial of a Malaria Vaccine in Young Kenyan Children

Primary Purpose

Plasmodium Falciparum Malaria

Status
Completed
Phase
Phase 1
Locations
Kenya
Study Type
Interventional
Intervention
FMP1/AS02A Malaria vaccine
Imovax Rabies vaccine
Sponsored by
U.S. Army Medical Research and Development Command
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Plasmodium Falciparum Malaria focused on measuring Vaccine, Phase 1, Plasmodium falciparum, Malaria, Merozoite surface protein-1, MSP-1, Falciparum malaria protein 1, FMP-1, AS02A

Eligibility Criteria

12 Months - 47 Months (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria: A healthy male or female child, 12 to 47 months of age at the time of screening. Written informed consent obtained from at least one parent before study start. Available to participate for the duration of the study (12 months). Exclusion Criteria: Acute disease at the time of entry into the study Axillary temperature of 37.5 degrees C Respiratory rate 50 Serum ALT 45 IU/l (i.e., > 1.5 X ULN) Decreased renal function: serum creatinine levels > 92.2 mM/l (> 1.1 mg/dl). Significant anemia (Hgb <8 gm/dL). Thrombocytopenia (Platelets < 100,000 per mm3) Impaired immunity: (Absolute lymphocyte count [ALC] for 1 year olds < 4.0 x 103/mm3; for 2 year olds < 3.0 x 103/mm3; for 3 year olds < 2.0 103/mm3. History of homozygous sickle cell disease (SS). Malnutrition (Z score; Malnutrition = Weight for height < - 3 z scores) Blood transfusion or use of blood-based product in previous 6 months. Prior receipt of a rabies vaccine or an investigational malaria vaccine. Use of any investigational drug or vaccine other than the study vaccine within 30 days preceding the first dose of study vaccine, or planned use up to 30 days after the third dose. Administration of chronic (defined as more than 14 days) immunosuppressants or other immune-modifying drugs within six months of vaccination. (For cortico-steroids, this will mean prednisone, or equivalent, greater than or equal to 0.5 mg/kg/day. Inhaled and topical steroids are allowed). Administration or anticipated administration of a vaccine not foreseen by the study protocol within 30 days of the first dose of vaccine(s) with the exception of tetanus toxoid. Previous vaccination with a vaccine containing MPL or QS21 (e.g., RTS,S). Any confirmed or suspected immunosuppressive or immunodeficient condition, including human immunodeficiency virus (HIV) infection. (No HIV testing will be undertaken as part of this study.) History of allergic reactions or anaphylaxis to immunizations or to any vaccine components. History of surgical splenectomy. Administration of immunoglobulins or any blood products within the 3 months preceding the first dose of study vaccine or planned administration during the study period. Simultaneous participation in any other clinical trial. Acute or chronic cardiovascular, pulmonary, hepatic or renal condition, which in the opinion of the PI may increase the risk to the subject from participating in the study. Any other condition or circumstance that in the opinion of the investigator may pose a threat to the subject.

Sites / Locations

  • Walter Reed Project Kombewa Clinic

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

FMP1/AS02A Malaria vaccine 10ug

FMP1/AS02A Malaria vaccine 25 ug

FMP1/AS02A Malaria vaccine 50 ug

Imovax Rabies Vaccine

Arm Description

Subject vaccinated with 10 ug of FMP1/AS02A on days 0, 29 and 57

Subject vaccinated with 25 ug of FMP1/AS02A on days 14, 42, and 70

Subject vaccinated with 50 ug of FMP1/AS02A on days 28, 56 and 84

Subject vaccinated with Imovax Rabies Vaccine on corresponding FMP1/AS021 vaccination days

Outcomes

Primary Outcome Measures

Occurrence of Solicited Symptoms During a 8 Day Follow-up Period After Each Vaccination
Occurrence of any, local, or general solicited symptoms during the 8 day follow-up period
Occurrence of Unsolicited Symptoms During a 30 Day Follow-up Period After Each Vaccination
Occurrence of unsolicited symptoms during a 30 day follow-up period after each vaccination (day of vaccination and the 29 subsequent days)
Occurrence of Serious Adverse Events During an 8 Month Follow-up Period Following the First Dose of Study Vaccine
Occurrence of solicited and unsolicited serious adverse events during an 8 month follow-up period following the first dose of study vaccine

Secondary Outcome Measures

Anti-FMP1 Antibody Titer Responses
Antibody responses to FMP1 by ELISA following immunization with the study vaccine through 364 days following the first dose of study vaccine

Full Information

First Posted
April 20, 2006
Last Updated
May 4, 2017
Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Kenya Medical Research Institute, Walter Reed Army Institute of Research (WRAIR), The PATH Malaria Vaccine Initiative (MVI), United States Agency for International Development (USAID), GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT00317473
Brief Title
Phase 1 Trial of a Malaria Vaccine in Young Kenyan Children
Official Title
Double-blind,Randomized,Controlled,Dose Escalation Phase 1 Trial in 12-47 Month Old Children in Western Kenya to Evaluate the Safety and Immunogenicity of WRAIR's MSP-1(FMP1) Malaria Vaccine Adjuvanted in GSK's AS02A Versus Rabies Vaccine.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
June 2003 (undefined)
Primary Completion Date
July 2004 (Actual)
Study Completion Date
July 2005 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Kenya Medical Research Institute, Walter Reed Army Institute of Research (WRAIR), The PATH Malaria Vaccine Initiative (MVI), United States Agency for International Development (USAID), GlaxoSmithKline

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To assess the safety and reactogenicity of the FMP-1/AS02A malaria vaccine in malaria-exposed children living in western Kenya and aged 12-47 months
Detailed Description
Study consists of 3 cohorts (12 to 23 months, 24 to 35 months, and 36 to 47 months). Within each cohort subjects were randomized in a 2:1 ration to receive one of three dose levels of FMP1/AS02A (Cohort A, 10 ug; Cohort B, 25 ug; Cohort C, 50 ug) or Imovax Rabies vaccine. Immunization was staggered among dose cohorts; subjects in Cohort B received their first immunization only after the Local Medical Monitor and Data Safety Monitoring Board reviewed Cohort A safety data for the eight-day follow-up period following their first immunization. The same procedure was followed for the immunization of Cohort C. This will be conducted in western Kenya a the Walter Reed Project Lumbewa Clinic.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Plasmodium Falciparum Malaria
Keywords
Vaccine, Phase 1, Plasmodium falciparum, Malaria, Merozoite surface protein-1, MSP-1, Falciparum malaria protein 1, FMP-1, AS02A

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
135 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FMP1/AS02A Malaria vaccine 10ug
Arm Type
Experimental
Arm Description
Subject vaccinated with 10 ug of FMP1/AS02A on days 0, 29 and 57
Arm Title
FMP1/AS02A Malaria vaccine 25 ug
Arm Type
Experimental
Arm Description
Subject vaccinated with 25 ug of FMP1/AS02A on days 14, 42, and 70
Arm Title
FMP1/AS02A Malaria vaccine 50 ug
Arm Type
Experimental
Arm Description
Subject vaccinated with 50 ug of FMP1/AS02A on days 28, 56 and 84
Arm Title
Imovax Rabies Vaccine
Arm Type
Active Comparator
Arm Description
Subject vaccinated with Imovax Rabies Vaccine on corresponding FMP1/AS021 vaccination days
Intervention Type
Biological
Intervention Name(s)
FMP1/AS02A Malaria vaccine
Intervention Description
Subjects vaccinated with FMP1/AS02 vaccine
Intervention Type
Biological
Intervention Name(s)
Imovax Rabies vaccine
Intervention Description
Subjects vaccinated on corresponding FMP1/AS02A vaccination days
Primary Outcome Measure Information:
Title
Occurrence of Solicited Symptoms During a 8 Day Follow-up Period After Each Vaccination
Description
Occurrence of any, local, or general solicited symptoms during the 8 day follow-up period
Time Frame
40 days
Title
Occurrence of Unsolicited Symptoms During a 30 Day Follow-up Period After Each Vaccination
Description
Occurrence of unsolicited symptoms during a 30 day follow-up period after each vaccination (day of vaccination and the 29 subsequent days)
Time Frame
90 days
Title
Occurrence of Serious Adverse Events During an 8 Month Follow-up Period Following the First Dose of Study Vaccine
Description
Occurrence of solicited and unsolicited serious adverse events during an 8 month follow-up period following the first dose of study vaccine
Time Frame
8 months
Secondary Outcome Measure Information:
Title
Anti-FMP1 Antibody Titer Responses
Description
Antibody responses to FMP1 by ELISA following immunization with the study vaccine through 364 days following the first dose of study vaccine
Time Frame
364 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Months
Maximum Age & Unit of Time
47 Months
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: A healthy male or female child, 12 to 47 months of age at the time of screening. Written informed consent obtained from at least one parent before study start. Available to participate for the duration of the study (12 months). Exclusion Criteria: Acute disease at the time of entry into the study Axillary temperature of 37.5 degrees C Respiratory rate 50 Serum ALT 45 IU/l (i.e., > 1.5 X ULN) Decreased renal function: serum creatinine levels > 92.2 mM/l (> 1.1 mg/dl). Significant anemia (Hgb <8 gm/dL). Thrombocytopenia (Platelets < 100,000 per mm3) Impaired immunity: (Absolute lymphocyte count [ALC] for 1 year olds < 4.0 x 103/mm3; for 2 year olds < 3.0 x 103/mm3; for 3 year olds < 2.0 103/mm3. History of homozygous sickle cell disease (SS). Malnutrition (Z score; Malnutrition = Weight for height < - 3 z scores) Blood transfusion or use of blood-based product in previous 6 months. Prior receipt of a rabies vaccine or an investigational malaria vaccine. Use of any investigational drug or vaccine other than the study vaccine within 30 days preceding the first dose of study vaccine, or planned use up to 30 days after the third dose. Administration of chronic (defined as more than 14 days) immunosuppressants or other immune-modifying drugs within six months of vaccination. (For cortico-steroids, this will mean prednisone, or equivalent, greater than or equal to 0.5 mg/kg/day. Inhaled and topical steroids are allowed). Administration or anticipated administration of a vaccine not foreseen by the study protocol within 30 days of the first dose of vaccine(s) with the exception of tetanus toxoid. Previous vaccination with a vaccine containing MPL or QS21 (e.g., RTS,S). Any confirmed or suspected immunosuppressive or immunodeficient condition, including human immunodeficiency virus (HIV) infection. (No HIV testing will be undertaken as part of this study.) History of allergic reactions or anaphylaxis to immunizations or to any vaccine components. History of surgical splenectomy. Administration of immunoglobulins or any blood products within the 3 months preceding the first dose of study vaccine or planned administration during the study period. Simultaneous participation in any other clinical trial. Acute or chronic cardiovascular, pulmonary, hepatic or renal condition, which in the opinion of the PI may increase the risk to the subject from participating in the study. Any other condition or circumstance that in the opinion of the investigator may pose a threat to the subject.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark R. Withers, M.D., MPH
Organizational Affiliation
USAMRU-K
Official's Role
Principal Investigator
Facility Information:
Facility Name
Walter Reed Project Kombewa Clinic
City
Kombewa
State/Province
Nyanza Province
Country
Kenya

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Kenya Medical Research Institute; WRAIR; The Path Malaria Vaccine Initiative; United States Agency for International Development; GlaxoSmith Kline
Citations:
PubMed Identifier
15364429
Citation
Pichyangkul S, Gettayacamin M, Miller RS, Lyon JA, Angov E, Tongtawe P, Ruble DL, Heppner DG Jr, Kester KE, Ballou WR, Diggs CL, Voss G, Cohen JD, Walsh DS. Pre-clinical evaluation of the malaria vaccine candidate P. falciparum MSP1(42) formulated with novel adjuvants or with alum. Vaccine. 2004 Sep 28;22(29-30):3831-40. doi: 10.1016/j.vaccine.2004.07.023.
Results Reference
background
PubMed Identifier
16356603
Citation
Ockenhouse CF, Angov E, Kester KE, Diggs C, Soisson L, Cummings JF, Stewart AV, Palmer DR, Mahajan B, Krzych U, Tornieporth N, Delchambre M, Vanhandenhove M, Ofori-Anyinam O, Cohen J, Lyon JA, Heppner DG; MSP-1 Working Group. Phase I safety and immunogenicity trial of FMP1/AS02A, a Plasmodium falciparum MSP-1 asexual blood stage vaccine. Vaccine. 2006 Apr 5;24(15):3009-17. doi: 10.1016/j.vaccine.2005.11.028. Epub 2005 Nov 28.
Results Reference
background
PubMed Identifier
16388879
Citation
Stoute JA, Gombe J, Withers MR, Siangla J, McKinney D, Onyango M, Cummings JF, Milman J, Tucker K, Soisson L, Stewart VA, Lyon JA, Angov E, Leach A, Cohen J, Kester KE, Ockenhouse CF, Holland CA, Diggs CL, Wittes J, Heppner DG Jr; MSP-1 Malaria Vaccine Working Group. Phase 1 randomized double-blind safety and immunogenicity trial of Plasmodium falciparum malaria merozoite surface protein FMP1 vaccine, adjuvanted with AS02A, in adults in western Kenya. Vaccine. 2007 Jan 2;25(1):176-84. doi: 10.1016/j.vaccine.2005.11.037. Epub 2005 Dec 7.
Results Reference
background
PubMed Identifier
12742586
Citation
Angov E, Aufiero BM, Turgeon AM, Van Handenhove M, Ockenhouse CF, Kester KE, Walsh DS, McBride JS, Dubois MC, Cohen J, Haynes JD, Eckels KH, Heppner DG, Ballou WR, Diggs CL, Lyon JA. Development and pre-clinical analysis of a Plasmodium falciparum Merozoite Surface Protein-1(42) malaria vaccine. Mol Biochem Parasitol. 2003 May;128(2):195-204. doi: 10.1016/s0166-6851(03)00077-x.
Results Reference
result

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Phase 1 Trial of a Malaria Vaccine in Young Kenyan Children

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