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Phase 2a ID93 + GLA-SE Vaccine Trial in TB Patients After Treatment Completion

Primary Purpose

Pulmonary Tuberculosis

Status
Completed
Phase
Phase 2
Locations
South Africa
Study Type
Interventional
Intervention
Placebo
ID93 + GLA-SE
Sponsored by
Access to Advanced Health Institute (AAHI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Pulmonary Tuberculosis focused on measuring Tuberculosis, TB, Pulmonary, Vaccine, Adjuvant

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males and females 18 to 60 years of age.
  2. Subjects must have been successfully treated, i.e., completed the scheduled course of TB treatment as per the prevailing South African national guidelines, for MTB culture-confirmed, drug sensitive pulmonary TB, as evidenced by a record of positive liquid MTB culture with formal drug sensitivity testing (DST) and/or by Xpert MTB/RIF test at baseline.
  3. Must have two separate samples showing bacteriologic confirmation of cure - defined in the first instance as Xpert MTB/RIF test negative, or, if Xpert MTB/RIF positive, as MTB liquid culture negative - on two successive occasions at least 30 days apart. Subjects who are sputum unproductive will be deemed Xpert MTB/RIF and MTB liquid culture negative.
  4. Female subjects of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test on the day of each study injection, must not be breast-feeding, and be willing to avoid pregnancy for 3 months following first study injection. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, intrauterine device (IUD), or the combination of a condom or diaphragm with spermicide gel.
  5. The following screening laboratory values must be within the laboratory reference range or, if abnormal, deemed not clinically significant and less than Grade 2 severity on the FDA Toxicity Scale, as determined by the PI and LMM or Sponsor Medical Advisor: ALT, AST, total bilirubin, creatinine, total WBC count, hemoglobin, and platelet count.
  6. The HIV 1/2 antibody serology tests must be negative.
  7. Must give informed consent, be able and willing to make all evaluation visits, be reachable by telephone or personal contact by the study site personnel, and be willing to remain in the study area for the duration of the trial.

Exclusion Criteria:

  1. TB treatment failure, as evidenced by clinical diagnosis or a positive MTB liquid culture at month 4 or 5 after starting treatment. A positive MTB liquid culture at, or after, end of treatment would exclude subjects from receiving further study injections.
  2. Previous course of TB treatment completed within 5 calendar years prior to obtaining baseline diagnostic sputum samples.
  3. Receipt of any investigational products or investigational drug in the past 6 months or investigational vaccine ever.
  4. Treatment with immunosuppressive drugs (e.g., oral or injected steroids, such as prednisone; high dose inhaled steroids) in the past 6 months. Topical steroids would be allowable.
  5. Received incomplete or investigational, or non-standard TB drug regimen, other than the prevailing current South African national guideline as reference standard, or poor adherence to TB treatment regimen.
  6. Diagnosed with rifampicin-resistant MTB strain (by Xpert MTB/RIF and/or culture and formal DST).
  7. History of autoimmune disease or other causes of immunosuppressive states.
  8. History or evidence of any acute or chronic illness (including diabetes mellitus, asthma), medical or surgical condition, or chronic heavy ethanol or drug use, or use of medication that, in the opinion of the Principal Investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine.
  9. Subjects with a history of previous anaphylaxis or severe allergic reaction to vaccines, eggs, or unknown allergens.
  10. Subjects who are unlikely to cooperate with the requirements of the study protocol.

Sites / Locations

  • TASK Applied Sciences
  • Desmond Tutu HIV Centre (DTHC)
  • South African Tuberculosis Vaccine Initiative (SATVI)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Arm Label

2 mcg ID93 + 2 mcg GLA-SE Vaccine

10 mcg ID93 + 2 mcg GLA-SE Vaccine

2 mcg ID93 + 5 mcg GLA-SE Vaccine

Placebo

2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 doses

Arm Description

Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and low dose of adjuvant.

Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. High dose of antigen and low dose of adjuvant.

Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and high dose of adjuvant. Placebo injection at Day 28 to maintain blind with the 3 dose arm.

Two intramuscular injections of normal saline at Days 0 and 56, or Days 0, 28, and 56.

Three intramuscular injections of ID93 + GLA-SE at Days 0, 28, and 56. Low dose of antigen and high dose of adjuvant.

Outcomes

Primary Outcome Measures

Number of Adverse Events
Safety outcomes will include solicited adverse events within 7 days and unsolicited adverse events within 28 days after each study injection; and serious adverse events after the first study injection until end of study follow-up.

Secondary Outcome Measures

Immunogenicity Responder Rate
Immunogenicity will be evaluated by measuring humoral and cellular responses to ID93 + GLA-SE at Day 70.

Full Information

First Posted
June 3, 2015
Last Updated
February 21, 2019
Sponsor
Access to Advanced Health Institute (AAHI)
Collaborators
Wellcome Trust, South African Tuberculosis Vaccine Initiative
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1. Study Identification

Unique Protocol Identification Number
NCT02465216
Brief Title
Phase 2a ID93 + GLA-SE Vaccine Trial in TB Patients After Treatment Completion
Official Title
A Phase 2A, Randomized, Double-Blind, Placebo-Controlled, Clinical Trial to Evaluate the Safety and Immunogenicity of the ID93 + GLA-SE Vaccine in HIV Uninfected Adult TB Patients After Treatment Completion
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
January 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Access to Advanced Health Institute (AAHI)
Collaborators
Wellcome Trust, South African Tuberculosis Vaccine Initiative

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and immunogenicity of ID93 + GLA-SE vaccine when administered to adult pulmonary Tuberculosis (TB) patients, following successful completion of TB treatment with confirmed bacteriologic cure, in preparation for a future Phase 2b prevention of TB recurrence trial in the same population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Tuberculosis
Keywords
Tuberculosis, TB, Pulmonary, Vaccine, Adjuvant

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
2 mcg ID93 + 2 mcg GLA-SE Vaccine
Arm Type
Experimental
Arm Description
Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and low dose of adjuvant.
Arm Title
10 mcg ID93 + 2 mcg GLA-SE Vaccine
Arm Type
Experimental
Arm Description
Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. High dose of antigen and low dose of adjuvant.
Arm Title
2 mcg ID93 + 5 mcg GLA-SE Vaccine
Arm Type
Experimental
Arm Description
Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and high dose of adjuvant. Placebo injection at Day 28 to maintain blind with the 3 dose arm.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two intramuscular injections of normal saline at Days 0 and 56, or Days 0, 28, and 56.
Arm Title
2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 doses
Arm Type
Experimental
Arm Description
Three intramuscular injections of ID93 + GLA-SE at Days 0, 28, and 56. Low dose of antigen and high dose of adjuvant.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo
Intervention Type
Biological
Intervention Name(s)
ID93 + GLA-SE
Intervention Description
ID93 + GLA-SE
Primary Outcome Measure Information:
Title
Number of Adverse Events
Description
Safety outcomes will include solicited adverse events within 7 days and unsolicited adverse events within 28 days after each study injection; and serious adverse events after the first study injection until end of study follow-up.
Time Frame
224 days
Secondary Outcome Measure Information:
Title
Immunogenicity Responder Rate
Description
Immunogenicity will be evaluated by measuring humoral and cellular responses to ID93 + GLA-SE at Day 70.
Time Frame
Day 70

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females 18 to 60 years of age. Subjects must have been successfully treated, i.e., completed the scheduled course of TB treatment as per the prevailing South African national guidelines, for MTB culture-confirmed, drug sensitive pulmonary TB, as evidenced by a record of positive liquid MTB culture with formal drug sensitivity testing (DST) and/or by Xpert MTB/RIF test at baseline. Must have two separate samples showing bacteriologic confirmation of cure - defined in the first instance as Xpert MTB/RIF test negative, or, if Xpert MTB/RIF positive, as MTB liquid culture negative - on two successive occasions at least 30 days apart. Subjects who are sputum unproductive will be deemed Xpert MTB/RIF and MTB liquid culture negative. Female subjects of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test on the day of each study injection, must not be breast-feeding, and be willing to avoid pregnancy for 3 months following first study injection. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, intrauterine device (IUD), or the combination of a condom or diaphragm with spermicide gel. The following screening laboratory values must be within the laboratory reference range or, if abnormal, deemed not clinically significant and less than Grade 2 severity on the FDA Toxicity Scale, as determined by the PI and LMM or Sponsor Medical Advisor: ALT, AST, total bilirubin, creatinine, total WBC count, hemoglobin, and platelet count. The HIV 1/2 antibody serology tests must be negative. Must give informed consent, be able and willing to make all evaluation visits, be reachable by telephone or personal contact by the study site personnel, and be willing to remain in the study area for the duration of the trial. Exclusion Criteria: TB treatment failure, as evidenced by clinical diagnosis or a positive MTB liquid culture at month 4 or 5 after starting treatment. A positive MTB liquid culture at, or after, end of treatment would exclude subjects from receiving further study injections. Previous course of TB treatment completed within 5 calendar years prior to obtaining baseline diagnostic sputum samples. Receipt of any investigational products or investigational drug in the past 6 months or investigational vaccine ever. Treatment with immunosuppressive drugs (e.g., oral or injected steroids, such as prednisone; high dose inhaled steroids) in the past 6 months. Topical steroids would be allowable. Received incomplete or investigational, or non-standard TB drug regimen, other than the prevailing current South African national guideline as reference standard, or poor adherence to TB treatment regimen. Diagnosed with rifampicin-resistant MTB strain (by Xpert MTB/RIF and/or culture and formal DST). History of autoimmune disease or other causes of immunosuppressive states. History or evidence of any acute or chronic illness (including diabetes mellitus, asthma), medical or surgical condition, or chronic heavy ethanol or drug use, or use of medication that, in the opinion of the Principal Investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine. Subjects with a history of previous anaphylaxis or severe allergic reaction to vaccines, eggs, or unknown allergens. Subjects who are unlikely to cooperate with the requirements of the study protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Hatherill, MD
Organizational Affiliation
South African Tuberculosis Vaccine Initiative
Official's Role
Principal Investigator
Facility Information:
Facility Name
TASK Applied Sciences
City
Cape Town
ZIP/Postal Code
7530
Country
South Africa
Facility Name
Desmond Tutu HIV Centre (DTHC)
City
Cape Town
ZIP/Postal Code
7750
Country
South Africa
Facility Name
South African Tuberculosis Vaccine Initiative (SATVI)
City
Worcester
ZIP/Postal Code
6850
Country
South Africa

12. IPD Sharing Statement

Citations:
PubMed Identifier
33306991
Citation
Day TA, Penn-Nicholson A, Luabeya AKK, Fiore-Gartland A, Du Plessis N, Loxton AG, Vergara J, Rolf TA, Reid TD, Toefy A, Shenje J, Geldenhuys H, Tameris M, Mabwe S, Bilek N, Bekker LG, Diacon A, Walzl G, Ashman J, Frevol A, Sagawa ZK, Lindestam Arlehamn C, Sette A, Reed SG, Coler RN, Scriba TJ, Hatherill M; TBVPX-203 study team. Safety and immunogenicity of the adjunct therapeutic vaccine ID93 + GLA-SE in adults who have completed treatment for tuberculosis: a randomised, double-blind, placebo-controlled, phase 2a trial. Lancet Respir Med. 2021 Apr;9(4):373-386. doi: 10.1016/S2213-2600(20)30319-2. Epub 2020 Dec 8. Erratum In: Lancet Respir Med. 2021 Jul;9(7):e62.
Results Reference
derived

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Phase 2a ID93 + GLA-SE Vaccine Trial in TB Patients After Treatment Completion

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