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Safety, Tolerability and Immunogenic Response of CV-MG01 in Patients With Myasthenia Gravis

Primary Purpose

Myasthenia Gravis

Status
Completed
Phase
Phase 1
Locations
Belgium
Study Type
Interventional
Intervention
CV-MG01
Placebo
Sponsored by
CuraVac
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myasthenia Gravis focused on measuring Myasthenia Gravis, CV-MG01 therapeutic vaccine, Acetylcholine receptor mimetic peptides, Safety, Immunogenic response, First-in-Human, Proof-of-Concept, Myasterix

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male and female subjects, with ocular and generalised myasthenia gravis (grade 1-2-3).
  • Between the ages of 18 and 64 years, inclusive, at the time of the first injection.
  • A Body Mass Index (BMI) between 18 and 35 kg/m2, inclusive.
  • Patient with positive antibodies to AChR based on radioimmunoassay(RIA) (AChRAb ≥ 1 nmol/l); if available, historical data on AChR Ab levels over the last 2 years will be collected in the study records.
  • Patient may use corticosteroid treatment, equivalent to a daily dose of 30 mg prednisone or lower and stable (dose +/- 5 mg) during the 3 months before participation.
  • Patient may use one immunosuppressive drug with or without concomitant use of corticosteroid, providing that the dosage has been stable/unchanged for 3 months before participation.
  • Blood pressure and heart rate (supine & standing) within normal reference range for the population or investigator site, or results with acceptable deviations that are judged to be not clinically significant by the investigator.
  • Venous access sufficient to allow blood sampling as per the protocol.
  • Are reliable and willing to make themselves available for the duration of the study and are willing to follow study procedures.
  • Have given written informed consent approved by the relevant Ethics Committee (EC) governing the site.

Exclusion Criteria:

  • MG patients of Grade 4 or 5 based on myasthenia gravis foundation of America (MGFA) classification.
  • Patients with history or presence of a primary or recurrent malignant disease including the presence or history of a thymoma.
  • Thymectomy planned during part A of the study period or performed within 1 year prior to the first dose of study vaccine.
  • Any confirmed or suspected immunosuppressive or immunodeficient condition not related to the treatment of MG, including human immunodeficiency virus (HIV) infection, or a family history of congenital or hereditary immunodeficiency.
  • History or evidence of administration of immunoglobulins and/or any blood products within 3 months prior to the first dose of study vaccine or a planned administration of immunoglobulins during the first 3 months of the trial.
  • History or evidence of rituximab treatment within 6 months prior to first dose of study vaccine.
  • History or evidence of plasmapheresis within 3 months prior to the first dose of study vaccine or a planned plasmapheresis during the first 3 months of the trial.
  • At high risk for aspiration.
  • Pulmonary: forced vital capacity reduced to less than 70% of predicted capacity.
  • History of severe allergic disease or reactions likely to be exacerbated by any component of the vaccine.
  • History or evidence of Lambert-Eaton myasthenic syndrome, drug-induced myasthenia gravis, hereditary forms of myasthenic syndrome.
  • History of relevant chronic degenerative, psychiatric, or neurological disorder other than MG.
  • Severe hepatic, renal or cardiac insufficiency.
  • Major congenital defects or serious chronic illness other than MG.
  • Positive pregnancy test or desire to become pregnant during the study.
  • Female patients of child-bearing potential that do not use a reliable and highly effective method of contraception at least one month before first injection, during the study and until 3 months after the last injection.
  • Any significant out-of-range Clinical Laboratory results considered as clinically significant according to Investigator's judgment.
  • Previous completion or withdrawal from this study.
  • Sponsor employees or investigator site personnel directly affiliated with this study, and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted.
  • Any medical condition that, in the opinion of the Investigator, might interfere with the subject's participation in the study, poses any added risk for the subject, or confounds the assessment of the subjects.

Sites / Locations

  • University Hospital, Antwerp

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CV-MG01

Placebo

Arm Description

The therapeutic vaccine candidate, CV-MG01 comprises two short synthetic peptides separately conjugated to a carrier protein for the potential treatment of myasthenia gravis

Aluminium hydroxide adjuvant alone

Outcomes

Primary Outcome Measures

Safety
Safety assessed by laboratory tests, vital signs, electrocardiogram (ECG), adverse events, assessment of local tolerance, physical exams
Immunogenicity
To assess the immunogenic response after subcutaneous injections of CV-MG01 on the plasma levels of anti-peptide antibodies.

Secondary Outcome Measures

Biomarker
To assess the effect of CV-MG01 subcutaneous injections on the plasma level of acetylcholine receptor antibodies.
Clinical efficacy
Clinical efficacy assessed by Quantitative MG testing Procedure extended with MG Composite Scale and MG-ADL (myasthenia gravis activities of daily living)

Full Information

First Posted
November 13, 2015
Last Updated
January 25, 2019
Sponsor
CuraVac
Collaborators
Aepodia, University Hospital, Antwerp, Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT02609022
Brief Title
Safety, Tolerability and Immunogenic Response of CV-MG01 in Patients With Myasthenia Gravis
Official Title
A First-in-human and Proof-of-concept Study to Assess the Safety, Tolerability and Immunogenic Response of CV-MG01, Acetylcholine Receptor Mimetic Peptides, as Potential Therapeutic Vaccine, in Patients With Myasthenia Gravis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
March 2016 (Actual)
Primary Completion Date
September 30, 2018 (Actual)
Study Completion Date
September 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CuraVac
Collaborators
Aepodia, University Hospital, Antwerp, Leiden University Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Study CV-0002 is the first clinical trial administering CV-MG01 in humans. This clinical trial is a safety and proof-of-concept study (proof of mechanism of action) intended to assess the safety, tolerability and immunogenic response following 3 subcutaneous injections of CV-MG01 as a potential therapeutic vaccine / active immunotherapy in myasthenia gravis (MG) patients.
Detailed Description
Part A of the trial has been designed as a human safety pharmacology and therapeutic exploratory, parallel group, randomised, placebo-controlled, single centre, Investigator and subject-blind study using adaptive dose and sample size approaches. At the end of part A of the present study, all patients, including those receiving placebo, will be monitored in an open label, long-term safety follow-up part B of the study to assess the treatment effects over time.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myasthenia Gravis
Keywords
Myasthenia Gravis, CV-MG01 therapeutic vaccine, Acetylcholine receptor mimetic peptides, Safety, Immunogenic response, First-in-Human, Proof-of-Concept, Myasterix

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CV-MG01
Arm Type
Experimental
Arm Description
The therapeutic vaccine candidate, CV-MG01 comprises two short synthetic peptides separately conjugated to a carrier protein for the potential treatment of myasthenia gravis
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Aluminium hydroxide adjuvant alone
Intervention Type
Biological
Intervention Name(s)
CV-MG01
Intervention Description
3 consecutive subcutaneous injections of CV-MG01. The three injections are planned for each patient on Days 1, 29 (+/- 3 days) and 85 (+/- 7 days), respectively. Two dose levels: low and high dose.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
3 consecutive subcutaneous injections of placebo. The three injections are planned for each patient on Days 1, 29 (+/- 3 days) and 85 (+/- 7 days), respectively.
Primary Outcome Measure Information:
Title
Safety
Description
Safety assessed by laboratory tests, vital signs, electrocardiogram (ECG), adverse events, assessment of local tolerance, physical exams
Time Frame
End of study part A (38 weeks)
Title
Immunogenicity
Description
To assess the immunogenic response after subcutaneous injections of CV-MG01 on the plasma levels of anti-peptide antibodies.
Time Frame
End of study part A (38 weeks)
Secondary Outcome Measure Information:
Title
Biomarker
Description
To assess the effect of CV-MG01 subcutaneous injections on the plasma level of acetylcholine receptor antibodies.
Time Frame
End of study part A (38 weeks)
Title
Clinical efficacy
Description
Clinical efficacy assessed by Quantitative MG testing Procedure extended with MG Composite Scale and MG-ADL (myasthenia gravis activities of daily living)
Time Frame
End of study part A (38 weeks)
Other Pre-specified Outcome Measures:
Title
Immune response
Description
To explore changes in the humoral and cellular immune responses.
Time Frame
End of study part A (38 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects, with ocular and generalised myasthenia gravis (grade 1-2-3). Between the ages of 18 and 64 years, inclusive, at the time of the first injection. A Body Mass Index (BMI) between 18 and 35 kg/m2, inclusive. Patient with positive antibodies to AChR based on radioimmunoassay(RIA) (AChRAb ≥ 1 nmol/l); if available, historical data on AChR Ab levels over the last 2 years will be collected in the study records. Patient may use corticosteroid treatment, equivalent to a daily dose of 30 mg prednisone or lower and stable (dose +/- 5 mg) during the 3 months before participation. Patient may use one immunosuppressive drug with or without concomitant use of corticosteroid, providing that the dosage has been stable/unchanged for 3 months before participation. Blood pressure and heart rate (supine & standing) within normal reference range for the population or investigator site, or results with acceptable deviations that are judged to be not clinically significant by the investigator. Venous access sufficient to allow blood sampling as per the protocol. Are reliable and willing to make themselves available for the duration of the study and are willing to follow study procedures. Have given written informed consent approved by the relevant Ethics Committee (EC) governing the site. Exclusion Criteria: MG patients of Grade 4 or 5 based on myasthenia gravis foundation of America (MGFA) classification. Patients with history or presence of a primary or recurrent malignant disease including the presence or history of a thymoma. Thymectomy planned during part A of the study period or performed within 1 year prior to the first dose of study vaccine. Any confirmed or suspected immunosuppressive or immunodeficient condition not related to the treatment of MG, including human immunodeficiency virus (HIV) infection, or a family history of congenital or hereditary immunodeficiency. History or evidence of administration of immunoglobulins and/or any blood products within 3 months prior to the first dose of study vaccine or a planned administration of immunoglobulins during the first 3 months of the trial. History or evidence of rituximab treatment within 6 months prior to first dose of study vaccine. History or evidence of plasmapheresis within 3 months prior to the first dose of study vaccine or a planned plasmapheresis during the first 3 months of the trial. At high risk for aspiration. Pulmonary: forced vital capacity reduced to less than 70% of predicted capacity. History of severe allergic disease or reactions likely to be exacerbated by any component of the vaccine. History or evidence of Lambert-Eaton myasthenic syndrome, drug-induced myasthenia gravis, hereditary forms of myasthenic syndrome. History of relevant chronic degenerative, psychiatric, or neurological disorder other than MG. Severe hepatic, renal or cardiac insufficiency. Major congenital defects or serious chronic illness other than MG. Positive pregnancy test or desire to become pregnant during the study. Female patients of child-bearing potential that do not use a reliable and highly effective method of contraception at least one month before first injection, during the study and until 3 months after the last injection. Any significant out-of-range Clinical Laboratory results considered as clinically significant according to Investigator's judgment. Previous completion or withdrawal from this study. Sponsor employees or investigator site personnel directly affiliated with this study, and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted. Any medical condition that, in the opinion of the Investigator, might interfere with the subject's participation in the study, poses any added risk for the subject, or confounds the assessment of the subjects.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rudy Mercelis, MD, PhD
Organizational Affiliation
University Hospital, Antwerp
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital, Antwerp
City
Edegem
State/Province
Antwerp
ZIP/Postal Code
2650
Country
Belgium

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
12901598
Citation
Weathington NM, Blalock JE. Rational design of peptide vaccines for autoimmune disease: harnessing molecular recognition to fix a broken network. Expert Rev Vaccines. 2003 Feb;2(1):61-73. doi: 10.1586/14760584.2.1.61.
Results Reference
background
PubMed Identifier
17113748
Citation
Galin FS, Chrisman CL, Cook JR Jr, Xu L, Jackson PL, Noerager BD, Weathington NM, Blalock JE. Possible therapeutic vaccines for canine myasthenia gravis: implications for the human disease and associated fatigue. Brain Behav Immun. 2007 Mar;21(3):323-31. doi: 10.1016/j.bbi.2006.10.001. Epub 2006 Nov 20.
Results Reference
background
Links:
URL
http://www.curavac.com
Description
CuraVac: Therapeutic Vaccines for Autoimmune Diseases

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Safety, Tolerability and Immunogenic Response of CV-MG01 in Patients With Myasthenia Gravis

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