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Shigella Flexneri 2a Invaplex 50 Vaccine Dose Finding and Assessment of Protection

Primary Purpose

Shigellosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
240 µg Shigella flexneri 2a Invaplex 50 vaccine
480 µg Shigella flexneri 2a Invaplex 50 vaccine
690 Shigella flexneri 2a Invaplex 50 vaccine
Shigella challenge strain
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 Shigellosis

Eligibility Criteria

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

Inclusion Criteria:

  • Healthy, adult, male or female, age 18 to 45 years (inclusive) at the time of enrollment.
  • Completion and review of comprehension test (achieved ≥ 70% accuracy).
  • Signed informed consent form.
  • Available for the required follow-up period and scheduled clinic visits.
  • Women: negative pregnancy test with understanding (through informed consent process) to not become pregnant during the study or within two (2) months following study completion.

Exclusion Criteria:

General Health

  • Health problems affecting study participation from medical history specifically to include chronic medical conditions such as psychiatric conditions, diabetes mellitus and hypertension or any other condition requiring chronic daily therapy that would place the volunteer at increased risk - as determined by a study physician, current use of antihypertensive medications, or other medications that may interact with pseudoephedrine in the event it is required to treat rhinorrhea).
  • Clinically significant abnormalities on physical examination.
  • Use of immunosuppressive drugs such as corticosteroids or chemotherapeutics that may influence antibody development.
  • Women currently nursing
  • Participation in research involving another investigational product (defined as receipt of investigational product or exposure to invasive investigational device) 30 days before planned date of first vaccination or anytime throughout the duration of the study.
  • Positive blood test for HBsAG, HCV, HIV-1.
  • Clinically significant abnormalities on basic laboratory screening.
  • Immunosuppressive illness or IgA deficiency (below the normal limits).

Research specific

  • Presence of nasal polyps, ulcers, or deviated nasal septum (further defined in section 4.2).
  • History of chronic sinusitis or chronic/seasonal rhinitis (further defined in section 4.2)
  • History of rhinoplasty.
  • History of reactive airway disease (asthma), chronic obstructive pulmonary disease, or chronic bronchitis.
  • History of Bell's palsy.
  • Current smoker or smoker in past 3 months ('smoker' defined as daily cigarette cigar, or pipe use for a period of at least 1 month).
  • Regular use (weekly or more often of antidiarrheal, anti-constipation, or antacid therapy
  • Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis; loose or liquid stools on other than an occasional basis.
  • Personal or family history of an inflammatory arthritis.
  • Positive blood test for HLA-B27.
  • Prior exposure to Shigella
  • History of microbiologically confirmed Shigella infection.
  • Received previous experimental Shigella vaccine or live Shigella challenge.
  • Travel to countries where Shigella or other enteric infections are endemic (most of the developing world) within two years prior to dosing.
  • Occupation involving handling of Shigella bacteria currently, or in the past 3 years.
  • Serum IgG titer ≥ 2500 to Shigella LPS

Additionally, subjects participating in stage 2 with any of the following will be excluded:

  • Are employed as a food handler, daycare provider or work in a nursing home, or are in direct care of an immunocompromised person, a child <2 years of age or frail elderly.
  • Significant abnormalities in pre-admission screening lab hematology, serum chemistry, urinalysis or EKG (EKG only in volunteers ≥40 years), as determined by PI or the PI in consultation with the medical monitor and sponsor.
  • Allergy to ciprofloxacin on ampicillin (excluded if allergic to either).
  • History of diarrhea in the 2 weeks prior to planned inpatient phase.
  • Use of antibiotics during the 7 days before Shigella inoculation or proton pump inhibitors, H2 blockers, or antacids within 48 hours of inoculation.
  • Inability to comply with inpatient rules and regulations.

Sites / Locations

  • Center for Immunization Research (CIR) John Hopkins Bayview Medical Center
  • Department of Clinical Trials, WRAIR

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Other

Other

Placebo Comparator

Arm Label

Stage 1: Group A, Dolphin 240 µg

Stage 1: Group B, Dolphin 480 µg

Stage 1: Group C, Dolphin 690 µg

Stage 1: Group D, Pipette 240 µg

Stage 2: Immunized / Challenge

Stage 2: Controls

Arm Description

240 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of lipopolysaccharides (LPS). 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).

480 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).

690 Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).

240 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. These subjects received 200 μL the vaccine via electronic pipette. This group is for lot bridging only, not included in dose-finding study.

The selected dose was to be administered with the Dolphin™ using the vaccination schedule from stage 1. Immunized and challenged with Shigella challenge strain approximately 42 days after receiving the last vaccination following a 90-minute fast.

A control was to be administered with the DolphinTM using the vaccination schedule from Stage 1. Non-immunized and challenged with Shigella challenge strain approximately 42 days after receiving the last vaccination following a 90-minute fast.

Outcomes

Primary Outcome Measures

Post-challenge Diarrhea, Fever, and Blood in Stool Adverse Events by Study Group
Fecal samples were collected through day 77 or until discharge (all stools collected for weighing/grading; maximum of 3 stools/day for culture; rectal swab obtained if no stool provided).

Secondary Outcome Measures

Post-challenge Loose Stool Samples Occurrences by Study Group
Post-challenge Loose Stool Sample Volumes by Study Group
Post-challenge Loose Stool Sample Durations by Study Group
S. Flexneri 2a Related Non-diarrheal Clinical Outcomes by Study Group
Number of Subjects Exhibiting an Immune Response to Invaplex 50 and/or LPS
Immune responder is defined as someone with both a serologic and an ASC response to either Invaplex 50 or LPS. Immune response defined as Serology: ≥ 4-fold increase in baseline serum titer antibody cecreting cells (ASC): ≥ 10 ASC per 106 peripheral blood mononuclear cells(PBMC).

Full Information

First Posted
June 11, 2007
Last Updated
August 8, 2017
Sponsor
U.S. Army Medical Research and Development Command
Collaborators
U.S. Army Office of the Surgeon General
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1. Study Identification

Unique Protocol Identification Number
NCT00485134
Brief Title
Shigella Flexneri 2a Invaplex 50 Vaccine Dose Finding and Assessment of Protection
Official Title
Shigella Flexneri 2a Invaplex 50 Vaccine Dose Finding and Assessment of Protection
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
May 2007 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
September 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command
Collaborators
U.S. Army Office of the Surgeon General

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to select a safe and immunogenic dose of Invaplex 50 intranasal vaccine, and to assess protection of Invaplex 50 intranasal vaccine against diarrhea, dysentery, and fever following challenge with the Shigella flexneri 2a 2457T strain.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Shigellosis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
113 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stage 1: Group A, Dolphin 240 µg
Arm Type
Experimental
Arm Description
240 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of lipopolysaccharides (LPS). 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).
Arm Title
Stage 1: Group B, Dolphin 480 µg
Arm Type
Experimental
Arm Description
480 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).
Arm Title
Stage 1: Group C, Dolphin 690 µg
Arm Type
Experimental
Arm Description
690 Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. 230 μL of the formulated vaccine (or placebo, sterile saline) was added to a nasal spray applicator (DolphinTM).
Arm Title
Stage 1: Group D, Pipette 240 µg
Arm Type
Other
Arm Description
240 µg Shigella flexneri 2a Invaplex 50 vaccine. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 mL glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. These subjects received 200 μL the vaccine via electronic pipette. This group is for lot bridging only, not included in dose-finding study.
Arm Title
Stage 2: Immunized / Challenge
Arm Type
Other
Arm Description
The selected dose was to be administered with the Dolphin™ using the vaccination schedule from stage 1. Immunized and challenged with Shigella challenge strain approximately 42 days after receiving the last vaccination following a 90-minute fast.
Arm Title
Stage 2: Controls
Arm Type
Placebo Comparator
Arm Description
A control was to be administered with the DolphinTM using the vaccination schedule from Stage 1. Non-immunized and challenged with Shigella challenge strain approximately 42 days after receiving the last vaccination following a 90-minute fast.
Intervention Type
Biological
Intervention Name(s)
240 µg Shigella flexneri 2a Invaplex 50 vaccine
Intervention Description
Vaccines were administered intranasally on Days 0, 14, and 28. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 ml glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. The pH was 8.9 and the buffer was 250 mM NaCl in 20 mM Tris.
Intervention Type
Biological
Intervention Name(s)
480 µg Shigella flexneri 2a Invaplex 50 vaccine
Intervention Description
Vaccines were administered intranasally on Days 0, 14, and 28. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 ml glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. The pH was 8.9 and the buffer was 250 mM NaCl in 20 mM Tris.
Intervention Type
Biological
Intervention Name(s)
690 Shigella flexneri 2a Invaplex 50 vaccine
Intervention Description
Vaccines were administered intranasally on Days 0, 14, and 28. The investigational vaccine was supplied as 1 mL of a sterile, clear liquid in a 3 ml glass vial. Each vial contained 3.5 mg of protein and 567 μg of LPS. The pH was 8.9 and the buffer was 250 mM NaCl in 20 mM Tris.
Intervention Type
Other
Intervention Name(s)
Shigella challenge strain
Other Intervention Name(s)
Shigella challenge material
Intervention Description
300 colony forming units (CFU) of Shigella challenge strain, Shigella flexneri 2a strain 2457T
Primary Outcome Measure Information:
Title
Post-challenge Diarrhea, Fever, and Blood in Stool Adverse Events by Study Group
Description
Fecal samples were collected through day 77 or until discharge (all stools collected for weighing/grading; maximum of 3 stools/day for culture; rectal swab obtained if no stool provided).
Time Frame
7 days after challenge
Secondary Outcome Measure Information:
Title
Post-challenge Loose Stool Samples Occurrences by Study Group
Time Frame
7 days after challenge
Title
Post-challenge Loose Stool Sample Volumes by Study Group
Time Frame
7 days after challenge
Title
Post-challenge Loose Stool Sample Durations by Study Group
Time Frame
7 days after challenge
Title
S. Flexneri 2a Related Non-diarrheal Clinical Outcomes by Study Group
Time Frame
56 days post-challenge
Title
Number of Subjects Exhibiting an Immune Response to Invaplex 50 and/or LPS
Description
Immune responder is defined as someone with both a serologic and an ASC response to either Invaplex 50 or LPS. Immune response defined as Serology: ≥ 4-fold increase in baseline serum titer antibody cecreting cells (ASC): ≥ 10 ASC per 106 peripheral blood mononuclear cells(PBMC).
Time Frame
56 days post-vaccination in stage 1

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: Healthy, adult, male or female, age 18 to 45 years (inclusive) at the time of enrollment. Completion and review of comprehension test (achieved ≥ 70% accuracy). Signed informed consent form. Available for the required follow-up period and scheduled clinic visits. Women: negative pregnancy test with understanding (through informed consent process) to not become pregnant during the study or within two (2) months following study completion. Exclusion Criteria: General Health Health problems affecting study participation from medical history specifically to include chronic medical conditions such as psychiatric conditions, diabetes mellitus and hypertension or any other condition requiring chronic daily therapy that would place the volunteer at increased risk - as determined by a study physician, current use of antihypertensive medications, or other medications that may interact with pseudoephedrine in the event it is required to treat rhinorrhea). Clinically significant abnormalities on physical examination. Use of immunosuppressive drugs such as corticosteroids or chemotherapeutics that may influence antibody development. Women currently nursing Participation in research involving another investigational product (defined as receipt of investigational product or exposure to invasive investigational device) 30 days before planned date of first vaccination or anytime throughout the duration of the study. Positive blood test for HBsAG, HCV, HIV-1. Clinically significant abnormalities on basic laboratory screening. Immunosuppressive illness or IgA deficiency (below the normal limits). Research specific Presence of nasal polyps, ulcers, or deviated nasal septum (further defined in section 4.2). History of chronic sinusitis or chronic/seasonal rhinitis (further defined in section 4.2) History of rhinoplasty. History of reactive airway disease (asthma), chronic obstructive pulmonary disease, or chronic bronchitis. History of Bell's palsy. Current smoker or smoker in past 3 months ('smoker' defined as daily cigarette cigar, or pipe use for a period of at least 1 month). Regular use (weekly or more often of antidiarrheal, anti-constipation, or antacid therapy Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis; loose or liquid stools on other than an occasional basis. Personal or family history of an inflammatory arthritis. Positive blood test for HLA-B27. Prior exposure to Shigella History of microbiologically confirmed Shigella infection. Received previous experimental Shigella vaccine or live Shigella challenge. Travel to countries where Shigella or other enteric infections are endemic (most of the developing world) within two years prior to dosing. Occupation involving handling of Shigella bacteria currently, or in the past 3 years. Serum IgG titer ≥ 2500 to Shigella LPS Additionally, subjects participating in stage 2 with any of the following will be excluded: Are employed as a food handler, daycare provider or work in a nursing home, or are in direct care of an immunocompromised person, a child <2 years of age or frail elderly. Significant abnormalities in pre-admission screening lab hematology, serum chemistry, urinalysis or EKG (EKG only in volunteers ≥40 years), as determined by PI or the PI in consultation with the medical monitor and sponsor. Allergy to ciprofloxacin on ampicillin (excluded if allergic to either). History of diarrhea in the 2 weeks prior to planned inpatient phase. Use of antibiotics during the 7 days before Shigella inoculation or proton pump inhibitors, H2 blockers, or antacids within 48 hours of inoculation. Inability to comply with inpatient rules and regulations.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Riddle, MD
Organizational Affiliation
Naval Medical Research Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Center for Immunization Research (CIR) John Hopkins Bayview Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Department of Clinical Trials, WRAIR
City
Silver Spring
State/Province
Maryland
ZIP/Postal Code
20910
Country
United States

12. IPD Sharing Statement

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Shigella Flexneri 2a Invaplex 50 Vaccine Dose Finding and Assessment of Protection

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