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Study of BPZE1 (High Dose) Nasal Live Attenuated B. Pertussis Vaccine

Primary Purpose

Pertussis, Whooping Cough

Status
Completed
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
BPZE1
Placebo
Sponsored by
Institut National de la Santé Et de la Recherche Médicale, France
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Pertussis focused on measuring Pertussis, Colonization, Vaccine, Immune response, BPZE1, Infection, Bordetella pertussis, B. pertussis, respiratory Tract Infection

Eligibility Criteria

18 Years - 32 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy individual between 18 and 32 years of age, vaccinated or unvaccinated with acellular pertussis vaccine.
  2. Female subject of child bearing potential must be willing to ensure that they use a highly efficient method of contraception during the study (e.g. contraceptive pill, intrauterine contraceptive device).
  3. Informed consent form (ICF) signed by the subject.
  4. Subject shall be able to attend all scheduled visits and to understand and comply with the study procedures.

Exclusion Criteria:

  1. Individual with PT and/or PRN serum IgG antibodies ≥20 International units/ml (IU/ml). NOTE! One control group with PRN serum IgG antibodies ≥ 20 IU/ml will be included.
  2. Vaccinated with the study vaccine in the Child Innovac study (EudraCT number 2010-019936-11).
  3. Pregnant or lactating women. Pregnancy not planned and to be avoided during the study by use of effective contraceptive methods.
  4. Blood pressure after resting ≥ 150/90 mm Hg at screening.
  5. Heart rate after resting ≥ 80 bpm at screening.
  6. Respiratory rate after resting ≥ 20/minute at screening.
  7. Unwillingness to refrain from the use of nicotine products from screening through day 28.
  8. Use of narcotic drugs and/or a history of drug/alcohol abuse with in the past 2 years prior to screening
  9. The subject has donated blood or suffered from blood loss of at least 450 ml (1 unit of blood) within 60 days prior to screening or donated plasma within 14 days prior to screening.
  10. Receipt of immunoglobulin, blood derived products, systemic corticosteroids or other immunosuppressant drugs within 90 days prior to day 0.
  11. Asthma or other chronic respiratory problems.
  12. Use of corticosteroids in the respiratory tract (e.g. nasal steroids, inhaled steroids) with in 30 days prior to day 0.
  13. Receipt of a vaccine within the last 30 days prior to day 0 or planned vaccination with in the next 30 days after day 0.
  14. Known hypersensitivity to any component of the study vaccine.
  15. Current participation in any other clinical trial or participation (and during the whole study) in any clinical trial in the previous 3 months prior to day 0.
  16. Inability to adhere to the protocol, including plans to move from the area.
  17. Family (first degree) history of congenital or hereditary immunodeficiency.
  18. Past or present infection with HIV, hepatitis B or C.
  19. Chronic conditions requiring ongoing active medical interventions, such as diabetes mellitus or cardiovascular disease.
  20. Any autoimmune or immunodeficiency disease/condition (inherited or iatrogenic).
  21. Any medical condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives or might affect the safety of the individual, e.g. evolving encephalopathy not attributable to another identifiable cause within 7 days of administration of a previous dose of any vaccine, hospitalization due to major depression or history of suicidal attempt.
  22. Abnormal laboratory values outside the limit of normal values for the screening laboratory with clinical significance at the discretion of the investigator.
  23. Person in frequent contact with children less than 1 year of age (parent, childcare worker, nurse, etc) or residence in the same household as persons with known immunodeficiency including persons on immunosuppressant therapy.

Sites / Locations

  • Karolinska University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

BPZE1 - 10,000,000 cfu

BPZE1 - 100,000,000 cfu

BPZE1 - 1,000,000,000 cfu

BPZE1 - High Antibody 1,000,000,000 cfu

Arm Description

Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).

Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).

Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).

Individuals will be vaccinated once intranasally with the designated dose of BPZE1 at a Dose 2 x 0.4 mL (0.4 mL per nostril).

Outcomes

Primary Outcome Measures

The Primary Safety Endpoint is the Number and Percentage of Participants Per Dose Group and Randomized Allocation, With at Least One of the Following Adverse Events Between Day 0 and Day 28
Percentage is based on subjects experiencing at least one of the following events: Cough and spasmodic cough of grade 2 or higher Other respiratory tract AE related or possibly related to vaccination of grade 3 or higher Any other AE related or possibly related to vaccination of grade 3 or higher

Secondary Outcome Measures

Proportion of Subjects With BPZE1 Colonization
To assess the proportion of subjects having positive colonization of the human respiratory tract by live attenuated B. pertussis strain BPZE1 per group at any time period measured at 4, 7, 11, 14, 21 and 28 days post vaccination.
The Proportion of Subjects That Have an Antibody Response to BPZE1 Vaccination
To assess the number of immune responders and levels of Immunoglobulin G/Immunoglobulin A (IgG/IgA) antibodies to pertussis toxin (PT), filamentous haemagglutinin adhesin (FHA), Pertactin (PRN), and fimbriae 2/3 in serum and nasopharyngeal aspirate. A positive antibody response after vaccination is defined as at least 100% increase from pre- to post-vaccination, to at least 4 times minimum level of detection (MLD) for PT, FHA, PRN, and fimbriae 2/3 in the post-vaccination sample. The 4 antigens described are the standard 4 antigens historically used to describe a serum immunological response to B. pertussis. The absolute serum antibody titers have not shown a correlation of protection in previous pertussis vaccine studies of the current acellular vaccine and there is no known serum antigen threshold of protection for pertussis. Antibodies are measured before vaccination and at 4, 7, 11, 14, 21, 28 days, 6-months and 12-months post-vaccination.

Full Information

First Posted
May 18, 2015
Last Updated
December 6, 2019
Sponsor
Institut National de la Santé Et de la Recherche Médicale, France
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1. Study Identification

Unique Protocol Identification Number
NCT02453048
Brief Title
Study of BPZE1 (High Dose) Nasal Live Attenuated B. Pertussis Vaccine
Official Title
Phase Ib (High Dose), Single Centre, Dose-escalating, Placebo-controlled, Randomized Study of a Live Attenuated B. Pertussis Strain Given as a Single Intranasal Dose to Healthy Adult Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
September 2015 (undefined)
Primary Completion Date
March 2017 (Actual)
Study Completion Date
December 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut National de la Santé Et de la Recherche Médicale, France

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study evaluates the safety and immunogenicity of a higher dose formulation of a new live attenuated vaccine, BPZE1, intended to prevent Bordetella pertussis nasopharyngeal colonization and pertussis disease, and investigates whether higher doses of BPZE1 induce the live vaccine to colonize subjects' nasopharynx. The study is a Phase Ib (high dose), single centre, dose-escalating, placebo-controlled study of the live attenuated B. pertussis strain BPZE1 given as a single intranasal dose to healthy adult volunteer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pertussis, Whooping Cough
Keywords
Pertussis, Colonization, Vaccine, Immune response, BPZE1, Infection, Bordetella pertussis, B. pertussis, respiratory Tract Infection

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
54 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BPZE1 - 10,000,000 cfu
Arm Type
Experimental
Arm Description
Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).
Arm Title
BPZE1 - 100,000,000 cfu
Arm Type
Experimental
Arm Description
Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).
Arm Title
BPZE1 - 1,000,000,000 cfu
Arm Type
Experimental
Arm Description
Individuals will be vaccinated once intranasally with the designated dose of BPZE1 or Placebo at a Dose 2 x 0.4 mL (0.4 mL per nostril).
Arm Title
BPZE1 - High Antibody 1,000,000,000 cfu
Arm Type
Experimental
Arm Description
Individuals will be vaccinated once intranasally with the designated dose of BPZE1 at a Dose 2 x 0.4 mL (0.4 mL per nostril).
Intervention Type
Biological
Intervention Name(s)
BPZE1
Intervention Description
Intranasal live, attenuated vaccine
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Diluent
Primary Outcome Measure Information:
Title
The Primary Safety Endpoint is the Number and Percentage of Participants Per Dose Group and Randomized Allocation, With at Least One of the Following Adverse Events Between Day 0 and Day 28
Description
Percentage is based on subjects experiencing at least one of the following events: Cough and spasmodic cough of grade 2 or higher Other respiratory tract AE related or possibly related to vaccination of grade 3 or higher Any other AE related or possibly related to vaccination of grade 3 or higher
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Proportion of Subjects With BPZE1 Colonization
Description
To assess the proportion of subjects having positive colonization of the human respiratory tract by live attenuated B. pertussis strain BPZE1 per group at any time period measured at 4, 7, 11, 14, 21 and 28 days post vaccination.
Time Frame
28 days
Title
The Proportion of Subjects That Have an Antibody Response to BPZE1 Vaccination
Description
To assess the number of immune responders and levels of Immunoglobulin G/Immunoglobulin A (IgG/IgA) antibodies to pertussis toxin (PT), filamentous haemagglutinin adhesin (FHA), Pertactin (PRN), and fimbriae 2/3 in serum and nasopharyngeal aspirate. A positive antibody response after vaccination is defined as at least 100% increase from pre- to post-vaccination, to at least 4 times minimum level of detection (MLD) for PT, FHA, PRN, and fimbriae 2/3 in the post-vaccination sample. The 4 antigens described are the standard 4 antigens historically used to describe a serum immunological response to B. pertussis. The absolute serum antibody titers have not shown a correlation of protection in previous pertussis vaccine studies of the current acellular vaccine and there is no known serum antigen threshold of protection for pertussis. Antibodies are measured before vaccination and at 4, 7, 11, 14, 21, 28 days, 6-months and 12-months post-vaccination.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
32 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy individual between 18 and 32 years of age, vaccinated or unvaccinated with acellular pertussis vaccine. Female subject of child bearing potential must be willing to ensure that they use a highly efficient method of contraception during the study (e.g. contraceptive pill, intrauterine contraceptive device). Informed consent form (ICF) signed by the subject. Subject shall be able to attend all scheduled visits and to understand and comply with the study procedures. Exclusion Criteria: Individual with PT and/or PRN serum IgG antibodies ≥20 International units/ml (IU/ml). NOTE! One control group with PRN serum IgG antibodies ≥ 20 IU/ml will be included. Vaccinated with the study vaccine in the Child Innovac study (EudraCT number 2010-019936-11). Pregnant or lactating women. Pregnancy not planned and to be avoided during the study by use of effective contraceptive methods. Blood pressure after resting ≥ 150/90 mm Hg at screening. Heart rate after resting ≥ 80 bpm at screening. Respiratory rate after resting ≥ 20/minute at screening. Unwillingness to refrain from the use of nicotine products from screening through day 28. Use of narcotic drugs and/or a history of drug/alcohol abuse with in the past 2 years prior to screening The subject has donated blood or suffered from blood loss of at least 450 ml (1 unit of blood) within 60 days prior to screening or donated plasma within 14 days prior to screening. Receipt of immunoglobulin, blood derived products, systemic corticosteroids or other immunosuppressant drugs within 90 days prior to day 0. Asthma or other chronic respiratory problems. Use of corticosteroids in the respiratory tract (e.g. nasal steroids, inhaled steroids) with in 30 days prior to day 0. Receipt of a vaccine within the last 30 days prior to day 0 or planned vaccination with in the next 30 days after day 0. Known hypersensitivity to any component of the study vaccine. Current participation in any other clinical trial or participation (and during the whole study) in any clinical trial in the previous 3 months prior to day 0. Inability to adhere to the protocol, including plans to move from the area. Family (first degree) history of congenital or hereditary immunodeficiency. Past or present infection with HIV, hepatitis B or C. Chronic conditions requiring ongoing active medical interventions, such as diabetes mellitus or cardiovascular disease. Any autoimmune or immunodeficiency disease/condition (inherited or iatrogenic). Any medical condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives or might affect the safety of the individual, e.g. evolving encephalopathy not attributable to another identifiable cause within 7 days of administration of a previous dose of any vaccine, hospitalization due to major depression or history of suicidal attempt. Abnormal laboratory values outside the limit of normal values for the screening laboratory with clinical significance at the discretion of the investigator. Person in frequent contact with children less than 1 year of age (parent, childcare worker, nurse, etc) or residence in the same household as persons with known immunodeficiency including persons on immunosuppressant therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nabil Al-Tawil, MD, PhD
Organizational Affiliation
Karolinska University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Karolinska University Hospital
City
Huddinge
State/Province
Stockholm
ZIP/Postal Code
141 86
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24421886
Citation
Thorstensson R, Trollfors B, Al-Tawil N, Jahnmatz M, Bergstrom J, Ljungman M, Torner A, Wehlin L, Van Broekhoven A, Bosman F, Debrie AS, Mielcarek N, Locht C. A phase I clinical study of a live attenuated Bordetella pertussis vaccine--BPZE1; a single centre, double-blind, placebo-controlled, dose-escalating study of BPZE1 given intranasally to healthy adult male volunteers. PLoS One. 2014 Jan 8;9(1):e83449. doi: 10.1371/journal.pone.0083449. eCollection 2014.
Results Reference
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24793938
Citation
Jahnmatz M, Amu S, Ljungman M, Wehlin L, Chiodi F, Mielcarek N, Locht C, Thorstensson R. B-cell responses after intranasal vaccination with the novel attenuated Bordetella pertussis vaccine strain BPZE1 in a randomized phase I clinical trial. Vaccine. 2014 Jun 5;32(27):3350-6. doi: 10.1016/j.vaccine.2014.04.048. Epub 2014 Apr 29.
Results Reference
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PubMed Identifier
24950361
Citation
Feunou PF, Kammoun H, Debrie AS, Locht C. Heterologous prime-boost immunization with live attenuated B. pertussis BPZE1 followed by acellular pertussis vaccine in mice. Vaccine. 2014 Jul 23;32(34):4281-8. doi: 10.1016/j.vaccine.2014.06.019. Epub 2014 Jun 17.
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Citation
Kammoun H, Feunou PF, Foligne B, Debrie AS, Raze D, Mielcarek N, Locht C. Dual mechanism of protection by live attenuated Bordetella pertussis BPZE1 against Bordetella bronchiseptica in mice. Vaccine. 2012 Aug 31;30(40):5864-70. doi: 10.1016/j.vaccine.2012.07.005. Epub 2012 Jul 17.
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Citation
Fedele G, Bianco M, Debrie AS, Locht C, Ausiello CM. Attenuated Bordetella pertussis vaccine candidate BPZE1 promotes human dendritic cell CCL21-induced migration and drives a Th1/Th17 response. J Immunol. 2011 May 1;186(9):5388-96. doi: 10.4049/jimmunol.1003765. Epub 2011 Mar 23.
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Skerry CM, Mahon BP. A live, attenuated Bordetella pertussis vaccine provides long-term protection against virulent challenge in a murine model. Clin Vaccine Immunol. 2011 Feb;18(2):187-93. doi: 10.1128/CVI.00371-10. Epub 2010 Dec 8.
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Feunou PF, Kammoun H, Debrie AS, Mielcarek N, Locht C. Long-term immunity against pertussis induced by a single nasal administration of live attenuated B. pertussis BPZE1. Vaccine. 2010 Oct 8;28(43):7047-53. doi: 10.1016/j.vaccine.2010.08.017. Epub 2010 Aug 13.
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Feunou PF, Bertout J, Locht C. T- and B-cell-mediated protection induced by novel, live attenuated pertussis vaccine in mice. Cross protection against parapertussis. PLoS One. 2010 Apr 15;5(4):e10178. doi: 10.1371/journal.pone.0010178.
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Study of BPZE1 (High Dose) Nasal Live Attenuated B. Pertussis Vaccine

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