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Study of Different Formulations of a Clostridium Difficile Toxoid Vaccine Given at Three Different Schedules in Adults

Primary Purpose

Clostridium Difficile Infection, Diarrhea

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Clostridium difficile toxoids A and B (Low-dose with adjuvant)
Clostridium difficile toxoids A and B (Low-dose without adjuvant)
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Clostridium difficile toxoids A and B (high-dose without adjuvant)
Placebo: 0.9% normal saline
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Sponsored by
Sanofi Pasteur, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Clostridium Difficile Infection focused on measuring Clostridium difficile infection, Diarrhea, Pseudomembranous colitis, Clostridium Difficile Toxoid Vaccine, ACAM-CDIFF™ vaccine

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Aged 40 to 75 years on the day of inclusion
  • Informed consent form has been signed and dated
  • Able to attend all scheduled visits and to comply with all trial procedures
  • For a woman of childbearing potential, use of an effective method of contraception or abstinence from at least 4 weeks prior to the first vaccination until at least 4 weeks after the last vaccination
  • At risk for developing Clostridium difficile infection during the trial because of impending elective surgery or hospitalization within 60 days of enrollment, or current or impending residence in a long-term care facility or rehabilitation facility.

Exclusion Criteria:

  • Known pregnancy, or a positive urine pregnancy test
  • Currently breastfeeding a child
  • Participation in another clinical trial investigating a vaccine, drug, medical device, or medical procedure in the 4 weeks preceding the first trial vaccination
  • Planned participation in another clinical trial during the present trial period
  • Receipt of any vaccine in the 4 weeks preceding the first trial vaccination, except for influenza (seasonal or pandemic) and pneumococcal vaccine
  • Planned receipt of any vaccine in the 4 weeks following any trial vaccination, except for influenza (seasonal or pandemic) and pneumococcal vaccines
  • Previous vaccination against Clostridium difficile with either the trial vaccine or another vaccine
  • Current or prior Clostridium difficile infection (CDI) episode
  • Receipt of blood or blood-derived products in the past 3 months, which might interfere with assessment of the immune response
  • Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months)
  • Self-reported seropositivity for Human Immunodeficiency Virus (HIV), hepatitis B, or hepatitis C
  • Anticipated or current receipt of kidney dialysis treatment
  • Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to a vaccine containing any of the same substances
  • Self-reported thrombocytopenia, contraindicating intramuscular (IM) vaccination
  • Bleeding disorder, or receipt of anticoagulants in the 3 weeks preceding inclusion, contraindicating IM vaccination
  • Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily
  • Current alcohol abuse or drug addiction that might interfere with the ability to comply with trial procedures
  • Chronic illness that, in the opinion of the investigator, is at a stage where it might interfere with trial conduct or completion
  • Identified as a study site employee who is involved in the protocol and may have direct access to trial-related data
  • Subjects who have any history of intestinal diverticular bleeding
  • Subjects who have had surgery within the past three months for gastrointestinal (GI) malignancy.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

Group 1

Group 2

Group 3

Group 4

Group 5

Group 6

Group 7

Arm Description

Participants will receive a dose Low-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 30, respectively.

Participants will receive a dose Low-dose ACAM-CDIFF™ vaccine without adjuvant on Day 0, 7, and 30, respectively.

Participants will receive a dose High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 30, respectively.

Participants will receive a dose High-dose ACAM-CDIFF™ vaccine without adjuvant on Day 0, 7, and 30, respectively.

Participants will receive a dose Placebo (0.9% normal saline) on Day 0, 7, and 30, respectively.

Participants will receive a dose of High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 180, respectively.

Participants will receive a dose of High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 30, and 180, respectively.

Outcomes

Primary Outcome Measures

Information concerning the safety profile in terms of solicited and unsolicited reactions in participants following vaccination with ACAM-CDIFF™ Vaccine.
Serum antitoxin IgG concentrations to Clostridium difficile toxins A and B in participants vaccinated with ACAM-CDIFF™.

Secondary Outcome Measures

Full Information

First Posted
October 28, 2010
Last Updated
July 13, 2018
Sponsor
Sanofi Pasteur, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT01230957
Brief Title
Study of Different Formulations of a Clostridium Difficile Toxoid Vaccine Given at Three Different Schedules in Adults
Official Title
Safety and Immunogenicity of Different Formulations of a Clostridium Difficile Toxoid Vaccine Administered at Three Different Schedules in Adults Aged 40 to 75 Years at Risk of C. Difficile Infection
Study Type
Interventional

2. Study Status

Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi Pasteur, a Sanofi Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will further evaluate the ACAM-CDIFF™ vaccine in a population of middle-aged to elderly individuals at risk of exposure to Clostridium difficile because of impending hospitalization or residence in a care facility. Primary Objectives: To describe the safety profile of subjects in each of the study groups. To describe the immune responses elicited by toxoid A and toxoid B of subjects in each of the study groups. Observational Objective: To describe the occurrence of first-time Clostridium difficile infection (CDI) episodes.
Detailed Description
Participants will receive 3 doses of either one of 4 different formulations of ACAM-CDIFF™ vaccine or placebo, on one of 3 different schedules. The trial will have 2 stages. Stage I will test 4 different formulations of ACAM-CDIFF™ vaccine. Stage II will explore different vaccination schedules using one of these formulations. Participants will be followed up for safety and immunogenicity; stool samples will also be provided in case of diarrhea.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clostridium Difficile Infection, Diarrhea
Keywords
Clostridium difficile infection, Diarrhea, Pseudomembranous colitis, Clostridium Difficile Toxoid Vaccine, ACAM-CDIFF™ vaccine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
650 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Participants will receive a dose Low-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 30, respectively.
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Participants will receive a dose Low-dose ACAM-CDIFF™ vaccine without adjuvant on Day 0, 7, and 30, respectively.
Arm Title
Group 3
Arm Type
Experimental
Arm Description
Participants will receive a dose High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 30, respectively.
Arm Title
Group 4
Arm Type
Experimental
Arm Description
Participants will receive a dose High-dose ACAM-CDIFF™ vaccine without adjuvant on Day 0, 7, and 30, respectively.
Arm Title
Group 5
Arm Type
Placebo Comparator
Arm Description
Participants will receive a dose Placebo (0.9% normal saline) on Day 0, 7, and 30, respectively.
Arm Title
Group 6
Arm Type
Experimental
Arm Description
Participants will receive a dose of High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 7, and 180, respectively.
Arm Title
Group 7
Arm Type
Experimental
Arm Description
Participants will receive a dose of High-dose ACAM-CDIFF™ vaccine with adjuvant on Day 0, 30, and 180, respectively.
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (Low-dose with adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 30
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (Low-dose without adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 30
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 30
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (high-dose without adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 30
Intervention Type
Biological
Intervention Name(s)
Placebo: 0.9% normal saline
Other Intervention Name(s)
0.9% normal saline
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 30
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 7, and 180
Intervention Type
Biological
Intervention Name(s)
Clostridium difficile toxoids A and B (high-dose with adjuvant)
Other Intervention Name(s)
ACAM-CDIFF™ vaccine
Intervention Description
0.5 mL, Intramuscular on Days 0, 30, and 180
Primary Outcome Measure Information:
Title
Information concerning the safety profile in terms of solicited and unsolicited reactions in participants following vaccination with ACAM-CDIFF™ Vaccine.
Time Frame
6 days after each vaccination and up to 6 months post-vaccination 3
Title
Serum antitoxin IgG concentrations to Clostridium difficile toxins A and B in participants vaccinated with ACAM-CDIFF™.
Time Frame
Up to 6 months post-vaccination 3

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Aged 40 to 75 years on the day of inclusion Informed consent form has been signed and dated Able to attend all scheduled visits and to comply with all trial procedures For a woman of childbearing potential, use of an effective method of contraception or abstinence from at least 4 weeks prior to the first vaccination until at least 4 weeks after the last vaccination At risk for developing Clostridium difficile infection during the trial because of impending elective surgery or hospitalization within 60 days of enrollment, or current or impending residence in a long-term care facility or rehabilitation facility. Exclusion Criteria: Known pregnancy, or a positive urine pregnancy test Currently breastfeeding a child Participation in another clinical trial investigating a vaccine, drug, medical device, or medical procedure in the 4 weeks preceding the first trial vaccination Planned participation in another clinical trial during the present trial period Receipt of any vaccine in the 4 weeks preceding the first trial vaccination, except for influenza (seasonal or pandemic) and pneumococcal vaccine Planned receipt of any vaccine in the 4 weeks following any trial vaccination, except for influenza (seasonal or pandemic) and pneumococcal vaccines Previous vaccination against Clostridium difficile with either the trial vaccine or another vaccine Current or prior Clostridium difficile infection (CDI) episode Receipt of blood or blood-derived products in the past 3 months, which might interfere with assessment of the immune response Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months) Self-reported seropositivity for Human Immunodeficiency Virus (HIV), hepatitis B, or hepatitis C Anticipated or current receipt of kidney dialysis treatment Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to a vaccine containing any of the same substances Self-reported thrombocytopenia, contraindicating intramuscular (IM) vaccination Bleeding disorder, or receipt of anticoagulants in the 3 weeks preceding inclusion, contraindicating IM vaccination Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily Current alcohol abuse or drug addiction that might interfere with the ability to comply with trial procedures Chronic illness that, in the opinion of the investigator, is at a stage where it might interfere with trial conduct or completion Identified as a study site employee who is involved in the protocol and may have direct access to trial-related data Subjects who have any history of intestinal diverticular bleeding Subjects who have had surgery within the past three months for gastrointestinal (GI) malignancy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Sanofi Pasteur Inc.
Official's Role
Study Director
Facility Information:
City
Redding
State/Province
California
ZIP/Postal Code
96001
Country
United States
City
Bristol
State/Province
Connecticut
ZIP/Postal Code
06010
Country
United States
City
Stamford
State/Province
Connecticut
ZIP/Postal Code
06905
Country
United States
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
City
Port Orange
State/Province
Florida
ZIP/Postal Code
32127
Country
United States
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33709
Country
United States
City
Tampa
State/Province
Florida
ZIP/Postal Code
33614
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
City
Idaho Falls
State/Province
Idaho
ZIP/Postal Code
83404
Country
United States
City
Newton
State/Province
Kansas
ZIP/Postal Code
67114
Country
United States
City
Brockton
State/Province
Massachusetts
ZIP/Postal Code
02301
Country
United States
City
Troy
State/Province
Michigan
ZIP/Postal Code
48098
Country
United States
City
Neptune
State/Province
New Jersey
ZIP/Postal Code
07753
Country
United States
City
Binghamton
State/Province
New York
ZIP/Postal Code
13901
Country
United States
City
Endwell
State/Province
New York
ZIP/Postal Code
13760
Country
United States
City
Cary
State/Province
North Carolina
ZIP/Postal Code
27518
Country
United States
City
Hickory
State/Province
North Carolina
ZIP/Postal Code
28602
Country
United States
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
City
Centerville
State/Province
Ohio
ZIP/Postal Code
45459
Country
United States
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15241
Country
United States
City
Uniontown
State/Province
Pennsylvania
ZIP/Postal Code
15401
Country
United States
City
Mount Pleasant
State/Province
South Carolina
ZIP/Postal Code
29464
Country
United States
City
Bristol
State/Province
Tennessee
ZIP/Postal Code
37620
Country
United States
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84093
Country
United States
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84109
Country
United States
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23294
Country
United States
City
Williamsburg
State/Province
Virginia
ZIP/Postal Code
23185
Country
United States
City
Marshfield
State/Province
Wisconsin
ZIP/Postal Code
54449
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
27013431
Citation
de Bruyn G, Saleh J, Workman D, Pollak R, Elinoff V, Fraser NJ, Lefebvre G, Martens M, Mills RE, Nathan R, Trevino M, van Cleeff M, Foglia G, Ozol-Godfrey A, Patel DM, Pietrobon PJ, Gesser R; H-030-012 Clinical Investigator Study Team. Defining the optimal formulation and schedule of a candidate toxoid vaccine against Clostridium difficile infection: A randomized Phase 2 clinical trial. Vaccine. 2016 Apr 27;34(19):2170-8. doi: 10.1016/j.vaccine.2016.03.028. Epub 2016 Mar 21.
Results Reference
result
PubMed Identifier
31537446
Citation
Small RD, Ozol-Godfrey A, Yan L. On the use of nonparametric tests for comparing immunological Reverse Cumulative distribution curves (RCDCs). Vaccine. 2019 Oct 16;37(44):6737-6742. doi: 10.1016/j.vaccine.2019.09.007. Epub 2019 Sep 16.
Results Reference
derived

Learn more about this trial

Study of Different Formulations of a Clostridium Difficile Toxoid Vaccine Given at Three Different Schedules in Adults

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