Testing Pfs25-EPA/Alhydrogel as a Potential Malaria Transmission Blocking Vaccine
NCT ID: NCT01867463
Last Updated: 2018-07-05
Study Results
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Basic Information
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COMPLETED
PHASE1
230 participants
INTERVENTIONAL
2013-03-27
2016-12-19
Brief Summary
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\- Malaria is a disease that is spread by mosquitoes. Researchers are looking for a vaccine that can prevent mosquitoes from transmitting malaria to people. They want to test a vaccine called Pfs25-EPA/Alhydrogel that may help stop malaria parasites from developing in mosquitoes. When a mosquito bites a vaccinated person, the vaccine should prevent parasites from developing in the mosquito. As a result, the mosquito will not spread malaria to the next person it bites. However, the vaccine will not directly prevent people vaccinated from getting sick with malaria. Researchers want to test this vaccine in people who live in rural Mali. To do so, the study will compare the symptoms and the blood tests of the participants who receive either the study vaccine or a regular hepatitis B/meningococcal vaccine.
Objectives:
\- To see if Pfs25-EPA/Alhydrogel is a safe and effective malaria vaccine.
Eligibility:
\- Healthy volunteers between 18 and 45 years of age who live in Bancoumana, Mali.
Design:
* Participants will be screened with a medical history, physical exam, and blood tests.
* Participants will be separated into two groups. One group will have Pfs25-EPA/Alhydrogel to test the study vaccine. The other group will have the regular Hepatitis B vaccine series, meningococcal vaccine.
* In the study vaccine group, participants will have either a lower dose or a higher dose. For the lower dose, they will have two vaccine shots over 1 year. For the higher dose, they will have four vaccine shots over about 14 months.
* In the other vaccine group, participants will have the Hepatitis B vaccine series, meningococcal vaccine according to the standard dose schedule.
* All participants will provide regular blood samples for testing during the study.
* Participants who develop malaria during the study will participate in evaluation of transmission and parasite development of malaria parasite from the person to mosquito via transmission assays. They will allow mosquitoes (that have no diseases) to bite them in a controlled clinic setting. This will let researchers see if the vaccine can stop the mosquitoes from carrying malaria to other people.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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Group 1
Group 1: n=20, randomized to receive 16 g Pfs25-EPA/Alhydrogel (n=10) or the comparator (EuvaxB, n=10) on D0, D56
Pfs25-EPA/Alhydrogel
The Pfs25-EPA conjugate was produced by reaction between thiolated PpPfs25 and maleimideactivated EcEPA, followed by purification using size-exclusion chromatography. The cGMP Pfs25-EPA conjugate Lot# WRAIR1634 was manufactured at Walter Reed Bioproduction facility in cGMP compliance in May 2010. Alhydrogel (Brenntag, Denmark) is an aluminum hydroxide gel and has been extensively used as an adjuvant in licensed human vaccines. Alhydrogel is supplied as a sterile product in water without preservatives. Pfs25- EPA/Alhydrogel WRAIR Lot #1668 was manufactured and filled as single-use vials at Walter Reed Bioproduction facility in cGMP compliance in October 2010. Each vial contains 78 g/mL conjugated Pfs25, 93 g/mL conjugated EPA and 1600 g/mL Alhydrogel in a volume of 0.8 mL. The vial label reads: 78 g/mL Conjugated Pfs25 on Alhydrogel .
Euvax B
Euvax B consists of highly purified, noninfectious particles of HBsAg absorbed onto aluminum salts as an adjuvant and preserved with thimerosal.
Group 2
Group 2: n=30, randomized to receive 47 g Pfs25-EPA/Alhydrogel (n=15) or the comparator (EuvaxB and Menactra , n=15) on D0, D56, D112, D480
Pfs25-EPA/Alhydrogel
The Pfs25-EPA conjugate was produced by reaction between thiolated PpPfs25 and maleimideactivated EcEPA, followed by purification using size-exclusion chromatography. The cGMP Pfs25-EPA conjugate Lot# WRAIR1634 was manufactured at Walter Reed Bioproduction facility in cGMP compliance in May 2010. Alhydrogel (Brenntag, Denmark) is an aluminum hydroxide gel and has been extensively used as an adjuvant in licensed human vaccines. Alhydrogel is supplied as a sterile product in water without preservatives. Pfs25- EPA/Alhydrogel WRAIR Lot #1668 was manufactured and filled as single-use vials at Walter Reed Bioproduction facility in cGMP compliance in October 2010. Each vial contains 78 g/mL conjugated Pfs25, 93 g/mL conjugated EPA and 1600 g/mL Alhydrogel in a volume of 0.8 mL. The vial label reads: 78 g/mL Conjugated Pfs25 on Alhydrogel .
Euvax B
Euvax B consists of highly purified, noninfectious particles of HBsAg absorbed onto aluminum salts as an adjuvant and preserved with thimerosal.
Menactra
Menactra , Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine, is a sterile, intramuscularly administered vaccine that contains Neisseria meningitidis serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein. N meningitidis A, C, Y and W-135 strains are cultured on Mueller Hinton agar (3) and grown in Watson Scherp (4) media. The polysaccharides are extracted from the N meningitidis cells and purified by centrifugation, detergent precipitation, alcohol precipitation, solvent extraction and diafiltration.
Group 3
Group 3: n=70 randomized to receive 47 g Pfs25-EPA/Alhydrogel (n=35) or the comparator (EuvaxB and Menactra , n=35) on D0, D56, D112, D480
Pfs25-EPA/Alhydrogel
The Pfs25-EPA conjugate was produced by reaction between thiolated PpPfs25 and maleimideactivated EcEPA, followed by purification using size-exclusion chromatography. The cGMP Pfs25-EPA conjugate Lot# WRAIR1634 was manufactured at Walter Reed Bioproduction facility in cGMP compliance in May 2010. Alhydrogel (Brenntag, Denmark) is an aluminum hydroxide gel and has been extensively used as an adjuvant in licensed human vaccines. Alhydrogel is supplied as a sterile product in water without preservatives. Pfs25- EPA/Alhydrogel WRAIR Lot #1668 was manufactured and filled as single-use vials at Walter Reed Bioproduction facility in cGMP compliance in October 2010. Each vial contains 78 g/mL conjugated Pfs25, 93 g/mL conjugated EPA and 1600 g/mL Alhydrogel in a volume of 0.8 mL. The vial label reads: 78 g/mL Conjugated Pfs25 on Alhydrogel .
Euvax B
Euvax B consists of highly purified, noninfectious particles of HBsAg absorbed onto aluminum salts as an adjuvant and preserved with thimerosal.
Menactra
Menactra , Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine, is a sterile, intramuscularly administered vaccine that contains Neisseria meningitidis serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein. N meningitidis A, C, Y and W-135 strains are cultured on Mueller Hinton agar (3) and grown in Watson Scherp (4) media. The polysaccharides are extracted from the N meningitidis cells and purified by centrifugation, detergent precipitation, alcohol precipitation, solvent extraction and diafiltration.
Interventions
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Pfs25-EPA/Alhydrogel
The Pfs25-EPA conjugate was produced by reaction between thiolated PpPfs25 and maleimideactivated EcEPA, followed by purification using size-exclusion chromatography. The cGMP Pfs25-EPA conjugate Lot# WRAIR1634 was manufactured at Walter Reed Bioproduction facility in cGMP compliance in May 2010. Alhydrogel (Brenntag, Denmark) is an aluminum hydroxide gel and has been extensively used as an adjuvant in licensed human vaccines. Alhydrogel is supplied as a sterile product in water without preservatives. Pfs25- EPA/Alhydrogel WRAIR Lot #1668 was manufactured and filled as single-use vials at Walter Reed Bioproduction facility in cGMP compliance in October 2010. Each vial contains 78 g/mL conjugated Pfs25, 93 g/mL conjugated EPA and 1600 g/mL Alhydrogel in a volume of 0.8 mL. The vial label reads: 78 g/mL Conjugated Pfs25 on Alhydrogel .
Euvax B
Euvax B consists of highly purified, noninfectious particles of HBsAg absorbed onto aluminum salts as an adjuvant and preserved with thimerosal.
Menactra
Menactra , Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine, is a sterile, intramuscularly administered vaccine that contains Neisseria meningitidis serogroup A, C, Y and W-135 capsular polysaccharide antigens individually conjugated to diphtheria toxoid protein. N meningitidis A, C, Y and W-135 strains are cultured on Mueller Hinton agar (3) and grown in Watson Scherp (4) media. The polysaccharides are extracted from the N meningitidis cells and purified by centrifugation, detergent precipitation, alcohol precipitation, solvent extraction and diafiltration.
Eligibility Criteria
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Inclusion Criteria
1. Adult age 18 45 years.
2. Known residents of the village of Bancoumana or immediate surrounding areas.
3. Available for the duration of the trial (approximately 2.5 years).
4. Good general health as a result of review of medical history and/or clinical testing at the time of screening.
5. Willingness to participate in the study as evidenced by signing the informed consent document, or by fingerprinting the consent document with the signature of a witness.
6. Willingness to undergo a HIV test.
7. Willingness to undergo direct skin feeds.
Exclusion Criteria
1. Pregnancy, as determined by a positive urine or serum human choriogonadotropin (beta human chorionic gonadotropin ) test at any point during the study (if female).
2. Currently lactating and breast-feeding (if female).
3. Unable or unwilling to use reliable contraception for a minimum of one month prior to the first vaccination to three months after the last vaccination (if female). Reliable birth control includes: pharmacologic contraceptives including oral, parenteral, and transcutaneous delivery; condoms with spermicide; diaphragm with spermicide; surgical sterilization; vaginal ring; transdermal patch; intrauterine device; abstinence; and postmenopause.
(Note: If screening of the female subject occurs \< 1 month prior to first vaccination, a negative serum pregnancy test at time of screening and at enrollment (first vaccination) and agreement to use of reliable contraception for the duration of the study until three months after the fourth vaccination is acceptable.)
4. Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the participant to understand and cooperate with the study protocol.
5. Hemoglobin, WBC, and platelets outside the local laboratory-defined upper limit of normal (subjects may be included at the investigator s discretion for not clinically significant values outside of normal range).
6. Neutropenia (absolute neutrophil count \<1250/mm3).
7. Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal.
8. Positive test for hepatitis C virus (HCV).
9. Positive test for hepatitis B (HBsAg).
10. Positive test for human immunodeficiency virus (HIV).
11. Known immunodeficiency syndrome.
12. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, or renal disease by history, physical examination, and/or laboratory studies including urinalysis.
13. Subject has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
14. History of a severe allergic reaction or anaphylaxis.
15. History of a severe reaction to mosquito bites.
16. Severe asthma, defined as asthma that is unstable or required emergent care, urgent care, hospitalization or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years.
17. Clinically significant reactive airway disease that does not respond to bronchodilators.
18. History of a surgical splenectomy.
19. Use of chronic (greater than or equal to 14 days) oral or intravenous corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone \>10 mg/ day) or immunosuppressive drugs within 30 days of starting this study.
20. Receipt of a live vaccine within past four weeks or a killed vaccine within past two weeks prior to entry into the study.
21. Receipt of blood products within the past 6 months.
22. Previous participation in a malaria vaccine trial.
23. History of receiving any investigational product within the past 30 days.
24. Refusal to allow storage of samples for future research at the time of enrollment.
25. Any medical, psychiatric, social, or occupational condition that, in the judgment of the Principal Investigator (PI), would interfere with the evaluation of study objectives or increase risk to the subject.
18 Years
45 Years
ALL
Yes
Sponsors
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Malaria Research and Training Center, Bamako, Mali
OTHER
National Institute of Allergy and Infectious Diseases (NIAID)
NIH
Responsible Party
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Principal Investigators
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Sara A Healy, M.D.
Role: PRINCIPAL_INVESTIGATOR
National Institute of Allergy and Infectious Diseases (NIAID)
Locations
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Malaria Research and Training Center
Bamako, , Mali
Countries
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References
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Kaslow DC. Transmission-blocking vaccines. Chem Immunol. 2002;80:287-307. doi: 10.1159/000058850. No abstract available.
Williamson KC, Keister DB, Muratova O, Kaslow DC. Recombinant Pfs230, a Plasmodium falciparum gametocyte protein, induces antisera that reduce the infectivity of Plasmodium falciparum to mosquitoes. Mol Biochem Parasitol. 1995 Dec;75(1):33-42. doi: 10.1016/0166-6851(95)02507-3.
Diallo M, Toure AM, Traore SF, Niare O, Kassambara L, Konare A, Coulibaly M, Bagayogo M, Beier JC, Sakai RK, Toure YT, Doumbo OK. Evaluation and optimization of membrane feeding compared to direct feeding as an assay for infectivity. Malar J. 2008 Dec 2;7:248. doi: 10.1186/1475-2875-7-248.
Sagara I, Healy SA, Assadou MH, Gabriel EE, Kone M, Sissoko K, Tembine I, Guindo MA, Doucoure M, Niare K, Dolo A, Rausch KM, Narum DL, Jones DL, MacDonald NJ, Zhu D, Mohan R, Muratova O, Baber I, Coulibaly MB, Fay MP, Anderson C, Wu Y, Traore SF, Doumbo OK, Duffy PE. Safety and immunogenicity of Pfs25H-EPA/Alhydrogel, a transmission-blocking vaccine against Plasmodium falciparum: a randomised, double-blind, comparator-controlled, dose-escalation study in healthy Malian adults. Lancet Infect Dis. 2018 Sep;18(9):969-982. doi: 10.1016/S1473-3099(18)30344-X. Epub 2018 Jul 27.
Other Identifiers
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13-I-N109
Identifier Type: -
Identifier Source: secondary_id
999913109
Identifier Type: -
Identifier Source: org_study_id
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