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CompletedNCT02465216Updated Mar 12, 2019Results posted

Phase 2a ID93 + GLA-SE Vaccine Trial in TB Patients After Treatment Completion

A Phase 2 interventional study of Placebo and ID93 + GLA-SE in Pulmonary Tuberculosis, sponsored by Access to Advanced Health Institute (AAHI). Completed at 3 sites in South Africa. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2019-03-12.

Sponsored by Access to Advanced Health Institute (AAHI) · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The purpose of this study is to evaluate the safety and immunogenicity of ID93 + GLA-SE vaccine when administered to adult pulmonary Tuberculosis (TB) patients, following successful completion of TB treatment with confirmed bacteriologic cure, in preparation for a future Phase 2b prevention of TB recurrence trial in the same population.

02

Conditions studied

  • Pulmonary Tuberculosis

Keywords

  • Tuberculosis
  • TB
  • Pulmonary
  • Vaccine
  • Adjuvant
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Males and females 18 to 60 years of age.
  2. Subjects must have been successfully treated, i.e., completed the scheduled course of TB treatment as per the prevailing South African national guidelines, for MTB culture-confirmed, drug sensitive pulmonary TB, as evidenced by a record of positive liquid MTB culture with formal drug sensitivity testing (DST) and/or by Xpert MTB/RIF test at baseline.
  3. Must have two separate samples showing bacteriologic confirmation of cure - defined in the first instance as Xpert MTB/RIF test negative, or, if Xpert MTB/RIF positive, as MTB liquid culture negative - on two successive occasions at least 30 days apart. Subjects who are sputum unproductive will be deemed Xpert MTB/RIF and MTB liquid culture negative.
  4. Female subjects of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test on the day of each study injection, must not be breast-feeding, and be willing to avoid pregnancy for 3 months following first study injection. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, intrauterine device (IUD), or the combination of a condom or diaphragm with spermicide gel.
  5. The following screening laboratory values must be within the laboratory reference range or, if abnormal, deemed not clinically significant and less than Grade 2 severity on the FDA Toxicity Scale, as determined by the PI and LMM or Sponsor Medical Advisor: ALT, AST, total bilirubin, creatinine, total WBC count, hemoglobin, and platelet count.
  6. The HIV 1/2 antibody serology tests must be negative.
  7. Must give informed consent, be able and willing to make all evaluation visits, be reachable by telephone or personal contact by the study site personnel, and be willing to remain in the study area for the duration of the trial.

Exclusion criteria

Exclusion Criteria:

  1. TB treatment failure, as evidenced by clinical diagnosis or a positive MTB liquid culture at month 4 or 5 after starting treatment. A positive MTB liquid culture at, or after, end of treatment would exclude subjects from receiving further study injections.
  2. Previous course of TB treatment completed within 5 calendar years prior to obtaining baseline diagnostic sputum samples.
  3. Receipt of any investigational products or investigational drug in the past 6 months or investigational vaccine ever.
  4. Treatment with immunosuppressive drugs (e.g., oral or injected steroids, such as prednisone; high dose inhaled steroids) in the past 6 months. Topical steroids would be allowable.
  5. Received incomplete or investigational, or non-standard TB drug regimen, other than the prevailing current South African national guideline as reference standard, or poor adherence to TB treatment regimen.
  6. Diagnosed with rifampicin-resistant MTB strain (by Xpert MTB/RIF and/or culture and formal DST).
  7. History of autoimmune disease or other causes of immunosuppressive states.
  8. History or evidence of any acute or chronic illness (including diabetes mellitus, asthma), medical or surgical condition, or chronic heavy ethanol or drug use, or use of medication that, in the opinion of the Principal Investigator, may interfere with the evaluation of the safety or immunogenicity of the vaccine.
  9. Subjects with a history of previous anaphylaxis or severe allergic reaction to vaccines, eggs, or unknown allergens.
  10. Subjects who are unlikely to cooperate with the requirements of the study protocol.
04

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
60 participants (actual)

Study arms

  • Experimental
    2 mcg ID93 + 2 mcg GLA-SE Vaccine

    Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and low dose of adjuvant.

    Biological: ID93 + GLA-SE

  • Experimental
    10 mcg ID93 + 2 mcg GLA-SE Vaccine

    Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. High dose of antigen and low dose of adjuvant.

    Biological: ID93 + GLA-SE

  • Experimental
    2 mcg ID93 + 5 mcg GLA-SE Vaccine

    Two intramuscular injections of ID93 + GLA-SE at Days 0 and 56. Low dose of antigen and high dose of adjuvant. Placebo injection at Day 28 to maintain blind with the 3 dose arm.

    Biological: ID93 + GLA-SE

  • Placebo comparator
    Placebo

    Two intramuscular injections of normal saline at Days 0 and 56, or Days 0, 28, and 56.

    Other: Placebo

  • Experimental
    2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 doses

    Three intramuscular injections of ID93 + GLA-SE at Days 0, 28, and 56. Low dose of antigen and high dose of adjuvant.

    Biological: ID93 + GLA-SE

Interventions

  • OtherPlacebo

    Placebo

  • BiologicalID93 + GLA-SE

    ID93 + GLA-SE

05

What researchers measure

Primary outcomes

  1. Number of Adverse Events

    Safety outcomes will include solicited adverse events within 7 days and unsolicited adverse events within 28 days after each study injection; and serious adverse events after the first study injection until end of study follow-up.

    Time frame: 224 days

Secondary outcomes

  1. Immunogenicity Responder Rate

    Immunogenicity will be evaluated by measuring humoral and cellular responses to ID93 + GLA-SE at Day 70.

    Time frame: Day 70

06

Results

Posted Nov 9, 2018

Participant flow

Participant flow — Overall Study
Milestone2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlacebo
Started155141412
Completed12513129
Not completed30123

Outcome measures

PrimaryNumber of Adverse Events

Safety outcomes will include solicited adverse events within 7 days and unsolicited adverse events within 28 days after each study injection; and serious adverse events after the first study injection until end of study follow-up.

Time frame:
224 days
Reported as:
Number · participants
Number of Adverse Events
participants2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlacebo
Local Injection Site Reactions541083
Solicited Systemic Reactions10110
Any Adverse Event12513129
Serious Adverse Events00002
SecondaryImmunogenicity Responder Rate

Immunogenicity will be evaluated by measuring humoral and cellular responses to ID93 + GLA-SE at Day 70.

Time frame:
Day 70
Reported as:
Count of participants · Participants
Immunogenicity Responder Rate
Participants2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlacebo
IgG antibody responder rate12513110
CD4 T cell responder rate (whole antigen stim)421011

Adverse events

Collected over 224 days. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
2 mcg ID93 + 2 mcg GLA-SE Vaccine0/15 (0%)0/15 (0%)12/15 (80%)
10 mcg ID93 + 2 mcg GLA-SE Vaccine0/5 (0%)0/5 (0%)5/5 (100%)
2 mcg ID93 + 5 mcg GLA-SE Vaccine0/14 (0%)0/14 (0%)13/14 (92.9%)
2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 Doses0/14 (0%)0/14 (0%)12/14 (85.7%)
Placebo1/12 (8.3%)2/12 (16.7%)9/12 (75%)
Most frequent serious events
Most frequent serious events
Event2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlacebo
Chest wall tumourNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/150/50/140/141/12
Delirium tremensPsychiatric disorders0/150/50/140/141/12
Most frequent other events
Showing 10 of 13
Most frequent other events
Event2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlacebo
Injection site painGeneral disorders5/154/510/147/143/12
HeadacheNervous system disorders1/152/51/140/143/12
Injection site erythemaGeneral disorders0/150/54/141/140/12
URTIInfections and infestations3/151/53/141/143/12
Injection site indurationGeneral disorders1/150/53/143/140/12
ALT increasedInvestigations2/150/51/143/142/12
TonsilitisInfections and infestations0/150/53/140/140/12
Haemoglobin decreasedInvestigations1/151/51/140/140/12
WBC count decreasedInvestigations0/151/52/142/140/12
Nasal congestionRespiratory, thoracic and mediastinal disorders0/151/52/140/140/12

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlaceboTotal
<=18 years000000
Between 18 and 65 years15514141260
>=65 years000000
Sex: Female, Male
Sex: Female, Male(Participants)2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlaceboTotal
Female11372427
Male42712833
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlaceboTotal
African Mixed Race101117837
Black African5437423
Region of Enrollment
Region of Enrollment(Participants)2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlaceboTotal
South Africa15514141260
BMI
BMI(kg/m^2)2 mcg ID93 + 2 mcg GLA-SE Vaccine10 mcg ID93 + 2 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine2 mcg ID93 + 5 mcg GLA-SE Vaccine 3 DosesPlaceboTotal
Mean20.6 ± 2.3222.8 ± 5.419.6 ± 2.3821.4 ± 4.9221.4 ± 1.9420.9 ± 3.39
07

Study locations

3 sites
  • TASK Applied Sciences
    Cape Town, 7530, South Africa
  • Desmond Tutu HIV Centre (DTHC)
    Cape Town, 7750, South Africa
  • South African Tuberculosis Vaccine Initiative (SATVI)
    Worcester, 6850, South Africa
08

References and documents

Publications

  • Day TA, Penn-Nicholson A, Luabeya AKK, Fiore-Gartland A, Du Plessis N, Loxton AG, Vergara J, Rolf TA, Reid TD, Toefy A, Shenje J, Geldenhuys H, Tameris M, Mabwe S, Bilek N, Bekker LG, Diacon A, Walzl G, Ashman J, Frevol A, Sagawa ZK, Lindestam Arlehamn C, Sette A, Reed SG, Coler RN, Scriba TJ, Hatherill M; TBVPX-203 study team. Safety and immunogenicity of the adjunct therapeutic vaccine ID93 + GLA-SE in adults who have completed treatment for tuberculosis: a randomised, double-blind, placebo-controlled, phase 2a trial. Lancet Respir Med. 2021 Apr;9(4):373-386. doi: 10.1016/S2213-2600(20)30319-2. Epub 2020 Dec 8. Erratum In: Lancet Respir Med. 2021 Jul;9(7):e62. doi: 10.1016/S2213-2600(21)00281-2. PubMed 33306991 ↗
09

Registry details

Key details

Study ID
NCT02465216
Lead sponsor
Access to Advanced Health Institute (AAHI)
Collaborators
Wellcome Trust, South African Tuberculosis Vaccine Initiative
Responsible party
Sponsor
First posted
Jun 8, 2015
Start date
Jun 2015
Primary completion
Jan 2017
Completion
Jan 2017
Results posted
Nov 9, 2018
Last update
Mar 12, 2019

Study contacts

Mark Hatherill, MD
principal investigator · South African Tuberculosis Vaccine Initiative

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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