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CompletedNCT03264157Updated Feb 25, 2020Results posted

Safety and Effectiveness of BPL HRIG With Active Rabies Vaccine in Healthy Subjects

A Phase 2/3 interventional study of HRIG and HyperRAB in Healthy, sponsored by Bio Products Laboratory. Completed at 2 sites in United States. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-02-25.

Sponsored by Bio Products Laboratory · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
162
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

A prospective, randomized, blinded, parallel-group, non-inferiority, phase II/III study of the safety and effectiveness of simulated post-exposure prophylaxis with BPL HRIG with co-administration of active rabies vaccine in healthy subjects.

Read the detailed description

Each subject will undergo a total of 9 visits. Subjects' eligibility will be assessed at Screening, which can occur up to 28 days prior to dosing. Following a repeat eligibility check at Day 0, eligible subjects will be randomized and dosed with the randomized treatment (BPL HRIG + vaccine or Comparator HRIG + vaccine) on Day 0. Further assessments will be conducted on Days 3, 5, 7, 14, 28, 49 and the end of study assessment on Day 140. Vaccine will be administered on Day 0, 3, 7, 14 and 28.

02

Conditions studied

  • Healthy

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03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Able and willing to sign an informed consent form.
  2. Healthy male or female subjects aged 18 - 75 years inclusive.
  3. No previous exposure to rabies virus, rabies vaccine and/or rabies immunoglobulin.
  4. No significant abnormalities in hematology, biochemistry, or urinalysis according to the Principal Investigator's judgment.
  5. No significant abnormalities in ECG according to the Investigator's judgment.
  6. Females of child-bearing potential (defined from the onset of menstruation to one-year post- menopause and not surgically sterilized) who are (or become) sexually active must agree to practice contraception by using a highly effective (>98%) method for the duration of the study.
  7. Females of child-bearing potential (defined from the onset of menstruation to one-year post- menopause and not surgically sterilized) must have a negative result on a serum at screening visit and a urine HCG-based pregnancy test at Day 0.

Exclusion criteria

Exclusion Criteria

  1. Female subjects who are pregnant and/or lactating.
  2. History of live virus vaccination, e.g., measles, mumps, varicella or rubella vaccine, within the last 3 months.
  3. Planned live virus vaccination, e.g., measles, mumps, varicella or rubella vaccine, within the 3 months after Day 0.
  4. History of anaphylactic or anaphylactoid hypersensitivity reactions to chicken egg; history of mild allergic reactions to chicken egg, e.g., skin rash only, is not an exclusion criterion
  5. History of hypersensitivity reaction to any of the following components of active rabies vaccine (US-FDA approved) e.g.: neomycin, bovine gelatin, trace amounts of chicken protein, chlortetracycline, and amphotericin B and in accordance with the product insert of the vaccine.
  6. History of life-threatening allergy, anaphylactic reaction, or systemic response to human plasma derived products.
  7. History of life-threatening allergy to blood or blood products.
  8. Fever at the time of the start of the injection (oral temperature >38ºC.) or acute illness at the time of the start of the injection. Subjects with fever on Day 0 may have entry to the study re-scheduled.
  9. History of or ongoing bleeding disorder.
  10. Previous organ transplant recipient.
  11. Ongoing immunosuppressive illness.
  12. Clinically significant illnesses including: cardiac, hepatic, renal, endocrine, neurological, hematological, neoplastic, immunological, skeletal or other) that in the opinion of the investigator, could interfere with the safety, compliance or other aspects of this study.
  13. All types of malignancies except for basal and squamous cell (scaly or plate-like) skin cancer, in- situ cervical carcinoma must be in remission for a minimum of 5 years prior to Day 0. For non-melanoma skin cancers and carcinoma in-situ of the cervix may be enrolled if treated and cured at the time of screening.
  14. Evidence of active systemic infection that requires treatment with antibiotics within 2 weeks prior to Day 0.
  15. Currently receiving or have received within the past 6 months (prior to Day 0):

    • immunosuppressive drugs
    • immunomodulatory drugs
  16. Currently receiving or have received oral or IV steroids within 14 days (prior to DAY 0) or expected to require oral or IV steroids during the study.
  17. Evidence of uncontrolled hypertension (systolic blood pressure of >150 mmHg, and/or diastolic blood pressure of >100 mmHg).
  18. Heart rate >120/min.
  19. Weight > 95.5 kg
  20. History of IgA deficiency.
  21. Is positive for any of the following at screening: serological test for HIV 1\&2, HCV or HBsAg.
  22. Presence of psychiatric disorder, other mental disorder or any other medical disorder which might impair the subject's ability to give informed consent or to comply with the requirements of the study protocol.
  23. Previous enrollment in this study.
  24. Participation in an interventional clinical trial within 30 days prior to baseline visit (Day 0).
  25. Evidence of alcohol abuse or history of alcohol abuse or illegal and/or legally prescribed drugs in the past 2 years.
  26. Any other factor that, in the opinion of the investigator, would prevent the subject from complying with the requirements of the protocol.
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
162 participants (actual)

Study arms

  • Experimental
    BPL HRIG + RabAvert

    20 IU/kg dose HRIG + active rabies vaccine

    Drug: HRIG · Biological: RabAvert

  • Active comparator
    Comparator HyperRab + RabAvert

    20 IU/kg dose HRIG + active rabies vaccine

    Drug: HyperRAB · Biological: RabAvert

Interventions

  • DrugHRIG

    A 20 IU/kg dose of BPL HRIG will be given on Day 0 via IM injection.

  • DrugHyperRAB

    A 20 IU/kg dose of Comparator HRIG will be given on Day 0 via IM injection.

    Also known as: HRIG

  • BiologicalRabAvert

    A 1.0 ml dose of active vaccine (2.5 IU/ml) will be given IM on 5 occasions: on Days 0, 3, 7, 14, and 28.

    Also known as: active rabies vaccine

05

What researchers measure

Primary outcomes

  1. Proportion of Subjects With Anti-rabies Antibody Titer of ≥0.5 IU/mL

    Non-inferiority in terms of the proportion of subjects with anti-rabies antibody titer of ≥0.5 IU/mL after study drug administration using a non-inferiority margin of 10%.

    Time frame: Day 14

Secondary outcomes

  1. Analysis of AUC0-7d

    The AUC0-7d for BPL HRIG and vaccine versus comparator HRIG and vaccine using a non inferiority margin of 20%.

    Time frame: Day 0 to Day 7

  2. RVNA Geometric Mean Titers at Days 3, 5, 7 and 14

    Comparison of the geometric mean titers (GMTs) for antirabies antibody titer after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine. The median peak RVNA titer occurred at Day 14, which is reflected in the analysis. The RVNA titer to peak geometric mean is analyzed using a repeated measures analysis. The inferential test compares RVNA values between BPL HRIG and HyperRab in a single analysis across all visits at or below the visit at which peak titer is observed. The geometric mean values presented represent a mean across all visits from baseline through and including Day 14.

    Time frame: Days 3, 5, 7 and 14

  3. Proportion of Subjects Reaching Antirabies Antibody Titer of ≥ 0.5 IU/mL by Visit

    The proportion of subjects reaching antirabies antibody titer of ≥ 0.5 IU/mL after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine.

    Time frame: Days 3, 5, 7, 14, 28, 49, and 140

  4. Proportion of Subjects Reaching Antirabies Antibody Titer of ≥ LLOQ of the Assay by Visit

    The proportion of subjects reaching antirabies antibody titer of ≥ LLOQ of the assay at each visit after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine.

    Time frame: Days 3, 5, 7, 14, 28, 49, and 140

  5. RVNA Geometric Mean Titers at Days 14, 28, 49 and 140

    Comparison of the GMTs for antirabies antibody titer after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine to assess the inhibitory effects of BPL HRIG on active immunization relative to that of the comparator HRIG.

    Time frame: Days 14, 28, 49 and 140

06

Results

Posted Feb 11, 2020

Participant flow

Participant flow — Overall Study
MilestoneBPL HRIG + RabAvertComparator HyperRab + RabAvert
Started8181
Completed6874
Not completed137

Outcome measures

PrimaryProportion of Subjects With Anti-rabies Antibody Titer of ≥0.5 IU/mL

Non-inferiority in terms of the proportion of subjects with anti-rabies antibody titer of ≥0.5 IU/mL after study drug administration using a non-inferiority margin of 10%.

Time frame:
Day 14
Reported as:
Count of participants · Participants
Proportion of Subjects With Anti-rabies Antibody Titer of ≥0.5 IU/mL
ParticipantsBPL HRIG + RabAvertComparator HyperRab + RabAvert
Proportion of Subjects With Anti-rabies Antibody Titer of ≥0.5 IU/mL7372
Statistical analysis
  • BPL HRIG + RabAvert vs Comparator HyperRab + RabAvert · Farrington and Manning test · p = 0.0006 (The threshold for this test is \<=0.025.) · Lower 95% ci: -0.05
SecondaryAnalysis of AUC0-7d

The AUC0-7d for BPL HRIG and vaccine versus comparator HRIG and vaccine using a non inferiority margin of 20%.

Time frame:
Day 0 to Day 7
Reported as:
Geometric mean · day*IU/mL
Analysis of AUC0-7d
day*IU/mLBPL HRIG + RabAvertComparator HyperRab + RabAvert
Analysis of AUC0-7d1.10 (1.02 to 1.20)1.32 (1.21 to 1.44)
Statistical analysis
  • BPL HRIG + RabAvert vs Comparator HyperRab + RabAvert · Lower 95% ci: 0.74 · 95% CI 0.74 to 0.94
SecondaryRVNA Geometric Mean Titers at Days 3, 5, 7 and 14

Comparison of the geometric mean titers (GMTs) for antirabies antibody titer after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine. The median peak RVNA titer occurred at Day 14, which is reflected in the analysis. The RVNA titer to peak geometric mean is analyzed using a repeated measures analysis. The inferential test compares RVNA values between BPL HRIG and HyperRab in a single analysis across all visits at or below the visit at which peak titer is observed. The geometric mean values presented represent a mean across all visits from baseline through and including Day 14.

Time frame:
Days 3, 5, 7 and 14
Reported as:
Geometric mean · IU/mL
RVNA Geometric Mean Titers at Days 3, 5, 7 and 14
IU/mLBPL HRIG + RabAvertComparator HyperRab + RabAvert
Through Day 140.37 (0.35 to 0.39)0.38 (0.36 to 0.40)
Day 30.18 (0.16 to 0.20)0.21 (0.19 to 0.24)
Day 50.19 (0.18 to 0.21)0.24 (0.21 to 0.26)
Day 70.23 (0.21 to 0.26)0.26 (0.23 to 0.29)
Day 1412.30 (10.15 to 14.90)8.38 (6.54 to 10.74)
Statistical analysis
  • BPL HRIG + RabAvert vs Comparator HyperRab + RabAvert · 95% ci: 0.97Data analyzed as log normal. The value presented is the untransformed value of the difference between means.
SecondaryProportion of Subjects Reaching Antirabies Antibody Titer of ≥ 0.5 IU/mL by Visit

The proportion of subjects reaching antirabies antibody titer of ≥ 0.5 IU/mL after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine.

Time frame:
Days 3, 5, 7, 14, 28, 49, and 140
Reported as:
Count of participants · Participants
Proportion of Subjects Reaching Antirabies Antibody Titer of ≥ 0.5 IU/mL by Visit
ParticipantsBPL HRIG + RabAvertComparator HyperRab + RabAvert
Day 000
Day 301
Day 501
Day 732
Day 147372
Day 287373
Day 497372
Day 1406065
Statistical analysis
  • BPL HRIG + RabAvert vs Comparator HyperRab + RabAvert · Farrington and Manning test · p = 0.0006 · Lower 95% ci: -0.05 · 95% CI -0.05 to 0.10
SecondaryProportion of Subjects Reaching Antirabies Antibody Titer of ≥ LLOQ of the Assay by Visit

The proportion of subjects reaching antirabies antibody titer of ≥ LLOQ of the assay at each visit after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine.

Time frame:
Days 3, 5, 7, 14, 28, 49, and 140
Reported as:
Count of participants · Participants
Proportion of Subjects Reaching Antirabies Antibody Titer of ≥ LLOQ of the Assay by Visit
ParticipantsBPL HRIG + RabAvertComparator HyperRab + RabAvert
Day 000
Day 37073
Day 57174
Day 77374
Day 147374
Day 287374
Day 497372
Day 1406271
Statistical analysis
  • BPL HRIG + RabAvert vs Comparator HyperRab + RabAvert · Farrington and Manning test · p = 0 · Lower 95% ci: 0 · 95% CI 0 to 0For Day 14, all subjects achieved the endpoint (RVNA titer \> LLOQ). Since the statistic to measure the performance is a proportion, the proportion is 1 and no variance is calculable.
SecondaryRVNA Geometric Mean Titers at Days 14, 28, 49 and 140

Comparison of the GMTs for antirabies antibody titer after administration of BPL HRIG and vaccine versus comparator HRIG and vaccine to assess the inhibitory effects of BPL HRIG on active immunization relative to that of the comparator HRIG.

Time frame:
Days 14, 28, 49 and 140
Reported as:
Geometric mean · IU/mL
RVNA Geometric Mean Titers at Days 14, 28, 49 and 140
IU/mLBPL HRIG + RabAvertComparator HyperRab + RabAvert
Day 1412.30 (10.15 to 14.90)8.38 (6.54 to 10.74)
Day 2810.18 (8.39 to 12.34)7.78 (6.26 to 9.66)
Day 4910.91 (8.94 to 13.32)7.78 (6.34 to 9.56)
Day 1402.72 (2.21 to 3.34)2.02 (1.62 to 2.53)

Adverse events

Collected over 20 weeks treatment. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
BPL HRIG + RabAvert0/81 (0%)0/81 (0%)19/81 (23.5%)
Comparator HyperRab + RabAvert0/81 (0%)0/81 (0%)19/81 (23.5%)
Most frequent other events
Most frequent other events
EventBPL HRIG + RabAvertComparator HyperRab + RabAvert
HeadacheNervous system disorders5/8110/81
Vaccination site painGeneral disorders9/812/81
Upper respiratory tract infectionInfections and infestations5/817/81

Baseline characteristics

Age, Continuous
Age, Continuous(years)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
Mean41.37 ± 15.044.56 ± 15.442.96 ± 15.2
Sex: Female, Male
Sex: Female, Male(Participants)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
Female5654110
Male252752
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
Hispanic or Latino235
Not Hispanic or Latino7978157
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
American Indian or Alaska Native022
Asian123
Native Hawaiian or Other Pacific Islander000
Black or African American161531
White6259121
More than one race112
Unknown or Not Reported123
Region of Enrollment
Region of Enrollment(participants)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
United States8181162
Weight
Weight(kg)BPL HRIG + RabAvertComparator HyperRab + RabAvertTotal
Mean74.61 ± 12.574.51 ± 13.274.56 ± 12.8
07

Study locations

2 sites
  • Prism Research
    Saint Paul, Minnesota 55114, United States
  • Wake Research Associates
    Raleigh, North Carolina 27612, United States
08

References and documents

Study documents

  • Study protocol · Oct 26, 2017
  • Statistical analysis plan · Oct 31, 2017

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03264157
Lead sponsor
Bio Products Laboratory
Responsible party
Sponsor
First posted
Aug 29, 2017
Start date
Dec 8, 2017
Primary completion
Mar 2, 2018
Completion
Jul 13, 2018
Results posted
Feb 11, 2020
Last update
Feb 25, 2020

Study contacts

Elizabeth Holmes, MD
study director · Bio Products Laboratory

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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