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Phase 1 Study of the Safety and Immunogenicity of BSAM-2/Alhydrogel® (Registered Trademark)+CPG 7909, an Asexual Blood Stage Vaccine for Plasmodiumfalciparum Malaria in Adults in the US and Mali
This study is currently recruiting participants.
Verified by National Institutes of Health Clinical Center (CC), April 2009
First Received: April 28, 2009   Last Updated: May 7, 2009   History of Changes
Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00889616
  Purpose

This Phase I study will evaluate the blood stage P. falciparummalaria vaccine candidate BSAM-2/Alhydrogel® (Registered Trademark)+CPG 7909 in adults in the US; and Mali. BSAM-2 contains a mixture of two proteins found on the surface of merozoites, AMA1 and MSP1(42). The study is open label, dose escalating in the US, and will be single-blinded and randomized with a licensed comparator vaccine (Recombivax HB® (Registered Trademark) Hepatitis B) in Mali. All volunteers will receive three doses of vaccine, given at 0, 2, and 6 months and administered in the deltoid muscle. The US arm of the study will be conducted at the Center for Immunization Research (CIR), in Washington DC. Fifteen (15) healthy volunteers will receive 40 (micro)g BSAM-2/Alhydrogel® (Registered Trademark)+500 (micro)g CPG 7909 at CIR, followed by another 15 who will receive 160 (micro)g BSAM-2/Altlhydrogel® (Registered Trademark)+500 (micro)g CPG 7909. Safety data to at least one week after the second vaccination from all US volunteers will be reviewed by a Safety Monitoring Committee prior to vaccinating volunteers in Mali. The highest safe dose will be administered in Mali after safety data in US adults have been reviewed by the SMC. The Mali arm of the study will be conducted in Bancoumana. Thirty (30) volunteers will be randomized to receive either BSAM 2/Alhydrogel® (Registered Trademark)+CPG7909 or the licensed comparator vaccine. The primary objective of the study is to demonstrate safety and reactogenicity of the vaccine in both malaria naive and semi-immune adults. Secondary objectives are to determine the antibody response of the combination vaccine to the AMA1 and MSPl(42) proteins, as measured by antibody levels and parasite growth inhibition. Study endpoints are the incidence of local and systemic adverse events, antibody responses to AMA1 and MSP1(42) proteins, and in vitro growth inhibition of falciparum parasites.

Exploratory immunologic analyses will also be conducted.


Condition Intervention Phase
Malaria
Biological: BSAM-2/Alhydrogel + CPG7909
Drug: BSAM2/Alhydrogel + CPG 7909
Phase I

MedlinePlus related topics: Malaria
Drug Information available for: Aluminum hydroxide Algeldrate
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Open Label, Active Control, Parallel Assignment, Safety Study
Official Title: Phase 1 Study of the Safety and Immunogenicity of BSAM-2/Alhydrogel® (Registered Trademark)+CPG 7909, an Asexual Blood Stage Vaccine for Plasmodiumfalciparum Malaria in Adults in the US and Mali

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • To assess safety and reactogenicity of BSAM-2/Alhydrogel + CPG 7909 in malaria-na ve US adults and semi-immune Malian adults.

Secondary Outcome Measures:
  • To determine the antibody response of the combination vaccine to the AMA1-1 and MSP1(42) proteins, as measured by antibody levels and growth inhibition.

Estimated Enrollment: 400
Study Start Date: April 2009
Intervention Details:
    Biological: BSAM-2/Alhydrogel + CPG7909
    N/A
    Drug: BSAM2/Alhydrogel + CPG 7909
    N/A
Detailed Description:

This Phase I study will evaluate the blood stage P. falciparummalaria vaccine candidate BSAM-2/Alhydrogel® (Registered Trademark)+CPG 7909 in adults in the US; and Mali. BSAM-2 contains a mixture of two proteins found on the surface of merozoites, AMA1 and MSP1(42). The study is open label, dose escalating in the US, and will be single-blinded and randomized with a licensed comparator vaccine (Recombivax HB® (Registered Trademark) Hepatitis B) in Mali. All volunteers will receive three doses of vaccine, given at 0, 2, and 6 months and administered in the deltoid muscle. The US arm of the study will be conducted at the Center for Immunization Research (CIR), in Washington DC. Fifteen (15) healthy volunteers will receive 40 (micro)g BSAM-2/Alhydrogel® (Registered Trademark)+500 (micro)g CPG 7909 at CIR, followed by another 15 who will receive 160 (micro)g BSAM-2/Altlhydrogel® (Registered Trademark)+500 (micro)g CPG 7909. Safety data to at least one week after the second vaccination from all US volunteers will be reviewed by a Safety Monitoring Committee prior to vaccinating volunteers in Mali. The highest safe dose will be administered in Mali after safety data in US adults have been reviewed by the SMC. The Mali arm of the study will be conducted in Bancoumana. Thirty (30) volunteers will be randomized to receive either BSAM 2/Alhydrogel® (Registered Trademark)+CPG7909 or the licensed comparator vaccine. The primary objective of the study is to demonstrate safety and reactogenicity of the vaccine in both malaria naive and semi-immune adults. Secondary objectives are to determine the antibody response of the combination vaccine to the AMA1 and MSPl(42) proteins, as measured by antibody levels and parasite growth inhibition. Study endpoints are the incidence of local and systemic adverse events, antibody responses to AMA1 and MSP1(42) proteins, and in vitro growth inhibition of falciparum parasites.

Exploratory immunologic analyses will also be conducted.

  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria
  • INCLUSION CRITERIA:

All of the following criteria must be fulfilled for a volunteer to participate in this trial:

  • Age between 18 and 50 years (US) or 18 and 45 years (Mali), inclusive
  • Good general health as a result of review of medical history and/or clinical testing at the time of screening
  • Available for the duration of the trial (52 weeks)
  • 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 (Mali)
  • Known resident of the village of Bancoumana (Mali)

EXCLUSION CRITERIA (US):

A volunteer will be excluded from participating in this trial if any one of the following criteria is fulfilled:

  1. Pregnancy as determined by a positive urine or serum test at any point during the study for human choriogonadotropin (Beta-hCG) (if female).
  2. Subject is unwilling to use reliable contraception methods for the period of at least 2 months prior to first vaccination to 3 months after last vaccination (if female). Reliable methods of birth control include: pharmacologic contraceptives including oral, parenteral, and transcutaneous delivery; condoms with spermicide; diaphragm with spermicide; surgical sterilization; vaginal ring; intrauterine device; abstinence; and post-menopause (if female).
  3. Currently is lactating and breast-feeding (if female).
  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. Neutropenia as defined by an absolute neutrophil count less than 1500/mm(3).
  6. Alanine transaminase (ALT) level above the laboratory-defined upper limit of normal.
  7. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, or renal disease by history, physical examination, and/or laboratory studies including urinalysis.
  8. Other condition that in the opinion of the investigator would jeopardize the safety or rights of a participant participating in the trial or would render the subject unable to comply with the protocol.
  9. History of receiving any investigational product within the past 30 days.
  10. Participant has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
  11. History of a severe allergic reaction or anaphylaxis.
  12. Severe asthma. This will be defined as:

    • Asthma that is unstable or required emergent care, urgent care, hospitalization or intubation during the past 2 years, or that requires the use of oral or parenteral corticosteroids
    • Clinically significant reactive airway disease that does not respond to bronchodilators
  13. Positive ELISA and confirmatory Western blot tests for HIV-1.
  14. Positive ELISA and confirmatory tests for hepatitis C virus (HCV).
  15. Positive hepatitis B surface antigen (HBsAg) by ELISA.
  16. Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, or autoimmune thrombocytopenia.
  17. Known immunodeficiency syndrome.
  18. Positive serum anti-dsDNA titer.
  19. Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of starting this study.
  20. Receipt of a live vaccine within past 4 weeks or a killed vaccine within past 2 weeks prior to entry into the study.
  21. History of a surgical splenectomy.
  22. Receipt of blood products within the past 6 months.
  23. Previous receipt of an investigational malaria vaccine.
  24. Receipt of antimalarial prophylaxis during the past 12 months, or receipt of chloroquine or related compounds (hydroxychloroquine, amodiaquine, or primaquine) in the 8 weeks prior to study entry.
  25. Prior malaria infection by history.
  26. Any medical, psychiatric, social, or occupational condition or other responsibility that, in the judgment of the Principal Investigator (PI), would interfere with the evaluation of study objectives.

EXCLUSION CRITERIA (MALI):

A volunteer will be excluded from participating in this trial if any one of the following criteria is fulfilled:

  1. Pregnancy as determined by a positive urine (Beta-hCG test at any point during the study (if female).
  2. If female, subject and her spouse have not used or are unwilling to use reliable contraceptive methods such as: abstinence, birth control pills or birth control patches or vaginal ring, diaphragm with spermicide, IUD (intrauterine device), condom with spermicide, progestin implant or injection, or surgical sterilization (hysterectomy, bilateral oophorectomy, tubal ligation) prior to enrollment to 3 months after the final vaccination. (At the time of vaccination, a female subject must have had a negative urine pregnancy test on 2 occasions at least 2 weeks apart, and must have used a reliable contraceptive method in the interim.)
  3. Currently is lactating and breast-feeding (if female).
  4. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, chronic infectious or renal disease by history, physical examination, and/or laboratory studies including urinalysis.
  5. Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and cooperate with the study protocol.
  6. Pre-existing known autoimmune diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, autoimmune thrombocytopenia.
  7. Laboratory evidence of possible autoimmune disease determined by anti-dsDNA titer that equals or exceeds 25 IU.
  8. Laboratory evidence of liver disease (alanine aminotransferase (ALT) greater than 1.25 times the upper limit of normal of the testing laboratory).
  9. Laboratory evidence of renal disease (serum creatinine greater than the upper limit of normal of the testing laboratory, or more than trace protein or blood on urine dipstick testing confirmed by repeat testing of clean-catch, midstream sample). (More than trace blood on urine dipstick will not exclude a female who is actively menstruating.)
  10. Laboratory evidence of hematologic disease (absolute leukocyte count less than 3000/mm(3) or greater than 11,500/mm(3); hemoglobin less than 0.9 times the lower limit of normal of the testing laboratory, by gender; absolute granulocyte count less than 1300/mm(3); absolute lymphocyte count less than 1000/mm(3); or platelet count less than 110,000/mm(3)).
  11. Other condition that, in the opinion of the investigator, would jeopardize the safety or rights of a volunteer participating in the trial or would render the subject unable to comply with the protocol.
  12. Participation in another investigational vaccine or drug trial within 30 days of starting this study, or while this study is ongoing.
  13. Volunteer 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. Severe asthma. This will be defined as:

    • Asthma that is unstable or required emergent care, urgent care, hospitalization or intubation during the past 2 years, or that requires the use of oral or parenteral corticosteroids
    • Clinically significant reactive airway disease that does not respond to bronchodilators
  16. Positive hepatitis B surface antigen (HBsAg). Hepatitis C antibody by rapid diagnostic test.
  17. Known immunodeficiency syndrome.
  18. Use of systemic corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of starting this study.
  19. Receipt of a live vaccine within past 4 weeks or a non-live vaccine within past 2 weeks prior to entry into the study.
  20. History of a surgical splenectomy.
  21. Receipt of blood products within the past 6 months.
  22. Previous receipt of an investigational malaria vaccine.
  23. History of use of chloroquine or related compounds (hydroxychloroquine, amodiaquine, or primaquine) within 8 weeks of study entry.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00889616

Contacts
Contact: Ruth D. Ellis, M.D. (703) 350-1936 ellisru@niaid.nih.gov

Locations
United States, Maryland
Johns Hopkins University Recruiting
Baltimore, Maryland, United States, 21205
Mali
Malaria Research and Training Center Recruiting
Bamako, Mali
Sponsors and Collaborators
  More Information

Publications:
Study ID Numbers: 999909134, 09-I-N134
Study First Received: April 28, 2009
Last Updated: May 7, 2009
ClinicalTrials.gov Identifier: NCT00889616     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Malaria
Asexual Blood Stafe
Plasmodium Falciparum
Immunogenicity
Safety

Study placed in the following topic categories:
Protozoan Infections
Immunologic Factors
Adjuvants, Immunologic
Antacids
Parasitic Diseases
Malaria
Aluminum Hydroxide

Additional relevant MeSH terms:
Protozoan Infections
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Coccidiosis
Physiological Effects of Drugs
Adjuvants, Immunologic
Antacids
Parasitic Diseases
Malaria
Pharmacologic Actions
Aluminum Hydroxide

ClinicalTrials.gov processed this record on May 07, 2009