AzTrials
AzTrials

DiarrheaPhase 1NCT03404674

Dose Escalating Study of a Prototype CS6 Subunit Vaccine With a Modified Heat-labile Enterotoxin From Enterotoxigenic Escherichia Coli (ETEC)

A Phase 1 study testing CssBA and dmLT in people with Diarrhea, run by PATH at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study will evaluate the safety of a prototype Coli surface antigen 6 (CS6) subunit vaccine (CssBA) alone or in combination with Escherichia coli double mutant heat labile toxin (dmLT) given by intramuscular (IM) injection. Read more about this study

Who is it for?
Ages 18 to 45 yearsHealthy volunteers can take part
Conditions the study is for
Diarrhea
What is being tested?
CssBA and dmLT
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteUnited States
Study dates
16 Jan 2018to 26 Mar 2019
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy, adult, male or female, age 18 to 45 years (inclusive) at the time of enrollment.
  • Completion and review of comprehension test (achieved > 70% accuracy).
  • Signed informed consent document.
  • Available for the required follow-up period and scheduled clinic visits.
  • Women: Negative pregnancy test with understanding (through informed consent process) to not become pregnant during the study or within three (3) months following last vaccination.

Who cannot join

  • Health problems (for example, intercurrent febrile illness, chronic medical conditions such as psychiatric conditions, diabetes mellitus, hypertension or any other condition that might place the subject at increased risk of adverse events) - study clinicians, in consultation with the PI, will use clinical judgment on a case-by-case basis to assess safety risks under this criterion. The PI will consult with the Research Monitor as appropriate.
  • Clinically significant abnormalities on physical examination.
  • Immunosuppressive drugs (use of systemic corticosteroids or chemotherapeutics that may influence antibody development) or illness (including immunoglobulin A [IgA] deficiency, defined by serum IgA < 7 mg/dL).
  • Women who are pregnant or planning to become pregnant during the study period plus three (3) months beyond the last received dose and currently nursing women.
  • Participation in research involving another investigational product (defined as receipt of investigational product or exposure to invasive investigational device) 30 days before planned date of first vaccination or anytime through the last study safety visit.
  • Positive blood test for Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV), human immunodeficiency virus (HIV)-1/2.
Show all 18Show fewer
  • Clinically significant abnormalities on basic laboratory screening.
  • Exclusionary skin disease history/findings that would confound assessment or prevent appropriate local monitoring of adverse events (AEs), or possibly increase the risk of a local AE
  • History of chronic skin disease (clinician judgement)
  • Acute skin infection/eruptions on the upper arms including fungal infections, severe acne or active contact dermatitis
  • Allergies that may increase the risk of AEs
  • Regular use (weekly or more often) of antidiarrheal, anti-constipation, or antacid therapy
  • Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis; loose or liquid stools on other than an occasional basis
  • History of microbiologically confirmed ETEC or cholera infection in the last 3 years
  • Travel to countries where ETEC or V. cholerae or other enteric infections are endemic (most of the developing world) within 3 years prior to dosing (clinician judgement)
  • Symptoms consistent with Travelers' Diarrhea or concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study
  • Vaccination for or ingestion of ETEC, cholera, or E. coli heat labile toxin within 3 years prior to dosing
  • Occupation involving handling of ETEC or V. cholerae currently, or in the past 3 years

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Walter Reed Army Institute of Research Clinical Trial Center

    Silver Spring, Maryland, 20910

Other trials in United States

About this study

Official title: A Phase 1 Dose Escalating Study of a Prototype CS6 Subunit Vaccine With a Modified Heat-labile Enterotoxin From Enterotoxigenic Escherichia Coli (ETEC)

This study will evaluate the safety of a prototype Coli surface antigen 6 (CS6) subunit vaccine (CssBA) alone or in combination with Escherichia coli double mutant heat labile toxin (dmLT) given by intramuscular (IM) injection.

Read the detailed description

This is an open-label clinical trial in which a total of 50 participants will receive three injections of either CssBA alone, dmLT alone or CssBA + dmLT. The vaccine will be administered via IM injection to alternating deltoid regions on days 1, 22, and 43. Each participant will receive the same dose at each vaccination dependent upon group assignment. Group A is considered a pilot group in which all 3 doses will be administered and participants monitored for safety 7 days after the third vaccination, prior to the enrollment of participants in Group B.

Conditions
Diarrhea
Being tested
CssBA, dmLT
Keywords
ETEC, Escherichia coli, enteric
Medical subject headings
Diarrhea, Escherichia coli Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CssBABiological

    Also called spd_dsc16Bntd14CssBAB7A[His]₆

    Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B

  • dmLTBiological

    Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211

Study groups in NCT03404674
Study groupRoleWhat they receive
Group A1: CssBA 5 ugExperimentalParticipants received an intramuscular injection of 5 ug CssBA on days 1, 22, and 43.
Receives: Biological: CssBA
Group A2: DmLT 100 ngExperimentalParticipants received an intramuscular injection of 100 ng DmLT on days 1, 22, and 43.
Receives: Biological: dmLT
Group B: CssBA 5 ug + DmLT 100 ngExperimentalParticipants received an intramuscular injection of 5 ug CssBA + 100 ng dmLT on days 1, 22, and 43.
Receives: Biological: CssBA; Biological: dmLT
Group C: CssBA 5 ug + DmLT 500 ngExperimentalParticipants received an intramuscular injection of 5 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Receives: Biological: CssBA; Biological: dmLT
Group D: CssBA 15 ug + DmLT 500 ngExperimentalParticipants received an intramuscular injection of 15 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Receives: Biological: CssBA; Biological: dmLT
Group E: CssBA 45 ug + DmLT 500 ngExperimentalParticipants received an intramuscular injection of 45 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Receives: Biological: CssBA; Biological: dmLT

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Solicited Adverse Events

    Solicited adverse events included vaccine site pain, vaccine site pruritus, vaccine site rash/eruption, vaccine site swelling, vaccine site tenderness, fever, headache, diarrhea, arthralgia, myalgia, malaise, nausea, and vomiting.

    Adverse events were assessed for severity by the investigator according to the following:

    Mild (Grade 1): Does not interfere with routine activities, minimal level of discomfort

    Moderate (Grade 2): Interferes with routine activities, moderate level of discomfort

    Severe (Grade 3): Unable to perform routine activities, significant level of discomfort

    Potentially life-threatening (Grade 4): Hospitalization or emergency room (ER) visit for potentially life-threatening event

    Measured: From first vaccination to 28 days after the third vaccination, 71 days.

  2. Number of Participants With Unsolicited Adverse Events

    Adverse events were assessed for severity by the investigator according to the following:

    Mild (Grade 1): Does not interfere with routine activities Minimal level of discomfort

    Moderate (Grade 2): Interferes with routine activities Moderate level of discomfort

    Severe (Grade 3): Unable to perform routine activities Significant level of discomfort

    Potentially life-threatening (Grade 4): Hospitalization or emergency room (ER) visit for potentially life-threatening event

    Measured: From first vaccination to 28 days after the third vaccination, 71 days.

Secondary outcomes (12)
  1. Percentage of Participants With a Serum Immunologic Response to Coli Surface Antigen 6 (CS6)

    Serum samples were assayed for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA). Immunologic response was defined as a ≥ 4-fold increase in reciprocal endpoint titer between Baseline and any post-vaccination sample.

    Measured: Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70

  2. Percentage of Participants With a Serum Immunologic Response to Labile Toxin

    Serum samples were assayed for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA). Immunologic response was defined as a ≥ 4-fold increase in reciprocal endpoint titer between Baseline and any post-vaccination sample.

    Measured: Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70

  3. Percentage of Participants With a Mucosal Immunologic Response to Coli Surface Antigen 6 (CS6)

    Peripheral blood mononuclear cells (PBMCs) were collected to determine antibody responses from lymphocyte supernatant against CS6 at Baseline and 7 days after each vaccination. Antibody in lymphocyte supernatant (ALS) is an indirect quantification of antibody secreting cells (ASC) activated in the mucosa that circulate in the peripheral blood about seven days post-mucosal immunization/infection. After incubation, lymphocyte supernatant was assayed for antigen-specific IgG and IgA antibodies using ELISA.

    A positive ALS response was defined as a four-fold rise in antibody titers between Baseline and any post vaccination sample.

    Measured: Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50

  4. Percentage of Participants With a Mucosal Immunologic Response to Labile Toxin

    Peripheral blood mononuclear cells (PBMCs) were collected to determine antibody responses from lymphocyte supernatant against labile toxin at Baseline and 7 days after each vaccination. Antibody in lymphocyte supernatant (ALS) is an indirect quantification of antibody secreting cells (ASC) activated in the mucosa that circulate in the peripheral blood about seven days post-mucosal immunization/infection. After incubation, lymphocyte supernatant was assayed for antigen-specific IgG and IgA antibodies using ELISA.

    A positive ALS response was defined as a four-fold rise in antibody titers between Baseline and any post vaccination sample.

    Measured: Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50

  5. Geometric Mean Titer of Serum Anti-CS6 Immunoglobulin G Antibodies

    Serum samples were assayed for IgG antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA).

    Measured: Days 1, 22, and 43 pre-vaccination, and Day 70

  6. Geometric Mean Titer of Serum Anti-CS6 Immunoglobulin A Antibodies

    Serum samples were assayed for IgA antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA).

    Measured: Days 1, 22, and 43 pre-vaccination, and Day 70

  7. Geometric Mean Titer of Serum Anti-LT Immunoglobulin G Antibodies

    Serum samples were assayed for IgG antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA).

    Measured: Days 1, 22, and 43 pre-vaccination, and Day 70

  8. Geometric Mean Titer of Serum Anti-LT Immunoglobulin A Antibodies

    Serum samples were assayed for IgA antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA).

    Measured: Days 1, 22, and 43 pre-vaccination, and Day 70

  9. Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-CS6 Immunoglobulin G Antibodies

    Lymphocyte supernatant was assayed for IgG antibody titers against CS6 using ELISA.

    Measured: Days 1, 8, 29 and 50

  10. Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-CS6 Immunoglobulin A Antibodies

    Lymphocyte supernatant was assayed for IgA antibody titers against CS6 using ELISA.

    Measured: Days 1, 8, 29, and 50

  11. Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-LT Immunoglobulin G Antibodies

    Lymphocyte supernatant was assayed for IgG antibody titers against labile toxin using ELISA.

    Measured: Days 1, 8, 29, and 50

  12. Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-LT Immunoglobulin A Antibodies

    Lymphocyte supernatant was assayed for IgA antibody titers against labile toxin using ELISA.

    Measured: Days 1, 8, 29, and 50

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jan 2018
  2. Study start16 Jan 2018
  3. Primary completion26 Mar 2019
  4. Study completion26 Mar 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03404674
Sponsor's protocol ID
VAC-050
Status last verified
Nov 2020
First submitted
10 Jan 2018
Last updated
6 Jan 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing CssBA and dmLT in people with Diarrhea, run by PATH at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Jan 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Solicited Adverse Events (time frame: From first vaccination to 28 days after the third vaccination, 71 days.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jan 2021.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in