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DiarrheaPhase 1NCT03869333

Dose Escalating Study of Intramuscular Invaplex[AR-DETOX]

A Phase 1 study testing Invaplex[AR-DETOX] 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
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Trial summary

The main purpose of this study is to evaluate the safety of a Shigella flexneri 2a detoxified artificial invasin complex (Invaplex[AR-Detox]) vaccine candidate administered by intramuscular immunization. Read more about this study

Who is it for?
Ages 18 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Diarrhea
What is being tested?
Invaplex[AR-DETOX]
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
58 participants
Where
1 siteUnited States
Study dates
18 Mar 2019to 12 Jun 2020
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 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy, adult, male or female, age 18 to 50 years (inclusive) at the time of enrollment.
  • Completion and review of comprehension test (achieved ≥ 70% accuracy, two attempts allowed).
  • Provide written informed consent before initiation of any study procedures.
  • Agrees to complete all study visits and procedures and to provide a screening stool sample.
  • Women of childbearing capacity: Negative pregnancy test with understanding (through informed consent process) to not become pregnant during the study or within three (3) months following the last vaccine dose.

Who cannot join

  • Health problems (for example, chronic medical conditions such as psychiatric conditions, diabetes mellitus, hypertension, or any other conditions that might place the subjects at increased risk of adverse events) - study clinicians, in consultation with the Principal Investigator (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.
  • History of autoimmune disorders, cardiovascular and renal disease.
  • Use of immunosuppressive medications (systemic corticosteroids or chemotherapeutics that may influence antibody development), or immunosuppressive 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 3 months beyond the last vaccine dose and currently nursing women.
  • Participation in research involving another investigational product (defined as receipt of an investigational product or exposure to an invasive investigational device) 30 days before planned date of first vaccination or anytime throughout the duration of the study until the last in-clinic study safety visit.
  • Positive blood test for hepatitis B surface antigen (HBsAG), hepatitis C virus antibody (HCV Ab), human immunodeficiency virus (HIV)-1/HIV-2 antibody.
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  • Clinically significant abnormalities on basic laboratory screening tests.
  • Systemic antimicrobial treatment (i.e., topical treatments are not an exclusion) within 1 week before administration of the first vaccine dose.
  • Allergies that may increase the risk of adverse events (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.
  • Personal or family history of an inflammatory arthritis.
  • Positive blood test for human leukocyte antigen (HLA) B27 (associated with increased risk of reactive arthritis secondary to Shigella infection)
  • History of allergy to any vaccine.
  • Exclusionary skin disease history/findings that would confound assessment or prevent appropriate local monitoring of AEs, or possibly increase the risk of a local AE.
  • Serum immunoglobulin G (IgG) titer > 2500 to Shigella flexneri 2a lipopolysaccharide antigen (LPS).
  • History of microbiologically confirmed Shigella infection.
  • Received previous licensed or experimental Shigella vaccine or live Shigella challenge.
  • Travel to countries where Shigella or other enteric infections are endemic (most of the developing world) within two years prior to dosing (clinician judgement).
  • Occupation involving handling of Shigella bacteria 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 Trials Center (WRAIR CTC)

    Silver Spring, Maryland, 20910

Other trials in United States

About this study

Official title: A Phase 1 Double-blind, Placebo-controlled, Dose Escalating Study of Intramuscular Detoxified Shigella Flexneri 2a Artificial Invasin Complex (Invaplex[AR-DETOX]) Vaccine

The main purpose of this study is to evaluate the safety of a Shigella flexneri 2a detoxified artificial invasin complex (Invaplex[AR-Detox]) vaccine candidate administered by intramuscular immunization.

Read the detailed description

This is a randomized, double-blind, placebo-controlled, Phase 1 clinical trial in which a total of 60 volunteers will receive one of three doses of Invaplex[AR-DETOX] or placebo (saline). The vaccine will be administered via intramuscular (IM) injection on study days 1, 22, and 43. Each participant will receive the same formulation at each vaccination dependent upon group assignment. The study will be initiated with the lowest dose level (2.5 μg) and will proceed to the next highest dose in an escalating fashion. All safety data will be summarized and reviewed by the Protocol Safety Review Team (PSRT) prior to dose-escalation.

Specimens will be collected at prescribed intervals to examine systemic and mucosal immune responses. Vaccine safety will be actively monitored during vaccination and for 28 days following the third vaccine dose.

Conditions
Diarrhea
Being tested
Invaplex[AR-DETOX], Placebo
Keywords
Shigella flexneri 2a, Enteric, Shigella
Medical subject headings
Diarrhea, Dysentery, Bacillary

What participants receive

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

  • Invaplex[AR-DETOX]Biological

    Detoxified Shigella flexneri 2a Artificial Invasin Complex (Invaplex[AR-Detox]) Vaccine

  • PlaceboOther

    Saline

Study groups in NCT03869333
Study groupRoleWhat they receive
Invaplex[AR-Detox] 2.5 μgExperimentalParticipants received an intramuscular injection of 2.5 μg Invaplex[AR-DETOX] vaccine on Days 1, 22, and 43.
Receives: Biological: Invaplex[AR-DETOX]
Invaplex[AR-Detox] 10 μgExperimentalParticipants received an intramuscular injection of 10 μg Invaplex[AR-DETOX] vaccine on Days 1, 22, and 43.
Receives: Biological: Invaplex[AR-DETOX]
Invaplex[AR-Detox] 25 μgExperimentalParticipants received an intramuscular injection of 25 μg Invaplex[AR-DETOX] vaccine on Days 1, 22, and 43.
Receives: Biological: Invaplex[AR-DETOX]
PlaceboPlacebo comparatorParticipants received an intramuscular injection of placebo solution on Days 1, 22, and 43.
Receives: Other: Placebo

What is being measured

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

  1. Percentage of Participants With Adverse Events

    All adverse events (AEs) were assessed for severity by the investigator according to the following scale:

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

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

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

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

    An AE was considered "serious" if it resulted in any of the following outcomes:

    • Death
    • Life-threatening AE
    • Inpatient hospitalization or prolongation of existing hospitalization
    • Persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions
    • Congenital anomaly/birth defect.

    The Investigator assessed the relationship of each adverse event to study drug.

    Measured: From first dose up to 28 days following the third immunization (71 days)

  2. Number of Participants With Solicited Adverse Events Up to 7 Days After Dose 1

    The solicited AEs for this study included:

    • Site pain
    • Site tenderness
    • Swelling
    • Induration (determined by investigator exam)
    • Site redness
    • Pruritus
    • Fever
    • Nausea
    • Vomiting
    • Abdominal pain
    • Diarrhea (loose stools)
    • Appetite change
    • Fatigue
    • Headache
    • Myalgias (general pain or soreness in muscles)
    • Arthralgias (general pain in joints)
    • Malaise

    Measured: 7 days after the first immunization (Days 1 to 7)

  3. Number of Participants With Solicited Adverse Events Up to 7 Days After Dose 2

    The solicited AEs for this study included:

    • Site pain
    • Site tenderness
    • Swelling
    • Induration (determined by investigator exam)
    • Site redness
    • Pruritus
    • Fever
    • Nausea
    • Vomiting
    • Abdominal pain
    • Diarrhea (loose stools)
    • Appetite change
    • Fatigue
    • Headache
    • Myalgias (general pain or soreness in muscles)
    • Arthralgias (general pain in joints)
    • Malaise

    Measured: 7 days after the second immunization (Days 22 to 28)

  4. Number of Participants With Solicited Adverse Events After Dose 3

    The solicited AEs for this study included:

    • Site pain
    • Site tenderness
    • Swelling
    • Induration (determined by investigator exam)
    • Site redness
    • Pruritus
    • Fever
    • Nausea
    • Vomiting
    • Abdominal pain
    • Diarrhea (loose stools)
    • Appetite change
    • Fatigue
    • Headache
    • Myalgias (general pain or soreness in muscles)
    • Arthralgias (general pain in joints)
    • Malaise

    Measured: 7 days after the third immunization (Days 43 to 49)

  5. Number of Participants With Unsolicited Adverse Events After Each Dose

    Measured: Dose 1: Days 1 to 21; Dose 2: Days 22 to 42; Dose 3: Days 43 to 71

Secondary outcomes (12)
  1. Geometric Mean Titer (GMT) of Serum Immunoglobulin A (IgA) Antibodies to Invaplex

    Measured: Days 1 (Baseline), 22, 43, 50, 57 and 71.

  2. Geometric Mean Titer (GMT) of Serum Immunoglobulin G (IgG) Antibodies to Invaplex

    Measured: Days 1 (Baseline), 22, 43, 50, 57 and 71.

  3. Geometric Mean Titer (GMT) of Immunoglobulin A Antibodies to Invaplex in α4β7+ Antibody in Lymphocyte Supernatant (ALS)

    Measured: Days 1 (Baseline), 8, 29, and 50

  4. Geometric Mean Titer of Immunoglobulin G Antibodies to Invaplex in α4β7+ Antibody in Lymphocyte Supernatant

    Measured: Days 1 (Baseline), 8, 29, and 50

  5. Percentage of Participants With a ≥ 4-fold Increase in Serum IgA Antibodies From Baseline

    Seroconversion was defined as ≥ 4-fold increase in antibody titer from Baseline.

    Measured: Days 1 (Baseline), 22 43, 50, 57 and 71

  6. Percentage of Participants With a ≥ 4-fold Increase in Serum IgG Antibodies From Baseline

    Seroconversion was defined as ≥ 4-fold increase in antibody titer from Baseline.

    Measured: Days 1 (Baseline), 22 43, 50, 57 and 71

  7. Percentage of Participants With a ≥ 4-fold Increase in ALS IgA From Baseline

    Seroconversion was defined as ≥ 4-fold increase in antibody titer from Baseline.

    Measured: Days 1 (Baseline), 8, 29, and 50

  8. Percentage of Participants With a ≥ 4-fold Increase in ALS IgG From Baseline

    Seroconversion was defined as ≥ 4-fold increase in antibody titer from Baseline.

    Measured: Days 1 (Baseline), 8, 29, and 50

  9. Geometric Mean Fold-rise (GMFR) in Serum IgA From Baseline

    Measured: Days 1 (Baseline), 22, 43, 50, 57 and 71.

  10. Geometric Mean Fold-rise in Serum IgG From Baseline

    Measured: Days 1 (Baseline), 22, 43, 50, 57 and 71.

  11. Geometric Mean Fold-rise in ALS IgA From Baseline

    Measured: Days 1 (Baseline), 8, 29, and 50

  12. Geometric Mean Fold-rise in ALS IgG From Baseline

    Measured: Days 1 (Baseline), 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 posted11 Mar 2019
  2. Study start18 Mar 2019
  3. Primary completion12 Jun 2020
  4. Study completion12 Jun 2020

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
Randomised
Intervention model
Sequential
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
58 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03869333
Sponsor's protocol ID
CVIA 064
Status last verified
May 2020
First submitted
4 Mar 2019
Last updated
29 Jul 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Invaplex[AR-DETOX] 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 20 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 29 Jul 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. Some participants in this study may receive a placebo. 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 29 Jul 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?

Percentage of Participants With Adverse Events (time frame: From first dose up to 28 days following the third immunization (71 days)). The study lists 5 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 29 Jul 2021.

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