RabiesPhase 1NCT04019444
Dosage-Escalation Study of the Safety and Immunogenicity of a Novel Rabies Vaccine ChAd155-RG vs. the Comparator RABAVERT Vaccine in Healthy Adult Subjects
A Phase 1 study testing ChAd155-RG and Rabies Vaccine in people with Rabies and Rabies Immunisation, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United States.
Trial summary
This is a single-center, observer-blinded, dosage-escalation trial to evaluate the safety, tolerability, reactogenicity, and immunogenicity of ChAd155-RG compared with RABAVERT in rabies virus-naïve healthy male and non-pregnant female adult subjects ages 18-49. Read more about this study
- Who is it for?
- Ages 18 to 49 yearsHealthy volunteers can take part
- Conditions the study is for
- Rabies, Rabies Immunisation
- What is being tested?
- ChAd155-RG and Rabies Vaccine
- Type of treatment
- Vaccines, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 50 participants
- Where
- 1 siteUnited States
- Study dates
- 19 Sep 2019to 24 Mar 2023
- 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 49 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Must be a male or female aged 18-49 years old (inclusive) at the time of first vaccination.
- Must be able to provide written informed consent.
- Must have a body mass index (BMI) = / >18.5 and <35.0 kg/m^2
- Must be in good health based on physical examination, vital signs*, medical history, safety labs**, and the investigator's clinical judgment.
- Vital signs must be within the normal ranges. If a subject has elevated systolic or diastolic blood pressure, subject may rest for 10 minutes in a quiet room and the blood pressure may be retaken.
- Safety lab normal ranges will be those used by the reference clinical lab. Protocol-specific criteria for individual subjects are listed in criteria #5.
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- Must have acceptable* lab values within 28 days before enrollment. *Acceptable values include:
- Hemoglobin: women >11.6 g/dL, men >13.1 g/dL
- White blood cells: >3,700 but <10,900 cells/mm^3
- Absolute neutrophil count: = / >1,500 cells/mm^3
- Absolute lymphocyte count: = / >850 cells/mm^3
- Platelets: >139,000 but <401,000 per mm^3
- Urine dipstick (clean urine sample): protein <1+, glucose negative
- Alanine transaminase and aspartate transaminase (ALT, AST) <1.1 x institutional upper limit of normal (ULN)
- Total bilirubin <1.1x institutional ULN
- Blood urea nitrogen (BUN) <1 x institutional ULN
- Serum creatinine <1x institutional ULN
- If lab screening tests are out of range, repeating them is permitted once, provided there is an alternative explanation for the out-of-range value.
- Women of childbearing potential* must have a negative serum pregnancy test at screening and negative urine pregnancy tests within 24 hours before each vaccination.
- Women of non-childbearing potential, defined as postmenopausal (any age with amenorrhea for = / >12 months without other known or suspected cause for amenorrhea), or surgically sterile [hysterectomy, bilateral tubal ligation, bilateral oophorectomy, or successful Essure(R) placement (permanent, non-surgical, non-hormonal sterilization)] with documented confirmation test = / >3 months after the procedure), are not required to use contraceptive methods.
- Women of childbearing potential must use an acceptable method of contraception* from 28 days before the first vaccination until = / >60 days after the last vaccination.
- Acceptable methods of contraception include: prescription oral contraceptives, contraceptive injections, intrauterine device (IUD), implants, vaginal ring, double-barrier method, contraceptive patch, male partner who had a vasectomy at least 6 months prior to study enrollment, abstinence (defined as refraining from heterosexual intercourse during participation in this trial [from 28 days before the first vaccination until = / >60 days after the last vaccination]).
- Female subjects must agree to not donate eggs (ova, oocytes) from the start of screening until = / >60 days after the last vaccination.
- Male subjects who have not had a vasectomy* and are sexually active with a woman of childbearing potential must agree to use an acceptable method of contraception**.
- Men who have had a vasectomy must have had the procedure performed at least 6 months prior to study enrollment.
- Acceptable methods of contraception must be used from the first vaccination until = / >60 days after the last vaccination, and include: abstinence (defined as refraining from heterosexual intercourse with a female partner of childbearing potential during participation in this trial [from 28 days before the first vaccination until = / >60 days after the last vaccination]; a double-barrier method, such as condom with spermicidal foam/gel/film/cream/suppository and partner with occlusive cap (diaphragm, cervical/vault caps); if the female partner is using an acceptable method of contraception (see Inclusion Criterion #7), a single-barrier method for the male subject is acceptable.
- Male subjects must agree to not donate sperm from the start of screening until = / >60 days after the last vaccination.
- Must be available and willing to participate for the duration of this trial.
- Must have a means to be contacted by telephone.
Who cannot join
- Was ever vaccinated with a licensed or investigational rabies vaccine* or was diagnosed with rabies exposure, infection, or disease.
- Includes RABAVERT and Imovax. Subject's verbal history will suffice.
- Has a higher risk than the average US resident with regard to exposure to rabies, per the Rabavert package insert and rabies vaccination recommendations from the CDC*.
- People at high risk of exposure to rabies, such as veterinarians, animal handlers, rabies laboratory workers, spelunkers, and rabies biologics production workers.
- People whose activities bring them into frequent contact with rabies virus or with possibly rabid animals.
- International travelers who are likely to come in contact with animals in parts of the world where rabies is common.
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- Was ever vaccinated with a licensed or investigational Ad vector or Ad vaccine.
- Is currently taking chloroquine or hydroxychloroquine.
- Was diagnosed with laboratory-confirmed COVID-19 (PCR or antigen-based test) in the preceding 28 days.
- Positive serology for HIV antibody, HCV antibody, or Hepatitis B surface antigen (HBsAg).
- Has known allergy or history of anaphylaxis or other serious adverse reaction to a vaccine or vaccine products*.
- Including egg products, aminoglycosides, gelatin, sorbitol, tris (hydroxymethyl)-amino methane (THAM), or any of the constituents of the study vaccines.
- Has severe allergy or anaphylaxis to latex.
- Has an acute illness or temperature = / >38.0 Degrees Celsius on Day 1*.
- Subjects with fever or acute illness on the day of vaccination may be re-assessed and enrolled if healthy or only minor residual symptoms remain within 3 days.
- Female subjects who are pregnant or breastfeeding, or planning to become pregnant while enrolled in this trial and at least 60 days after last vaccination.
- Has history of autoimmune disease, or clinically significant cardiac, pulmonary, hepatic, rheumatologic, or renal disease by history, physical examination, and/or lab studies.
- Has history of malignancy other than squamous cell or basal cell skin cancer, unless there has been surgical excision that is considered to have achieved cure*.
- Subjects with a history of skin cancer must not be vaccinated at the previous tumor site.
- Has known or suspected congenital or acquired immunodeficiency, or recent history or current use of immunosuppressive therapy*.
- Anti-cancer chemotherapy or radiation therapy within the preceding 6 months, or long-term (= / >2 weeks within the previous 3 months) systemic corticosteroid therapy (at a dosage of = / >0.5 mg/kg/day). Intranasal or topical prednisone (or equivalent) are allowed.
- Is post-organ and/or stem cell transplant, whether or not on chronic immunosuppressive therapy.
- Had major surgery (per the investigator's judgment) within 4 weeks before study entry or planned major surgery during this trial.
- Has history of diabetes mellitus type 1 or type 2, including cases controlled with diet alone.
- Note: history of isolated gestational diabetes is not an exclusion criterion.
- Has history of thyroidectomy, or thyroid disease requiring medication in the last 12 months.
- Has history of hypertension, even if medically controlled.
- Note: Vital signs must be normal by protocol toxicity grading scale. In the event of an abnormal heart rate or blood pressure due to physiological variation or activity, the subject may rest for 10 minutes in a quiet room, and then blood pressure and/or heart rate re-measured. Repeated vital signs may be used to determine eligibility.
- Received live attenuated vaccines from 30 days before first vaccination until 30 days after final vaccination*.
- Not including licensed or authorized COVID-19 vaccines.
- Received killed or inactivated vaccines from 14 days before first vaccination until 30 days after final vaccination*.
- Not including licensed COVID-19 vaccines
- Received experimental therapeutic agents within 3 months before first vaccination or plans to receive any experimental therapeutic agents during this trial*.
- That that in the opinion of the investigator would interfere with safety or immunogenicity assessments.
- Is currently participating or plans to participate in another clinical study which would involve receipt of the following:*
- An investigational product, blood drawing, or an invasive medical procedure that would require administration of anesthetics, intravenous (IV) dyes, or removal of tissue during this trial and, in the opinion of the investigator, would interfere with safety or immunogenicity assessments.
- -Includes endoscopy, bronchoscopy, and administration of IV contrast.
- Received blood products or immunoglobulin in the 3 months before study entry or planned use during this trial.
- Donated a unit of blood or blood products within 8 weeks before Day 1 or plans to donate blood or blood products during this trial.
- Has major psychiatric illness in the past 12 months that in the opinion of the investigator would preclude participation.
- Has current alcohol use or current or past abuse of recreational or narcotic drugs by history as judged by the investigator to potentially interfere with study adherence.
- Has a history of chronic urticaria.
- Has tattoos, scars, or other marks on both deltoid areas which would, in the opinion of the investigator, interfere with assessment of the vaccination site.
- Is a site employee* or staff who are paid entirely or partially by/through the OCRR contract for this trial, or staff who are supervised by the Principal Investigator (PI) or sub-investigators.
- Including the PI, sub-investigators listed on Form FDA 1572 or Investigator of Record Form.
- In the opinion of the investigator cannot communicate reliably, is unlikely to adhere to the requirements of this trial, or has any condition which would limit the ability to complete this trial.
- Has history of Guillain-Barre syndrome, meningitis, encephalitis, neuroparalysis, transient paralysis, myelitis, retrobulbar neuritis, multiple sclerosis, vertigo, or visual disturbances.
- Has a history of arterial or venous thrombosis, or thrombocytopenia that required medical attention.
Trial locations and contacts
1 site in 1 country.
United States1 site
The Hope Clinic of Emory University
Decatur, Georgia, 30030-1705
About this study
Official title: A Phase 1, Dosage-Escalation Study of the Safety and Immunogenicity of a Novel Rabies Vaccine ChAd155-RG vs. the Comparator RABAVERT Vaccine in Healthy Adult Subjects
This is a single-center, observer-blinded, dosage-escalation trial to evaluate the safety, tolerability, reactogenicity, and immunogenicity of ChAd155-RG compared with RABAVERT in rabies virus-naïve healthy male and non-pregnant female adult subjects ages 18-49. There are 4 dose groups: Group A will receive ChAd155-RG at the lower dosage (5x1010vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group B will receive ChAd155-RG at the higher dosage (1x1011vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group C will receive ChAd155-RG at the higher dosage (1x1011vp) on Days 1 and 15, and placebo injections on Days 8 and 22; Group D will receive RABAVERT at the standard dose (1 mL) on Days 1, 8, and 22, and a placebo injection on Day 15. Since this is a dosage-escalation study, sentinel subjects will be used at each dosage level before non-sentinel subjects will be enrolled. The study will be conducted at Emory University Vaccine and Treatment Evaluation Unit (VTEU). This trial is expected to take approximately 48 months to complete. The duration of each subject's participation is approximately 13 months, from recruitment through the last study visit. The primary objectives of this study are: 1) Assessment of the safety, tolerability, and reactogenicity of one dose of ChAd155-RG at 5x1010vp per dose, or one or two doses of ChAd155-RG at 1x1011vp per dose; 2) Comparison of the safety, tolerability, and reactogenicity of one or two doses of ChAd155-RG, with three doses of RABAVERT.
Read the detailed description
This is a single-center, observer-blinded, Phase 1, dosage-escalation trial to evaluate the safety, tolerability, reactogenicity, and immunogenicity of ChAd155-RG compared with RABAVERT in rabies virus-naïve healthy male and non-pregnant female adult subjects ages 18-49. Subjects who have never received a licensed or investigational rabies virus vaccine, or an Ad-based investigational vaccine, and who have never been exposed to a rabid animal will be eligible for enrollment. There are 4 dose groups: Group A will receive ChAd155-RG at the lower dosage (5x1010vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group B will receive ChAd155-RG at the higher dosage (1x1011vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group C will receive ChAd155-RG at the higher dosage (1x1011vp) on Days 1 and 15, and placebo injections on Days 8 and 22; Group D will receive RABAVERT at the standard dose (1 mL) on Days 1, 8, and 22, and a placebo injection on Day 15. Since this is a dosage-escalation study, sentinel subjects will be used at each dosage level before non-sentinel subjects will be enrolled. The SMC will review the available safety, reactogenicity, AE, and lab data of all the sentinel subjects, and will decide if the remaining non-sentinel subjects should be enrolled. The study will be conducted at Emory University Vaccine and Treatment Evaluation Unit (VTEU). This trial is expected to take approximately 48 months to complete. The duration of each subject's participation is approximately 13 months, from recruitment through the last study visit. The primary objectives of this study are: 1) Assessment of the safety, tolerability, and reactogenicity of one dose of ChAd155-RG at 5x1010vp per dose, or one or two doses of ChAd155-RG at 1x1011vp per dose; 2) Comparison of the safety, tolerability, and reactogenicity of one or two doses of ChAd155-RG, with three doses of RABAVERT. The secondary objective is to assess the serum rabies VNA levels by a standard, WHO-approved, RFFIT, as assessed by immune response kinetics (through approximately 12 months after first dose of vaccine), seroconversion rates, and peak GMT in each treatment arm.
- Conditions
- Rabies, Rabies Immunisation
- Being tested
- ChAd155-RG, Placebo, Rabies Vaccine
- Keywords
- Adults, ChAd155-RG, Dosage-Escalation, Healthy, Immunogenicity, RABAVERT, Rabies, Safety, Vaccine
- Medical subject headings
- Rabies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ChAd155-RGBiological
The ChAd155-RG Vaccine consists of a replication-defective group C ChAd, ChAd155, expressing RG under the control of the CMV promoter. The RG sequence cloned into the ChAd155 vector is a medoid, a natural viral strain with the highest average percent of amino acid identity among all RG sequences annotated in the NCBI database. The selected RG (NCBI strain AGN94271) shares an average 94% percent identity to the RGs in current vaccines.
PlaceboOther
0.9% Sodium Chloride, USP injection.
Rabies VaccineBiological
The RABAVERT Vaccine is an inactivated, purified chick embryo cell vaccine (PCECV). It consists of lyophilized rabies virus (strain Flury LEP) that has been propagated in chicken fibroblasts, inactivated with beta-propiolactone, and concentrated and purified by centrifugation
| Study group | Role | What they receive |
|---|---|---|
| Arm A | Experimental | One dose (1 ml (5x10^10 vp)) of ChAd155-RG vaccine administered intramuscularly on Day 1, and 1 ml of matching placebo administered intramuscularly on Days 8, 15, 22. N=14 (3 sentinel, 11 non-sentinel) Receives: Biological: ChAd155-RG; Other: Placebo |
| Arm B | Experimental | One dose (1 ml (1x10^11 vp)) of ChAd155-RG vaccine administered intramuscularly on Day 1, and 1 ml of matching placebo administered intramuscularly on Days 8, 15, 22. N=14 (3 sentinel, 11 non-sentinel) Receives: Biological: ChAd155-RG; Other: Placebo |
| Arm C | Experimental | Two doses (1 ml (1x10^11 vp) each) of ChAd155-RG vaccine administered intramuscularly on Day 1 (first dose) and Day 15 (second dose), and 1 ml of matching placebo administered intramuscularly on Days 8 and 22. N=10 Receives: Biological: ChAd155-RG; Other: Placebo |
| Arm D | Active comparator | Three doses (1 ml each) of RABAVERT vaccine administered intramuscularly on Day 1 (first dose), Day 8 (second dose), and Day 22 (third dose), and 1 ml of matching placebo administered intramuscularly on Day 15. N=12 (2 sentinel, 10 non-sentinel) Receives: Other: Placebo; Biological: Rabies Vaccine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number and Percentage of Participants With Solicited Injection Site Reactogenicity Events in Each Treatment Arm and Overall
Injection site reactogenicity events were solicited on a memory aid completed by participants from the time of each vaccination through Day 7 following each vaccination. Injection site reactogenicity events included pruritus, erythema, ecchymosis, induration/swelling, pain, and tenderness. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of injection site event reported. Participants reporting no injection site events are counted under "None".
Measured: Day 1 through Day 29
Number and Percentage of Participants With Solicited Systemic Reactogenicity Events in Each Treatment Arm and Overall
Systemic reactogenicity events were solicited on a memory aid completed by participants from the time of each vaccination through Day 7 following each vaccination. Systemic reactogenicity events included fever, chills/shivering/sweating, fatigue, malaise, myalgia and arthralgia (exclusive of the injection site), headache, and nausea. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of systemic event reported. Participants reporting no systemic events are counted under "None".
Measured: Day 1 through Day 29
Number and Percentage of Participants With Serious Adverse Events (SAEs) Considered Study Vaccine-Related in Each Treatment Arm and Overall
An AE or suspected AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect.
Events were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE.
Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no vaccine-related SAEs are counted under "None".
Measured: Day 1 through Day 381
Number and Percentage of Participants With Study Vaccine-related Lab Adverse Events (AEs) in Each Treatment Arm and Overall
Clinical safety lab parameters evaluated after receipt of vaccine (on Days 2, 8, 16, and Day 22) included WBCs, hemoglobin, platelets, absolute neutrophil count, absolute lymphocyte count, ALT, AST, total bilirubin, BUN, and creatinine. Lab events were assessed for relatedness and were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE.
Each lab event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no lab events are counted under "None".
Measured: Day 1 through Day 22
Number and Percentage of Participants With Unsolicited Study Vaccine-related Adverse Events (AEs) in Each Treatment Arm and Overall
Adverse events were defined as any untoward medical occurrence in a patient or clinical investigation participant administered a study product regardless of its causal relationship to the study product administration. Unsolicited, non-serious AEs were collected from participants from Day 1 through Day 28 after the last vaccination (Day 50).
Events were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE.
Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no vaccine-related AEs are counted under "None".
Measured: Day 1 through Day 50
Number and Percentage of Participants With New Onset of a Chronic Medical Condition in Each Treatment Arm and Overall
Participants were queried at each visit for the occurrence of new onset chronic medical conditions throughout the duration of the study.
Measured: Day 1 through Day 381
Number and Percentage of Participants With Serious Adverse Events (SAEs) in Each Treatment Arm and Overall
An AE or suspected AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect.
Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no SAEs are counted under "None".
Measured: Day 1 through Day 381
Secondary outcomes (3)
Percentage of Participants Seroconverting to Rabies Virus in Each Treatment Arm and Overall
Serum samples for rabies VNA were collected prior to vaccination (Day 1) and on Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381. Results from the rabies VNA RFFIT assay were reported in IU/mL, with a typical range of 1-15 IU/mL. Results beyond 15 IU/mL required dilution and retesting per the lab's standard operating procedures. The lower limit of quantification for the RFFIT assay is 0.1 IU/mL; values below the LLOQ were imputed as 1/2 the LLOQ, or 0.05 IU/mL. Seroconverting to rabies virus is defined as VNA concentration =0.5 IU/mL post-vaccination.
Measured: Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381
Rabies VNA Geometric Mean Titer
Serum samples for rabies VNA were collected prior to vaccination (Day 1) and on Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381. Results from the rabies VNA RFFIT assay were reported in IU/mL, with a typical range of 1-15 IU/mL. Results beyond 15 IU/mL required dilution and retesting per the lab's standard operating procedures. The lower limit of quantification for the RFFIT assay is 0.1 IU/mL; values below the LLOQ were imputed as 1/2 the LLOQ, or 0.05 IU/mL. The geometric mean titer was calculated for each study arm at each immunogenicity time point.
Measured: Day 1, Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381
Peak Rabies VNA Geometric Mean Titer
Serum samples for rabies VNA were collected prior to vaccination (Day 1) and on Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381. Results from the rabies VNA RFFIT assay were reported in IU/mL, with a typical range of 1-15 IU/mL. Results beyond 15 IU/mL required dilution and retesting per the lab's standard operating procedures. The lower limit of quantification for the RFFIT assay is 0.1 IU/mL; values below the LLOQ were imputed as 1/2 the LLOQ, or 0.05 IU/mL. Peak geometric mean titer was defined for each study arm as the geometric mean of the highest titer per participant across all post-vaccination antibody timepoints.
Measured: Day 8 through Day 381
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2019
- Study start19 Sep 2019
- Primary completion24 Mar 2023
- Study completion24 Mar 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for RabiesStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04019444
- Sponsor's protocol ID
- 17-0089
- Status last verified
- 5 Jul 2019
- First submitted
- 11 Jul 2019
- Last updated
- 3 Jun 2024
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Phadke VK, Gromer DJ, Rebolledo PA, Graciaa DS, Wiley Z, Sherman AC, Scherer EM, Leary M, Girmay T, McCullough MP, Min JY, Capone S, Sommella A, Vitelli A, Retallick J, Seetahal J, Koller M, Tsong R, Neill-Gubitz H, Mulligan MJ, Rouphael NG. Safety and immunogenicity of a ChAd155-vectored rabies vaccine compared with inactivated, purified chick embryo cell rabies vaccine in healthy adults. Vaccine. 2024 Dec 2;42(26):126441. doi: 10.1016/j.vaccine.2024.126441. Epub 2024 Oct 16.
PubMed 39418686
Study at a glance
From the registry record, last updated by the sponsor on 3 Jun 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1, Dosage-Escalation Study of the Safety and Immunogenicity of a Novel Rabies Vaccine ChAd155-RG vs. the Comparator RABAVERT Vaccine in Healthy Adult Subjects
- ClinicalTrials.gov ID
- NCT04019444
- Acronym / sponsor ID
- 17-0089
- Conditions
- Rabies, Rabies Immunisation
- Keywords
- Adults, ChAd155-RG, Dosage-Escalation, Healthy, Immunogenicity, RABAVERT, Rabies, Safety
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Study start
- 19 Sep 2019 (actual)
- Primary completion
- 24 Mar 2023 (actual)
- Study completion
- 24 Mar 2023 (actual)
- First posted
- 15 Jul 2019 (actual)
- Results
- Posted 10 Apr 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a single-center, observer-blinded, dosage-escalation trial to evaluate the safety, tolerability, reactogenicity, and immunogenicity of ChAd155-RG compared with RABAVERT in rabies virus-naïve healthy male and non-pregnant female adult subjects ages 18-49. There are 4 dose groups: Group A will receive ChAd155-RG at the lower dosage (5x1010vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group B will receive ChAd155-RG at the higher dosage (1x1011vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group C will receive ChAd155-RG at the higher dosage (1x1011vp) on Days 1 and 15, and placebo injections on Days 8 and 22; Group D will receive RABAVERT at the standard dose (1 mL) on Days 1, 8, and 22, and a placebo injection on Day 15. Since this is a dosage-escalation study, sentinel subjects will be used at each dosage level before non-sentinel subjects will be enrolled. The study will be conducted at Emory University Vaccine and Treatment Evaluation Unit (VTEU). This trial is expected to take approximately 48 months to complete. The duration of each subject's participation is approximately 13 months, from recruitment through the last study visit. The primary objectives of this study are: 1) Assessment of the safety, tolerability, and reactogenicity of one dose of ChAd155-RG at 5x1010vp per dose, or one or two doses of ChAd155-RG at 1x1011vp per dose; 2) Comparison of the safety, tolerability, and reactogenicity of one or two doses of ChAd155-RG, with three doses of RABAVERT.
Detailed description
This is a single-center, observer-blinded, Phase 1, dosage-escalation trial to evaluate the safety, tolerability, reactogenicity, and immunogenicity of ChAd155-RG compared with RABAVERT in rabies virus-naïve healthy male and non-pregnant female adult subjects ages 18-49. Subjects who have never received a licensed or investigational rabies virus vaccine, or an Ad-based investigational vaccine, and who have never been exposed to a rabid animal will be eligible for enrollment. There are 4 dose groups: Group A will receive ChAd155-RG at the lower dosage (5x1010vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group B will receive ChAd155-RG at the higher dosage (1x1011vp) on Day 1, then placebo injections on Days 8, 15, and 22; Group C will receive ChAd155-RG at the higher dosage (1x1011vp) on Days 1 and 15, and placebo injections on Days 8 and 22; Group D will receive RABAVERT at the standard dose (1 mL) on Days 1, 8, and 22, and a placebo injection on Day 15. Since this is a dosage-escalation study, sentinel subjects will be used at each dosage level before non-sentinel subjects will be enrolled. The SMC will review the available safety, reactogenicity, AE, and lab data of all the sentinel subjects, and will decide if the remaining non-sentinel subjects should be enrolled. The study will be conducted at Emory University Vaccine and Treatment Evaluation Unit (VTEU). This trial is expected to take approximately 48 months to complete. The duration of each subject's participation is approximately 13 months, from recruitment through the last study visit. The primary objectives of this study are: 1) Assessment of the safety, tolerability, and reactogenicity of one dose of ChAd155-RG at 5x1010vp per dose, or one or two doses of ChAd155-RG at 1x1011vp per dose; 2) Comparison of the safety, tolerability, and reactogenicity of one or two doses of ChAd155-RG, with three doses of RABAVERT. The secondary objective is to assess the serum rabies VNA levels by a standard, WHO-approved, RFFIT, as assessed by immune response kinetics (through approximately 12 months after first dose of vaccine), seroconversion rates, and peak GMT in each treatment arm.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Arm A | Experimental | Biological: ChAd155-RG, Other: PlaceboOne dose (1 ml (5x10^10 vp)) of ChAd155-RG vaccine administered intramuscularly on Day 1, and 1 ml of matching placebo administered intramuscularly on Days 8, 15, 22. N=14 (3 sentinel, 11 non-sentinel) |
| Arm B | Experimental | Biological: ChAd155-RG, Other: PlaceboOne dose (1 ml (1x10^11 vp)) of ChAd155-RG vaccine administered intramuscularly on Day 1, and 1 ml of matching placebo administered intramuscularly on Days 8, 15, 22. N=14 (3 sentinel, 11 non-sentinel) |
| Arm C | Experimental | Biological: ChAd155-RG, Other: PlaceboTwo doses (1 ml (1x10^11 vp) each) of ChAd155-RG vaccine administered intramuscularly on Day 1 (first dose) and Day 15 (second dose), and 1 ml of matching placebo administered intramuscularly on Days 8 and 22. N=10 |
| Arm D | Active comparator | Other: Placebo, Biological: Rabies VaccineThree doses (1 ml each) of RABAVERT vaccine administered intramuscularly on Day 1 (first dose), Day 8 (second dose), and Day 22 (third dose), and 1 ml of matching placebo administered intramuscularly on Day 15. N=12 (2 sentinel, 10 non-sentinel) |
Who may qualify
- Ages
- 18 to 49 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (29 listed)
- Must be a male or female aged 18-49 years old (inclusive) at the time of first vaccination.
- Must be able to provide written informed consent.
- Must have a body mass index (BMI) = / >18.5 and <35.0 kg/m^2
- Must be in good health based on physical examination, vital signs*, medical history, safety labs**, and the investigator's clinical judgment.
- Vital signs must be within the normal ranges. If a subject has elevated systolic or diastolic blood pressure, subject may rest for 10 minutes in a quiet room and the blood pressure may be retaken.
Key exclusion criteria (48 listed)
- Was ever vaccinated with a licensed or investigational rabies vaccine* or was diagnosed with rabies exposure, infection, or disease.
- Includes RABAVERT and Imovax. Subject's verbal history will suffice.
- Has a higher risk than the average US resident with regard to exposure to rabies, per the Rabavert package insert and rabies vaccination recommendations from the CDC*.
- Was ever vaccinated with a licensed or investigational Ad vector or Ad vaccine.
- Is currently taking chloroquine or hydroxychloroquine.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ChAd155-RGThe ChAd155-RG Vaccine consists of a replication-defective group C ChAd, ChAd155, expressing RG under the control of the CMV promoter. The RG sequence cloned into the ChAd155 vector is a medoid, a natural viral strain with the highest average percent of amino acid identity among all RG sequences annotated in the NCBI database. The selected RG (NCBI strain AGN94271) shares an average 94% percent identity to the RGs in current vaccines. | Biological | Arm A, Arm B, Arm C |
| Placebo0.9% Sodium Chloride, USP injection. | Other | Arm A, Arm B, Arm C, Arm D |
| Rabies VaccineThe RABAVERT Vaccine is an inactivated, purified chick embryo cell vaccine (PCECV). It consists of lyophilized rabies virus (strain Flury LEP) that has been propagated in chicken fibroblasts, inactivated with beta-propiolactone, and concentrated and purified by centrifugation | Biological | Arm D |
Primary outcome
Number and Percentage of Participants With Solicited Injection Site Reactogenicity Events in Each Treatment Arm and Overall
Time frame: Day 1 through Day 29
Injection site reactogenicity events were solicited on a memory aid completed by participants from the time of each vaccination through Day 7 following each vaccination. Injection site reactogenicity events included pruritus, erythema, ecchymosis, induration/swelling, pain, and tenderness. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of injection site event reported. Participants reporting no injection site events are counted under "None".
Number and Percentage of Participants With Solicited Systemic Reactogenicity Events in Each Treatment Arm and Overall
Time frame: Day 1 through Day 29
Systemic reactogenicity events were solicited on a memory aid completed by participants from the time of each vaccination through Day 7 following each vaccination. Systemic reactogenicity events included fever, chills/shivering/sweating, fatigue, malaise, myalgia and arthralgia (exclusive of the injection site), headache, and nausea. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of systemic event reported. Participants reporting no systemic events are counted under "None".
Number and Percentage of Participants With Serious Adverse Events (SAEs) Considered Study Vaccine-Related in Each Treatment Arm and Overall
Time frame: Day 1 through Day 381
An AE or suspected AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect. Events were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no vaccine-related SAEs are counted under "None".
Number and Percentage of Participants With Study Vaccine-related Lab Adverse Events (AEs) in Each Treatment Arm and Overall
Time frame: Day 1 through Day 22
Clinical safety lab parameters evaluated after receipt of vaccine (on Days 2, 8, 16, and Day 22) included WBCs, hemoglobin, platelets, absolute neutrophil count, absolute lymphocyte count, ALT, AST, total bilirubin, BUN, and creatinine. Lab events were assessed for relatedness and were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE. Each lab event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no lab events are counted under "None".
Number and Percentage of Participants With Unsolicited Study Vaccine-related Adverse Events (AEs) in Each Treatment Arm and Overall
Time frame: Day 1 through Day 50
Adverse events were defined as any untoward medical occurrence in a patient or clinical investigation participant administered a study product regardless of its causal relationship to the study product administration. Unsolicited, non-serious AEs were collected from participants from Day 1 through Day 28 after the last vaccination (Day 50). Events were determined to be related if there was a reasonable possibility that the study product caused the AE; that is, there was evidence to suggest a causal relationship between the study product and the AE. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no vaccine-related AEs are counted under "None".
Number and Percentage of Participants With New Onset of a Chronic Medical Condition in Each Treatment Arm and Overall
Time frame: Day 1 through Day 381
Participants were queried at each visit for the occurrence of new onset chronic medical conditions throughout the duration of the study.
Number and Percentage of Participants With Serious Adverse Events (SAEs) in Each Treatment Arm and Overall
Time frame: Day 1 through Day 381
An AE or suspected AE was considered "serious" if, in the view of either the investigator or sponsor, it resulted in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect. Each event was graded as mild, moderate, or severe. Participants are counted according to their maximum severity of event reported. Participants reporting no SAEs are counted under "None".
3 secondary outcomes
Percentage of Participants Seroconverting to Rabies Virus in Each Treatment Arm and Overall
Time frame: Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381
Rabies VNA Geometric Mean Titer
Time frame: Day 1, Day 8, Day 15, Day 22, Day 29, Day 91, Day 181, and Day 381
Peak Rabies VNA Geometric Mean Titer
Time frame: Day 8 through Day 381
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jun 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39418686Phadke VK, Gromer DJ, Rebolledo PA, Graciaa DS, Wiley Z, Sherman AC, Scherer EM, Leary M, Girmay T, McCullough MP, Min JY, Capone S, Sommella A, Vitelli A, Retallick J, Seetahal J, Koller M, Tsong R, Neill-Gubitz H, Mulligan MJ, Rouphael NG. Safety and immunogenicity of a ChAd155-vectored rabies vaccine compared with inactivated, purified chick embryo cell rabies vaccine in healthy adults. Vaccine. 2024 Dec 2;42(26):126441. doi: 10.1016/j.vaccine.2024.126441. Epub 2024 Oct 16.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing ChAd155-RG and Rabies Vaccine in people with Rabies and Rabies Immunisation, run by National Institute of Allergy and Infectious Diseases (NIAID) 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 29 inclusion and 48 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 3 Jun 2024. 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 10 Apr 2024). 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 and Percentage of Participants With Solicited Injection Site Reactogenicity Events in Each Treatment Arm and Overall (time frame: Day 1 through Day 29). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04019444, which also lists 1 linked publication.
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 3 Jun 2024.