MalariaPhase 1NCT04206332
Trial to Evaluate CIS43LS in Healthy Adults
A Phase 1 study testing VRC-MALMAB0100-00-AB and Plasmodium falciparum (P. falciparum) sporozoite challenge in people with Malaria, run by National Institute of Allergy and Infectious Diseases (NIAID) at 2 sites in United States.
Trial summary
Background: People get malaria when they are bitten by an infected mosquito. Malaria can be serious and sometimes deadly. Although there are medicines to treat malaria, there is no vaccine that fully prevents infection. Researchers want to test if an experimental drug can help. Read more about this study
- Who is it for?
- Ages 18 to 50 yearsHealthy volunteers can take part
- Conditions the study is for
- Malaria
- What is being tested?
- VRC-MALMAB0100-00-AB and Plasmodium falciparum (P. falciparum) sporozoite challenge
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 71 participants
- Where
- 2 sitesUnited States
- Study dates
- 7 Jan 2020to 28 Feb 2022
- 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
- Able and willing to complete the informed consent process
- Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process
- Available for clinical follow-up through the last study visit
- 18 to 50 years of age
- In good general health without clinically significant medical history
- Physical examination without clinically significant findings within the 56 days prior to enrollment
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- Weight <= 115 kg (for all groups except Groups 5, 10, and 16) and < 100 kg for Group 15
- Adequate venous access if assigned to an IV group or adequate subcutaneous tissue if assigned to an SC group
- Willing to have blood samples collected, stored indefinitely, and used for research purposes
- Agrees to participate in a controlled human malaria infection (CHMI) and to comply with post-CHMI follow-up requirements (except Group 4B)
- Agrees to refrain from blood donation to blood banks for 3 years following participation in CHMI (except Group 4B)
- Agrees not to travel to a malaria endemic region during the entire course of study participation
- Laboratory Criteria within 56 days prior to enrollment:
- White Blood Cell (WBC) 2,500-12,000/mm^3
- WBC differential either within institutional normal range or accompanied by the Principal Investigator (PI) or designee approval
- Platelets = 125,000 - 500,000/mm^3
- Hemoglobin within institutional normal range or accompanied by the PI or designee approval
- Creatinine <= 1.1 x upper limit of normal (ULN)
- Alanine aminotransferase (ALT) <= 1.25 x ULN
- Negative for HIV infection by an FDA approved method of detection
- Laboratory Criteria documented any time prior to enrollment:
- Negative sickle cell screening test
- Negative troponin test (except Group 4B)
- Electrocardiogram (ECG) without clinically significant abnormalities (examples may include: pathologic Q waves, significant ST-T wave changes, left ventricular hypertrophy, any non-sinus rhythm excluding isolated premature atrial contractions, right or left bundle branch block, advanced A-V heart block). ECG abnormalities determined by a cardiologist to be clinically insignificant as related to study participation do not preclude study enrollment (except Group 4B)
- No evidence of increased cardiovascular disease risk; defined as >10% five-year risk by the non-laboratory method (except Group 4B)
- Criteria Specific to Women:
- Postmenopausal for at least 1 year, post-hysterectomy or bilateral oophorectomy, or if of childbearing potential:
- Negative beta-human chorionic gonadotropin (beta-HCG) pregnancy test (urine or serum) on day of enrollment, and prior to product administration and CHMI, and
- Agrees to use an effective means of birth control through the duration of study participation
Who cannot join
- Woman who is breast-feeding or planning to become pregnant during study participation
- Previous receipt of a malaria vaccine
- History of malaria infection
- History of severe infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) defined per FDA guidance
- Active SARS-CoV-2 infection
- Any history of a severe allergic reaction with generalized urticaria, angioedema or anaphylaxis prior to enrollment that has a reasonable risk of recurrence during the study
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- Hypertension that is not well controlled
- Receipt of any investigational study product within 28 days prior to enrollment (note: Emergency Use Authorization Coronavirus Disease 2019 (COVID-19) vaccine is not exclusionary)
- Receipt of any live attenuated vaccines within 28 days prior to enrollment
- Bleeding disorder diagnosed by a doctor (e.g. factor deficiency, coagulopathy, or platelet disorder requiring special precautions) or significant bruising or bleeding difficulties with intramuscular injections or blood draws
- History of a splenectomy, sickle cell disease or sickle cell trait
- History of skeeter syndrome or anaphylactic response to mosquito-bites (except Group 4B)
- Known intolerance to chloroquine phosphate, atovaquone or proguanil (except Group 4B)
- Use or planned use of any drug, including antibiotics, with antimalarial activity within 4 weeks prior to CHMI
- History of psoriasis or porphyria, which may be exacerbated after treatment with chloroquine (except Group 4B)
- Anticipated use of medications known to cause drug reactions with chloroquine or atovaquone-proguanil (Malarone) such as cimetidine, metoclopramide, antacids, and kaolin (except Group 4B)
- Any other chronic or clinically significant medical condition that in the opinion of the investigator would jeopardize the safety or rights of the volunteer, including but not limited to: diabetes mellitus type I, chronic hepatitis; OR clinically significant forms of: drug or alcohol abuse, asthma, autoimmune disease, psychiatric disorders, heart disease, or cancer
Trial locations and contacts
2 sites in 1 country.
United States2 sites
University of Maryland Baltimore, Center for Vaccine Development
Baltimore, Maryland, 21201-1595
VRC Clinic, NIH Clinical Center
Bethesda, Maryland, 20814
About this study
Official title: A Phase 1, Dose Escalation, Open-Label Clinical Trial With Experimental Controlled Human Malaria Infections (CHMI) to Evaluate Safety and Protective Efficacy of an Anti-Malaria Human Monoclonal Antibody, VRC-MALMAB0100-00-AB (CIS43LS), in Healthy, Malaria-Naive Adults
Background:
People get malaria when they are bitten by an infected mosquito. Malaria can be serious and sometimes deadly. Although there are medicines to treat malaria, there is no vaccine that fully prevents infection. Researchers want to test if an experimental drug can help.
Read more
Objective:
To test the safety and effectiveness of a drug called CIS43LS that could prevent malaria infection.
Eligibility:
Healthy people ages 18-50 who have never been infected with malaria
Design:
Participants were enrolled on the basis of eligibility criteria, evaluated by clinical laboratory tests, self-reported medical history, and physical examination.
Participants received CIS43LS either infused into a vein in their arm or injected into the fat under the skin. They were monitored for side effects for up to 4 hours after they received the drug. Participants received a thermometer and recorded their temperature and symptoms every day on/with/via a diary card for 7 days after administration. The administration site was checked for redness, swelling, itching or bruising.
Participants had up to 12 follow-up visits. At follow-up visits, participants had blood drawn and were checked for health changes or problems.
Most participants who received CIS43LS took part in a Controlled Human Malaria Infection Challenge (CHMI) along with control participants who did not receive CIS43LS. During the CHMI, mosquitoes carrying the malaria parasite bit participants in a controlled setting. The participants had clinic visits every day for up to 12 days starting 7 days after the CHMI. Participants were treated right away with antimalarial medication if they tested positive for malaria. Approximately 21 days after the CHMI, participants were treated with antimalarial medication for 3 days.
The study lasted 2-6 months depending on the participant's study group.
Read the detailed description
This was a multicenter, three-part, first-in-human, Phase 1, open-label, dose escalation study to evaluate the dose, safety, tolerability and protective efficacy of an anti-malaria human monoclonal antibody, VRC-MALMAB0100-00-AB (CIS43LS). The primary objective was to evaluate the safety and tolerability of CIS43LS when administered by either intravenous (IV) or subcutaneous (SC) routes. The secondary objectives were to evaluate the pharmacokinetics of CIS43LS at each dose level, determine if IV or SC administration will confer protection following a controlled human malaria infection (CHMI), and estimate the lowest protective dose of CIS43LS.
Part A: Part A evaluated the doses and routes in an open-label, dose escalation design.
Part B: Part B evaluated CIS43LS doses and routes prior to CHMI in participants previously enrolled in Part A and new Part B enrollees. A subgroup of participants from Part A continued to Part B, and some received a second CIS43LS dose intravenously. Additional participants were enrolled in Part B and received CIS43LS intravenously.
Part C: Part C evaluated CIS43LS doses and routes needed to reach a threshold of protection by assessing serum concentration prior to CHMI in a dose down design.
Study Product:
CIS43LS is a human immunoglobulin gamma-1 (IgG1) monoclonal antibody that was developed and manufactured by the National Institutes of Health (NIH) Vaccine Research Center (VRC). A recombinant Chinese hamster ovary DG44 clonal cell line14 developed by the Vaccine Production Program was transferred to the VRC pilot plant for clinical material manufacture. The study product was manufactured according to Good Manufacturing Practice at the VRC pilot plant operated by the Vaccine Clinical Materials Program, Leidos Biomedical Research (Frederick, MD, USA).
VRC-MALMAB0100-00-AB (CIS43LS) is a monoclonal antibody that recognizes a unique and conserved region of the Plasmodium falciparum (P. falciparum) circumsporozoite protein and incorporates an LS mutation to increase product half-life in plasma.
Participants:
A total of 71 participants enrolled in the study as follows:
Part A: 29 participants enrolled in Groups 1-5
Part B: 21* participants enrolled in Groups 6-10
*Out of the 21 Part B participants, 11 were newly enrolled and 10 were Part A participants who re-enrolled.
Of the 10 Part A participants who re-enrolled in Part B, 3 were back up participants who did not receive additional CIS43LS or CHMI and were terminated early because they were not needed.
Therefore, only 18 participants were actively enrolled in Part B: 11 newly enrolled and 7 Part A participants who re-enrolled.
Part C: 31 participants enrolled in Groups 11-16
Of the 71 participants enrolled, 47 participants received at least one dose of CIS43LS and 43 participants completed the CHMI.
Of the 47 participants who received CIS43LS, 4 participants who received a dose in Part A were also enrolled in Part B and received a second dose as follows:
- one participant received a 5 mg/kg IV dose in Part A and 20 mg/kg IV dose in Part B,
- one participant received a 5 mg/kg SC dose in Part A and 20 mg/kg IV dose in Part B, and
- two participants received a 20 mg/kg IV dose in Part A and Part B.
Therefore, a total of 51 doses of CIS43LS were administered to 47 participants as follows:
- 7 doses of 1 mg/kg IV
- 8 doses of 5 mg/kg SC
- 8 doses of 5 mg/kg IV
- 3 doses of 10 mg/kg IV
- 4 doses of 10 mg/kg SC
- 9 doses of 20 mg/kg IV and
- 12 doses of 40 mg/kg IV
Study Duration:
Participants who received CIS43LS were followed for up to 24 weeks after product administration. Control participants were followed through 7 weeks after CHMI.
- Conditions
- Malaria
- Being tested
- VRC-MALMAB0100-00-AB, Plasmodium falciparum (P. falciparum) sporozoite challenge
- Keywords
- Prevention and Control, Mosquito, Malaria Challenge, Parasitemia, Passive Immunization, Controlled Human Malaria Infection (CHMI)
- Medical subject headings
- Malaria, Parasitemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
VRC-MALMAB0100-00-ABDrug
Also called CIS43LS
VRC-MALMAB0100-00-AB (CIS43LS) is a monoclonal antibody that recognizes a unique and conserved region of the Plasmodium falciparum (P. falciparum) circumsporozoite protein and incorporates an LS mutation to increase product half-life in plasma.
Plasmodium falciparum (P. falciparum) sporozoite challengeOther
Participants were exposed to bites on the forearm from Anopheles stephensi mosquitoes infected with P. falciparum (3D7 strain).
| Study group | Role | What they receive |
|---|---|---|
| Part A, Group 1: CIS43LS (5 mg/kg IV) | Experimental | CIS43LS (5 mg/kg) administered by intravenous (IV) infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB |
| Part A, Group 2: CIS43LS (5 mg/kg SC) | Experimental | CIS43LS (5 mg/kg) administered by subcutaneous (SC) injection (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB |
| Part A, Group 3: CIS43LS (20 mg/kg IV) | Experimental | CIS43LS (20 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB |
| Part A, Group 4A: CIS43LS (40 mg/kg IV) | Experimental | CIS43LS (40 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB |
| Part A, Group 4B: CIS43LS (40 mg/kg IV) | Experimental | CIS43LS (40 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB |
| Part A, Group 5: CHMI Controls | No intervention | Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI); however, Group 5 did not undergo CHMI because of restrictions related to coronavirus disease 2019 (COVID-19) |
| Part B, Group 6: CIS43LS (5 mg/kg SC) | Experimental | CIS43LS (5 mg/kg) administered by SC injection (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part B, Group 7: CIS43LS (20 mg/kg IV) | Experimental | CIS43LS (20 mg/kg) administered by IV infusion (Day 0)
Part B, Group 7 participants included participants previously enrolled in Part A who received either 5 mg/kg IV (1), 5 mg/kg SC (1) or 20 mg/kg IV (2) in the first part of the study and newly enrolled Part B participants Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part B, Group 8: CHMI [CIS43LS (40 mg/kg IV) in Part A] | Other | Part B, Group 8 participants included participants previously enrolled in Part A who received CIS43LS (40 mg/kg IV) in the first part of the study but did not receive CIS43LS in Part B of the study. Group 8 participants were enrolled to complete the controlled human malaria infection (CHMI). Receives: Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part B, Group 9: CIS43LS (40 mg/kg IV) | Experimental | CIS43LS (40 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part B, Group 10: CHMI Controls | Other | Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI) Receives: Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 11: CIS43LS (1 mg/kg IV) | Experimental | CIS43LS (1 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 12: CIS43LS (5 mg/kg IV) | Experimental | CIS43LS (5 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 13: CIS43LS (5 mg/kg SC) | Experimental | CIS43LS (5 mg/kg) administered by SC injection (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 14: CIS43LS (10 mg/kg IV) | Experimental | CIS43LS (10 mg/kg) administered by IV infusion (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 15: CIS43LS (10 mg/kg SC) | Experimental | CIS43LS (10 mg/kg) administered by SC injection (Day 0) Receives: Drug: VRC-MALMAB0100-00-AB; Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
| Part C, Group 16: CHMI Controls | Other | Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI) Receives: Other: Plasmodium falciparum (P. falciparum) sporozoite challenge |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants Reporting Local Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration
Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Local Symptom" is the number of participants reporting any local symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.
Measured: 7 days after CIS43LS product administration, at approximately Week 1
Number of Participants Reporting Systemic Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration
Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Systemic Symptom" is the number of participants reporting any systemic symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.
Measured: 7 days after CIS43LS product administration, at approximately Week 1
Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following CIS43LS Product Administration
Unsolicited adverse event (AE) data collection included AEs of all severities from the date of product administration through the Day 28 post-product administration visit. At other time periods between study product administration and when greater than 4 weeks after the study product administration, only serious AEs (SAEs reported as a separate outcome and in the AE module) and new chronic medical conditions that required ongoing medical management (reported as a separate outcome) were recorded through the last study visit. The relationship between an AE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Measured: Day 0 through 4 weeks after CIS43LS product administration
Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following Controlled Human Malaria Infection (CHMI)
Unsolicited adverse event (AE) data collection included AEs of all severities from CHMI through the Day 28 post-CHMI visit. The relationship between an AE and CHMI was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Measured: Day 0 through 4 weeks after CHMI
Number of Participants With Serious Adverse Events (SAEs) Following CIS43LS Product Administration
SAEs were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a SAE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Measured: Day 0 after CIS43LS product administration through the study participation, up to Week 24
Number of Participants With New Chronic Medical Conditions Following CIS43LS Product Administration
New chronic medical conditions that required ongoing medical management were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a new chronic medical condition and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Measured: Day 0 after CIS43LS product administration through the study participation, up to Week 24
Number of Participants With Abnormal Laboratory Measures of Safety Following CIS43LS Product Administration
Abnormal laboratory results recorded as unsolicited adverse events (AEs) are summarized. Safety lab parameters included hematology (hemoglobin, hematocrit, mean corpuscular volume (MCV) platelets, and white blood cell (WBC), red blood cell (RBC), neutrophil, lymphocyte, monocyte, eosinophil and basophil counts) and chemistry (alanine aminotransferase (ALT) and creatinine). Complete Blood Count (CBC) with differential and Chemistry (ALT and creatinine) results were collected at different timepoints in Parts A, B and C throughout the study per the protocol's schedule of evaluations. Institutional laboratory normal ranges as well as the DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1 were used.
Measured: Day 0 through 4 weeks after CIS43LS product administration
Secondary outcomes (10)
Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part A and Part B)
Serum concentrations of CIS43LS by dose group following a single administration. Cmax is the peak serum concentration that CIS43LS achieves after it has been administered; it is determined as a maximum value on the summary pharmacokinetic (PK) curve for each study group. After subcutaneous injection, Cmax could not be fully calculated because of COVID-19-related interruptions in sample collection.
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part C)
Serum concentrations of CIS43LS by dose group following a single administration. Cmax is the peak serum concentration that CIS43LS achieves after it has been administered; it is determined as a maximum value on the summary pharmacokinetic (PK) curve for each study group.
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part A and Part B)
Tmax is the time it takes to reach Cmax of CIS43LS after it has been administered; it is determined based on the summary PK curve for each dose group.
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part C)
Tmax is the time it takes to reach Cmax of CIS43LS after it has been administered; it is determined based on the summary PK curve for each dose group.
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part A and Part B)
Beta half-life (T1/2b) is being reported for this study. Beta half-life (T1/2b) is the time required for half of the CIS43LS product to be eliminated from the serum. A two-compartmental population pharmacokinetic model with first order SC absorption was used to estimate overall beta half-life and bootstrap 90% confidence intervals (CIs).
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part C)
Beta half-life (T1/2b) is the time required for half of the CIS43LS product to be eliminated from the serum. A two-compartmental population pharmacokinetic model with first order SC absorption was used to estimate overall beta half-life and bootstrap 95% confidence intervals (CIs).
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part A and Part B)
Rate of CIS43LS elimination divided by the plasma CIS43LS concentration; determined based on the summary pharmacokinetic (PK) curve for each study group. A two-compartmental population pharmacokinetic model with first order SC absorption was used to estimate overall clearance and bootstrap 90% confidence intervals (CIs).
Measured: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part C)
Rate of CIS43LS elimination divided by the plasma CIS43LS concentration; determined based on the summary pharmacokinetic (PK) curve for each study group. A two-compartmental population pharmacokinetic model with first order SC absorption was used to estimate overall clearance and bootstrap 95% confidence intervals (CIs).
Measured: Baseline through 24 weeks after CIS43LS product administration
Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part B)
Parasitemia as determined by polymerase chain reaction (PCR) up to day 21 following CHMI to determine whether IV or SC administration of CIS43LS mediates protection against infectious P. falciparum following CHMI
Measured: Up to 21 days after CHMI
Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part C)
Parasitemia as determined by polymerase chain reaction (PCR) up to day 21 following CHMI to determine the lowest dose of CIS43LS administered IV and SC that confers protection against infectious P. falciparum following CHMI in Part C of the study
Measured: Up to 21 days after CHMI
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Dec 2019
- Study start7 Jan 2020
- Primary completion28 Feb 2022
- Study completion28 Feb 2022
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 (6)Papers the sponsor has linked to this study.
- Other trials for MalariaStudies 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
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 71 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
- Investigators
- Clinical Trials Program Leadership:ctpleadership@mail.nih.gov, Study director, VRC, National Institute of Allergy and Infectious Diseases, National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04206332
- Sponsor's protocol ID
- 200017
- Other IDs
- 20-I-0017
- Status last verified
- Apr 2023
- First submitted
- 19 Dec 2019
- Last updated
- 18 Apr 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) is not shared because it has limited value in a small phase 1 trial of healthy volunteers. We instead report non-IPD data as required in ClinicalTrials.gov.
Publications
Gaudinski MR, Coates EE, Novik L, Widge A, Houser KV, Burch E, Holman LA, Gordon IJ, Chen GL, Carter C, Nason M, Sitar S, Yamshchikov G, Berkowitz N, Andrews C, Vazquez S, Laurencot C, Misasi J, Arnold F, Carlton K, Lawlor H, Gall J, Bailer RT, McDermott A, Capparelli E, Koup RA, Mascola JR, Graham BS, Sullivan NJ, Ledgerwood JE; VRC 608 Study team. Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study. Lancet. 2019 Mar 2;393(10174):889-898. doi: 10.1016/S0140-6736(19)30036-4. Epub 2019 Jan 24.
PubMed 30686586Ishizuka AS, Lyke KE, DeZure A, Berry AA, Richie TL, Mendoza FH, Enama ME, Gordon IJ, Chang LJ, Sarwar UN, Zephir KL, Holman LA, James ER, Billingsley PF, Gunasekera A, Chakravarty S, Manoj A, Li M, Ruben AJ, Li T, Eappen AG, Stafford RE, K C N, Murshedkar T, DeCederfelt H, Plummer SH, Hendel CS, Novik L, Costner PJ, Saunders JG, Laurens MB, Plowe CV, Flynn B, Whalen WR, Todd JP, Noor J, Rao S, Sierra-Davidson K, Lynn GM, Epstein JE, Kemp MA, Fahle GA, Mikolajczak SA, Fishbaugher M, Sack BK, Kappe SH, Davidson SA, Garver LS, Bjorkstrom NK, Nason MC, Graham BS, Roederer M, Sim BK, Hoffman SL, Ledgerwood JE, Seder RA. Protection against malaria at 1 year and immune correlates following PfSPZ vaccination. Nat Med. 2016 Jun;22(6):614-23. doi: 10.1038/nm.4110. Epub 2016 May 9.
PubMed 27158907Seder RA, Chang LJ, Enama ME, Zephir KL, Sarwar UN, Gordon IJ, Holman LA, James ER, Billingsley PF, Gunasekera A, Richman A, Chakravarty S, Manoj A, Velmurugan S, Li M, Ruben AJ, Li T, Eappen AG, Stafford RE, Plummer SH, Hendel CS, Novik L, Costner PJ, Mendoza FH, Saunders JG, Nason MC, Richardson JH, Murphy J, Davidson SA, Richie TL, Sedegah M, Sutamihardja A, Fahle GA, Lyke KE, Laurens MB, Roederer M, Tewari K, Epstein JE, Sim BK, Ledgerwood JE, Graham BS, Hoffman SL; VRC 312 Study Team. Protection against malaria by intravenous immunization with a nonreplicating sporozoite vaccine. Science. 2013 Sep 20;341(6152):1359-65. doi: 10.1126/science.1241800. Epub 2013 Aug 8.
PubMed 23929949Kayentao K, Ongoiba A, Preston AC, Healy SA, Doumbo S, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Kisalu NK, Carlton K, Serebryannyy L, Narpala S, McDermott AB, Gaudinski M, Traore S, Cisse H, Keita M, Skinner J, Hu Z, Zeguime A, Ouattara A, Doucoure M, Dolo A, Djimde A, Traore B, Seder RA, Crompton PD; Mali Malaria mAb Trial Team. Safety and Efficacy of a Monoclonal Antibody against Malaria in Mali. N Engl J Med. 2022 Nov 17;387(20):1833-1842. doi: 10.1056/NEJMoa2206966. Epub 2022 Oct 31.
PubMed 36317783Gaudinski MR, Berkowitz NM, Idris AH, Coates EE, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Hu Z, Campos Chagas A, O'Connell S, Basappa M, Douek N, Narpala SR, Barry CR, Widge AT, Hicks R, Awan SF, Wu RL, Hickman S, Wycuff D, Stein JA, Case C, Evans BP, Carlton K, Gall JG, Vazquez S, Flach B, Chen GL, Francica JR, Flynn BJ, Kisalu NK, Capparelli EV, McDermott A, Mascola JR, Ledgerwood JE, Seder RA; VRC 612 Study Team. A Monoclonal Antibody for Malaria Prevention. N Engl J Med. 2021 Aug 26;385(9):803-814. doi: 10.1056/NEJMoa2034031. Epub 2021 Aug 11.
PubMed 34379916Lyke KE, Berry AA, Mason K, Idris AH, O'Callahan M, Happe M, Strom L, Berkowitz NM, Guech M, Hu Z, Castro M, Basappa M, Wang L, Low K, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Strauss KS, Joshi S, Shrestha B, Adams M, Chagas AC, Murphy JR, Stein J, Hickman S, McDougal A, Lin B, Narpala SR, Vazquez S, Serebryannyy L, McDermott A, Gaudinski MR, Capparelli EV, Coates EE, Wu RL, Ledgerwood JE, Dropulic LK, Seder RA; VRC 612 Part C Study Team. Low-dose intravenous and subcutaneous CIS43LS monoclonal antibody for protection against malaria (VRC 612 Part C): a phase 1, adaptive trial. Lancet Infect Dis. 2023 May;23(5):578-588. doi: 10.1016/S1473-3099(22)00793-9. Epub 2023 Jan 25.
PubMed 36708738
Study at a glance
From the registry record, last updated by the sponsor on 18 Apr 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1, Dose Escalation, Open-Label Clinical Trial With Experimental Controlled Human Malaria Infections (CHMI) to Evaluate Safety and Protective Efficacy of an Anti-Malaria Human Monoclonal Antibody, VRC-MALMAB0100-00-AB (CIS43LS), in Healthy, Malaria-Naive Adults
- ClinicalTrials.gov ID
- NCT04206332
- Acronym / sponsor ID
- 200017
- Conditions
- Malaria
- Keywords
- Prevention and Control, Mosquito, Malaria Challenge, Parasitemia, Passive Immunization, Controlled Human Malaria Infection (CHMI)
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 71 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Study start
- 7 Jan 2020 (actual)
- Primary completion
- 28 Feb 2022 (actual)
- Study completion
- 28 Feb 2022 (actual)
- First posted
- 20 Dec 2019 (actual)
- Results
- Posted 18 Apr 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background:
People get malaria when they are bitten by an infected mosquito. Malaria can be serious and sometimes deadly. Although there are medicines to treat malaria, there is no vaccine that fully prevents infection. Researchers want to test if an experimental drug can help.
Objective:
To test the safety and effectiveness of a drug called CIS43LS that could prevent malaria infection.
Eligibility:
Healthy people ages 18-50 who have never been infected with malaria
Design:
Participants were enrolled on the basis of eligibility criteria, evaluated by clinical laboratory tests, self-reported medical history, and physical examination.
Participants received CIS43LS either infused into a vein in their arm or injected into the fat under the skin. They were monitored for side effects for up to 4 hours after they received the drug. Participants received a thermometer and recorded their temperature and symptoms every day on/with/via a diary card for 7 days after administration. The administration site was checked for redness, swelling, itching or bruising.
Participants had up to 12 follow-up visits. At follow-up visits, participants had blood drawn and were checked for health changes or problems.
Most participants who received CIS43LS took part in a Controlled Human Malaria Infection Challenge (CHMI) along with control participants who did not receive CIS43LS. During the CHMI, mosquitoes carrying the malaria parasite bit participants in a controlled setting. The participants had clinic visits every day for up to 12 days starting 7 days after the CHMI. Participants were treated right away with antimalarial medication if they tested positive for malaria. Approximately 21 days after the CHMI, participants were treated with antimalarial medication for 3 days.
The study lasted 2-6 months depending on the participant's study group.
Detailed description
This was a multicenter, three-part, first-in-human, Phase 1, open-label, dose escalation study to evaluate the dose, safety, tolerability and protective efficacy of an anti-malaria human monoclonal antibody, VRC-MALMAB0100-00-AB (CIS43LS). The primary objective was to evaluate the safety and tolerability of CIS43LS when administered by either intravenous (IV) or subcutaneous (SC) routes. The secondary objectives were to evaluate the pharmacokinetics of CIS43LS at each dose level, determine if IV or SC administration will confer protection following a controlled human malaria infection (CHMI), and estimate the lowest protective dose of CIS43LS.
Part A: Part A evaluated the doses and routes in an open-label, dose escalation design.
Part B: Part B evaluated CIS43LS doses and routes prior to CHMI in participants previously enrolled in Part A and new Part B enrollees. A subgroup of participants from Part A continued to Part B, and some received a second CIS43LS dose intravenously. Additional participants were enrolled in Part B and received CIS43LS intravenously.
Part C: Part C evaluated CIS43LS doses and routes needed to reach a threshold of protection by assessing serum concentration prior to CHMI in a dose down design.
Study Product:
CIS43LS is a human immunoglobulin gamma-1 (IgG1) monoclonal antibody that was developed and manufactured by the National Institutes of Health (NIH) Vaccine Research Center (VRC). A recombinant Chinese hamster ovary DG44 clonal cell line14 developed by the Vaccine Production Program was transferred to the VRC pilot plant for clinical material manufacture. The study product was manufactured according to Good Manufacturing Practice at the VRC pilot plant operated by the Vaccine Clinical Materials Program, Leidos Biomedical Research (Frederick, MD, USA).
VRC-MALMAB0100-00-AB (CIS43LS) is a monoclonal antibody that recognizes a unique and conserved region of the Plasmodium falciparum (P. falciparum) circumsporozoite protein and incorporates an LS mutation to increase product half-life in plasma.
Participants:
A total of 71 participants enrolled in the study as follows:
Part A: 29 participants enrolled in Groups 1-5
Part B: 21* participants enrolled in Groups 6-10
*Out of the 21 Part B participants, 11 were newly enrolled and 10 were Part A participants who re-enrolled.
Of the 10 Part A participants who re-enrolled in Part B, 3 were back up participants who did not receive additional CIS43LS or CHMI and were terminated early because they were not needed.
Therefore, only 18 participants were actively enrolled in Part B: 11 newly enrolled and 7 Part A participants who re-enrolled.
Part C: 31 participants enrolled in Groups 11-16
Of the 71 participants enrolled, 47 participants received at least one dose of CIS43LS and 43 participants completed the CHMI.
Of the 47 participants who received CIS43LS, 4 participants who received a dose in Part A were also enrolled in Part B and received a second dose as follows:
- one participant received a 5 mg/kg IV dose in Part A and 20 mg/kg IV dose in Part B,
- one participant received a 5 mg/kg SC dose in Part A and 20 mg/kg IV dose in Part B, and
- two participants received a 20 mg/kg IV dose in Part A and Part B.
Therefore, a total of 51 doses of CIS43LS were administered to 47 participants as follows:
- 7 doses of 1 mg/kg IV
- 8 doses of 5 mg/kg SC
- 8 doses of 5 mg/kg IV
- 3 doses of 10 mg/kg IV
- 4 doses of 10 mg/kg SC
- 9 doses of 20 mg/kg IV and
- 12 doses of 40 mg/kg IV
Study Duration:
Participants who received CIS43LS were followed for up to 24 weeks after product administration. Control participants were followed through 7 weeks after CHMI.
Study design
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 17
| Arm | Type | Receives |
|---|---|---|
| Part A, Group 1: CIS43LS (5 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-ABCIS43LS (5 mg/kg) administered by intravenous (IV) infusion (Day 0) |
| Part A, Group 2: CIS43LS (5 mg/kg SC) | Experimental | Drug: VRC-MALMAB0100-00-ABCIS43LS (5 mg/kg) administered by subcutaneous (SC) injection (Day 0) |
| Part A, Group 3: CIS43LS (20 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-ABCIS43LS (20 mg/kg) administered by IV infusion (Day 0) |
| Part A, Group 4A: CIS43LS (40 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-ABCIS43LS (40 mg/kg) administered by IV infusion (Day 0) |
| Part A, Group 4B: CIS43LS (40 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-ABCIS43LS (40 mg/kg) administered by IV infusion (Day 0) |
| Part A, Group 5: CHMI Controls | No intervention | –Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI); however, Group 5 did not undergo CHMI because of restrictions related to coronavirus disease 2019 (COVID-19) |
| Part B, Group 6: CIS43LS (5 mg/kg SC) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (5 mg/kg) administered by SC injection (Day 0) |
| Part B, Group 7: CIS43LS (20 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (20 mg/kg) administered by IV infusion (Day 0) Part B, Group 7 participants included participants previously enrolled in Part A who received either 5 mg/kg IV (1), 5 mg/kg SC (1) or 20 mg/kg IV (2) in the first part of the study and newly enrolled Part B participants |
| Part B, Group 8: CHMI [CIS43LS (40 mg/kg IV) in Part A] | Other | Other: Plasmodium falciparum (P. falciparum) sporozoite challengePart B, Group 8 participants included participants previously enrolled in Part A who received CIS43LS (40 mg/kg IV) in the first part of the study but did not receive CIS43LS in Part B of the study. Group 8 participants were enrolled to complete the controlled human malaria infection (CHMI). |
| Part B, Group 9: CIS43LS (40 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (40 mg/kg) administered by IV infusion (Day 0) |
| Part B, Group 10: CHMI Controls | Other | Other: Plasmodium falciparum (P. falciparum) sporozoite challengeControl participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI) |
| Part C, Group 11: CIS43LS (1 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (1 mg/kg) administered by IV infusion (Day 0) |
| Part C, Group 12: CIS43LS (5 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (5 mg/kg) administered by IV infusion (Day 0) |
| Part C, Group 13: CIS43LS (5 mg/kg SC) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (5 mg/kg) administered by SC injection (Day 0) |
| Part C, Group 14: CIS43LS (10 mg/kg IV) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (10 mg/kg) administered by IV infusion (Day 0) |
| Part C, Group 15: CIS43LS (10 mg/kg SC) | Experimental | Drug: VRC-MALMAB0100-00-AB, Other: Plasmodium falciparum (P. falciparum) sporozoite challengeCIS43LS (10 mg/kg) administered by SC injection (Day 0) |
| Part C, Group 16: CHMI Controls | Other | Other: Plasmodium falciparum (P. falciparum) sporozoite challengeControl participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI) |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (29 listed)
Key exclusion criteria (17 listed)
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 |
|---|---|---|
| VRC-MALMAB0100-00-ABAlso: CIS43LSVRC-MALMAB0100-00-AB (CIS43LS) is a monoclonal antibody that recognizes a unique and conserved region of the Plasmodium falciparum (P. falciparum) circumsporozoite protein and incorporates an LS mutation to increase product half-life in plasma. | Drug | Part A, Group 1: CIS43LS (5 mg/kg IV), Part A, Group 2: CIS43LS (5 mg/kg SC), Part A, Group 3: CIS43LS (20 mg/kg IV), Part A, Group 4A: CIS43LS (40 mg/kg IV), Part A, Group 4B: CIS43LS (40 mg/kg IV), Part B, Group 6: CIS43LS (5 mg/kg SC), Part B, Group 7: CIS43LS (20 mg/kg IV), Part B, Group 9: CIS43LS (40 mg/kg IV), Part C, Group 11: CIS43LS (1 mg/kg IV), Part C, Group 12: CIS43LS (5 mg/kg IV), Part C, Group 13: CIS43LS (5 mg/kg SC), Part C, Group 14: CIS43LS (10 mg/kg IV), Part C, Group 15: CIS43LS (10 mg/kg SC) |
| Plasmodium falciparum (P. falciparum) sporozoite challengeParticipants were exposed to bites on the forearm from Anopheles stephensi mosquitoes infected with P. falciparum (3D7 strain). | Other | Part B, Group 10: CHMI Controls, Part B, Group 6: CIS43LS (5 mg/kg SC), Part B, Group 7: CIS43LS (20 mg/kg IV), Part B, Group 8: CHMI [CIS43LS (40 mg/kg IV) in Part A], Part B, Group 9: CIS43LS (40 mg/kg IV), Part C, Group 11: CIS43LS (1 mg/kg IV), Part C, Group 12: CIS43LS (5 mg/kg IV), Part C, Group 13: CIS43LS (5 mg/kg SC), Part C, Group 14: CIS43LS (10 mg/kg IV), Part C, Group 15: CIS43LS (10 mg/kg SC), Part C, Group 16: CHMI Controls |
Primary outcome
Number of Participants Reporting Local Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration
Time frame: 7 days after CIS43LS product administration, at approximately Week 1
Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Local Symptom" is the number of participants reporting any local symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.
Number of Participants Reporting Systemic Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration
Time frame: 7 days after CIS43LS product administration, at approximately Week 1
Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Systemic Symptom" is the number of participants reporting any systemic symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.
Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following CIS43LS Product Administration
Time frame: Day 0 through 4 weeks after CIS43LS product administration
Unsolicited adverse event (AE) data collection included AEs of all severities from the date of product administration through the Day 28 post-product administration visit. At other time periods between study product administration and when greater than 4 weeks after the study product administration, only serious AEs (SAEs reported as a separate outcome and in the AE module) and new chronic medical conditions that required ongoing medical management (reported as a separate outcome) were recorded through the last study visit. The relationship between an AE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following Controlled Human Malaria Infection (CHMI)
Time frame: Day 0 through 4 weeks after CHMI
Unsolicited adverse event (AE) data collection included AEs of all severities from CHMI through the Day 28 post-CHMI visit. The relationship between an AE and CHMI was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Number of Participants With Serious Adverse Events (SAEs) Following CIS43LS Product Administration
Time frame: Day 0 after CIS43LS product administration through the study participation, up to Week 24
SAEs were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a SAE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Number of Participants With New Chronic Medical Conditions Following CIS43LS Product Administration
Time frame: Day 0 after CIS43LS product administration through the study participation, up to Week 24
New chronic medical conditions that required ongoing medical management were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a new chronic medical condition and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.
Number of Participants With Abnormal Laboratory Measures of Safety Following CIS43LS Product Administration
Time frame: Day 0 through 4 weeks after CIS43LS product administration
Abnormal laboratory results recorded as unsolicited adverse events (AEs) are summarized. Safety lab parameters included hematology (hemoglobin, hematocrit, mean corpuscular volume (MCV) platelets, and white blood cell (WBC), red blood cell (RBC), neutrophil, lymphocyte, monocyte, eosinophil and basophil counts) and chemistry (alanine aminotransferase (ALT) and creatinine). Complete Blood Count (CBC) with differential and Chemistry (ALT and creatinine) results were collected at different timepoints in Parts A, B and C throughout the study per the protocol's schedule of evaluations. Institutional laboratory normal ranges as well as the DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1 were used.
10 secondary outcomes
Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part A and Part B)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part C)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part A and Part B)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part C)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part A and Part B)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part C)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part A and Part B)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part C)
Time frame: Baseline through 24 weeks after CIS43LS product administration
Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part B)
Time frame: Up to 21 days after CHMI
Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part C)
Time frame: Up to 21 days after CHMI
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Apr 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 30686586Gaudinski MR, Coates EE, Novik L, Widge A, Houser KV, Burch E, Holman LA, Gordon IJ, Chen GL, Carter C, Nason M, Sitar S, Yamshchikov G, Berkowitz N, Andrews C, Vazquez S, Laurencot C, Misasi J, Arnold F, Carlton K, Lawlor H, Gall J, Bailer RT, McDermott A, Capparelli E, Koup RA, Mascola JR, Graham BS, Sullivan NJ, Ledgerwood JE; VRC 608 Study team. Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study. Lancet. 2019 Mar 2;393(10174):889-898. doi: 10.1016/S0140-6736(19)30036-4. Epub 2019 Jan 24.
- Background: PubMed 27158907Ishizuka AS, Lyke KE, DeZure A, Berry AA, Richie TL, Mendoza FH, Enama ME, Gordon IJ, Chang LJ, Sarwar UN, Zephir KL, Holman LA, James ER, Billingsley PF, Gunasekera A, Chakravarty S, Manoj A, Li M, Ruben AJ, Li T, Eappen AG, Stafford RE, K C N, Murshedkar T, DeCederfelt H, Plummer SH, Hendel CS, Novik L, Costner PJ, Saunders JG, Laurens MB, Plowe CV, Flynn B, Whalen WR, Todd JP, Noor J, Rao S, Sierra-Davidson K, Lynn GM, Epstein JE, Kemp MA, Fahle GA, Mikolajczak SA, Fishbaugher M, Sack BK, Kappe SH, Davidson SA, Garver LS, Bjorkstrom NK, Nason MC, Graham BS, Roederer M, Sim BK, Hoffman SL, Ledgerwood JE, Seder RA. Protection against malaria at 1 year and immune correlates following PfSPZ vaccination. Nat Med. 2016 Jun;22(6):614-23. doi: 10.1038/nm.4110. Epub 2016 May 9.
- Background: PubMed 23929949Seder RA, Chang LJ, Enama ME, Zephir KL, Sarwar UN, Gordon IJ, Holman LA, James ER, Billingsley PF, Gunasekera A, Richman A, Chakravarty S, Manoj A, Velmurugan S, Li M, Ruben AJ, Li T, Eappen AG, Stafford RE, Plummer SH, Hendel CS, Novik L, Costner PJ, Mendoza FH, Saunders JG, Nason MC, Richardson JH, Murphy J, Davidson SA, Richie TL, Sedegah M, Sutamihardja A, Fahle GA, Lyke KE, Laurens MB, Roederer M, Tewari K, Epstein JE, Sim BK, Ledgerwood JE, Graham BS, Hoffman SL; VRC 312 Study Team. Protection against malaria by intravenous immunization with a nonreplicating sporozoite vaccine. Science. 2013 Sep 20;341(6152):1359-65. doi: 10.1126/science.1241800. Epub 2013 Aug 8.
- Background: PubMed 36317783Kayentao K, Ongoiba A, Preston AC, Healy SA, Doumbo S, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Kisalu NK, Carlton K, Serebryannyy L, Narpala S, McDermott AB, Gaudinski M, Traore S, Cisse H, Keita M, Skinner J, Hu Z, Zeguime A, Ouattara A, Doucoure M, Dolo A, Djimde A, Traore B, Seder RA, Crompton PD; Mali Malaria mAb Trial Team. Safety and Efficacy of a Monoclonal Antibody against Malaria in Mali. N Engl J Med. 2022 Nov 17;387(20):1833-1842. doi: 10.1056/NEJMoa2206966. Epub 2022 Oct 31.
- Results publication: PubMed 34379916Gaudinski MR, Berkowitz NM, Idris AH, Coates EE, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Hu Z, Campos Chagas A, O'Connell S, Basappa M, Douek N, Narpala SR, Barry CR, Widge AT, Hicks R, Awan SF, Wu RL, Hickman S, Wycuff D, Stein JA, Case C, Evans BP, Carlton K, Gall JG, Vazquez S, Flach B, Chen GL, Francica JR, Flynn BJ, Kisalu NK, Capparelli EV, McDermott A, Mascola JR, Ledgerwood JE, Seder RA; VRC 612 Study Team. A Monoclonal Antibody for Malaria Prevention. N Engl J Med. 2021 Aug 26;385(9):803-814. doi: 10.1056/NEJMoa2034031. Epub 2021 Aug 11.
- Results publication: PubMed 36708738Lyke KE, Berry AA, Mason K, Idris AH, O'Callahan M, Happe M, Strom L, Berkowitz NM, Guech M, Hu Z, Castro M, Basappa M, Wang L, Low K, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Strauss KS, Joshi S, Shrestha B, Adams M, Chagas AC, Murphy JR, Stein J, Hickman S, McDougal A, Lin B, Narpala SR, Vazquez S, Serebryannyy L, McDermott A, Gaudinski MR, Capparelli EV, Coates EE, Wu RL, Ledgerwood JE, Dropulic LK, Seder RA; VRC 612 Part C Study Team. Low-dose intravenous and subcutaneous CIS43LS monoclonal antibody for protection against malaria (VRC 612 Part C): a phase 1, adaptive trial. Lancet Infect Dis. 2023 May;23(5):578-588. doi: 10.1016/S1473-3099(22)00793-9. Epub 2023 Jan 25.
- NIH Clinical Center Detailed Web PageLink provided by the sponsor.
- Individual participant dataSharing planned: No. Individual participant data (IPD) is not shared because it has limited value in a small phase 1 trial of healthy volunteers. We instead report non-IPD data as required in ClinicalTrials.gov.
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Recruiting
The Effects of Iron Treatment on Vaccine Immunogenicity in Kenyan Infants With Iron Deficiency
Iron Deficiencies
RecruitingObservational study
Host and Parasite Factors That Influence Susceptibility to Malaria Infection and Disease During Pregnancy and Early Childhood in Ouelessebougou and Bamako, Mali
Malaria
RecruitingPhase 1
Safety, Tolerability and Efficacy of PfSPZ-LARC2 Vaccine Against CHMI in Malaria-Naïve Adults
Malaria Falciparum
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.
Clinical Trials Program Leadership:ctpleadership@mail.nih.gov study director
VRC, National Institute of Allergy and Infectious Diseases, National Institutes of Health
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing VRC-MALMAB0100-00-AB and Plasmodium falciparum (P. falciparum) sporozoite challenge in people with Malaria, run by National Institute of Allergy and Infectious Diseases (NIAID) at 2 sites 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 17 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 18 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites 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 18 Apr 2023). 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 Reporting Local Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration (time frame: 7 days after CIS43LS product administration, at approximately Week 1). 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 NCT04206332, which also lists 6 linked publications.
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 18 Apr 2023.