A Two-dose Primary Vaccination Study of a Tetravalent Dengue Virus Purified Inactivated Vaccine vs. Placebo in Healthy Adults (in Puerto Rico) (DPIV-002)

Study Description

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Brief Summary:

This is a first time in humans (FTiH) study designed to assess the experimental TDENV-PIV vaccine in a predominantly dengue-primed adult population. The study is designed to afford a first time in humans (FTiH) safety and immunogenicity assessment of three TDENV-PIV vaccine candidates, each formulated with a different adjuvant: either aluminum hydroxide, AS01E or AS03B (adjuvants used in GSK Biologicals' hepatitis B candidate vaccine, malaria candidate vaccine and pandemic flu vaccine, respectively). Each vaccine candidate will contain 1 µg of purified virus antigen per each of the four DENV types. Additionally, the study will evaluate an alum adjuvanted TDENV-PIV vaccine candidate containing 4 µg of purified virus antigen per each of the four DENV types. The control group will receive a saline placebo. All experimental vaccinations will be administered according to a 2-dose schedule, 28 days apart. There is a parallel FTiH study that is conducted in the United States in a dengue-naive population using the same investigational vaccines.

Condition or disease	Intervention/treatment	Phase
Dengue Fever	Biological: Biological/Vaccine: 4 µg TDENV-PIV with Alum adjuvant; Biological: Biological/Vaccine: 1 µg TDENV-PIV with AS03B adjuvant; Other: Phosphate buffered saline; Biological: 1 µg TDENV-PIV with Alum adjuvant; Biological: 1 µg TDENV-PIV with AS01E adjuvant	Phase 1

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	100 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:	Prevention
Official Title:	A Phase I, Randomized, Placebo-Controlled, Observer-blind, Two-dose (0-28 Day Schedule) Primary Vaccination Study of WRAIR Tetravalent Dengue Virus Purified Inactivated Vaccine (TDENV-PIV) in Healthy Adults in Puerto Rico
Actual Study Start Date :	November 2012
Actual Primary Completion Date :	January 20, 2017
Actual Study Completion Date :	March 23, 2017

Arms and Interventions

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Arm	Intervention/treatment
Experimental: TDENV-PIV alum4; 4 µg TDENV-PIV with Alum adjuvant; 0.5 mL intramuscular injection at 0 and 28 days	Biological: Biological/Vaccine: 4 µg TDENV-PIV with Alum adjuvant
Experimental: TDENV-PIV AS03B; 1 µg TDENV-PIV with AS03B adjuvant; 0.5 mL intramuscular injection at 0 and 28 days	Biological: Biological/Vaccine: 1 µg TDENV-PIV with AS03B adjuvant
Placebo Comparator: Placebo; Phosphate buffered saline; 0.5 mL intramuscular injection at 0 and 28 days	Other: Phosphate buffered saline
Experimental: TDENV-PIV alum1; 1 µg TDENV-PIV with Alum adjuvant; 0.5 mL intramuscular injection at 0 and 28 days	Biological: 1 µg TDENV-PIV with Alum adjuvant
Experimental: TDENV-PIV AS01E; 1 µg TDENV-PIV with AS01E adjuvant; 0.5 mL intramuscular injection at 0 and 28 days	Biological: 1 µg TDENV-PIV with AS01E adjuvant

Outcome Measures

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Primary Outcome Measures :

1. Safety and reactogenicity of various TDENV-PIV formulations from Day 0 through 28 days after the second dose (Day 0 - Day 56) [ Time Frame: Up to Day 56 ]

   Safety and Reactogenicity:

   • Occurrence, intensity and relationship to vaccination of solicited local and general adverse events (AEs) during the 7-day follow-up period post each vaccination (Day 0-6)
   • Occurrence, intensity and relationship to vaccination of unsolicited AEs during the 28-day follow-up period post each vaccination (Day 0-27)
   • Hematological and biochemical levels at study visits on Days 0, 7, 28, 35 and 56
   • Occurrence of serious adverse events (SAEs) from Day 0 to Day 56
   • Occurrence of potential immune-mediated diseases (pIMDs) and medically attended AEs from Day 0 to Day 56
2. Humoral immunogenicity to each of four DENV types of various TDENV-PIV formulations 28 days after the second dose (Day 56) [ Time Frame: Day 56 ]

   Humoral Immunogenicity:

   Neutralizing antibody titers specific to each DENV type at Day 56

   • Geometric mean titers (GMTs) of neutralizing antibody titers to each DENV type
   • Rate of fold increases in neutralizing antibody from Day 0 for each DENV type
   • Seropositivity rates for each DENV type
   • Trivalent and tetravalent seropositivity rates

Secondary Outcome Measures :

1. Safety of various TDENV-PIV formulations, from Day 0 to Month 13 (Visits 1-11) [ Time Frame: Up to month 13 ]

   Safety:

   • Hematological and biochemical levels at study visits on Months 4, 7, 10 and Month 13
   • Occurrence of pIMDs and medically attended AEs from Day 0 to Month 13
   • Occurrence of any SAE from Day 0 to Month 13
2. Humoral immunogenicity to each of four DENV types of various TDENV-PIV formulations on Days 0, 7 and 28 and Months 7 and 13 [ Time Frame: Up to month 13 ]

   Humoral Immunogenicity:

   • Geometric mean titers (GMTs) of neutralizing antibody titers to each DENV type
   • Rate of fold increases in neutralizing antibody from Day 0 for each DENV type
   • Seropositivity rates for each DENV type
   • Trivalent and tetravalent seropositivity rates
3. • To evaluate the safety of various TDENV-PIV formulations from Month 14 through the end of the study (Visit 15) [ Time Frame: Up to the end of study (Month 37-39) ]
   Occurrence of serious adverse events (SAEs) related to study procedures from Month 14 to end of study (Month 37-39)

Eligibility Criteria

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Ages Eligible for Study:	20 Years to 39 Years (Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

• Subjects who the investigator believes can and will comply with the requirements of the protocol (e.g., completion of the diary cards, return for follow-up visits, etc.)
• A male or female between 20 and 39 years of age (inclusive) at the time of consent
• Written informed consent obtained from the subject
• Healthy subjects as established by medical history and clinical examination before entering into the study
• Subject has lived in the Caribbean for more than 10 years
• Female subjects of non-childbearing potential (non-childbearing potential is defined as having either a current tubal ligation at least three months prior to enrollment, hysterectomy, ovariectomy, or is post-menopause).

• Female subjects of childbearing potential may be enrolled in the study, if the subject has:

  • practiced adequate contraception for 30 days prior to vaccination, and
  • a negative urine pregnancy test on the day of vaccination, and
  • agreed to continue adequate contraception until two months after completion of the vaccination series

Exclusion Criteria:

• Use of any investigational or non-registered product (drug or vaccine) other than the study vaccines/placebo during the period starting 30 days preceding the first dose of study vaccine/placebo and/or planned use during the study period
• Chronic administration (defined as more than 14 days in total) of immunosuppressants or other immune-modifying drugs during the period starting 180 days prior to the first vaccine/placebo dose (for corticosteroids, this will mean prednisone ≥ 20 mg/day or equivalent; inhaled and topical steroids are allowed)
• Planned administration or administration of a vaccine/product not foreseen by the study protocol during the Exclusion:
• Use of any investigational or non-registered product (drug or vaccine) other than the study vaccines/placebo during the period starting 30 days preceding the first dose of study vaccine/placebo and/or planned use during the study period
• Chronic administration (defined as more than 14 days in total) of immunosuppressants or other immune-modifying drugs during the period starting 180 days prior to the first vaccine/placebo dose (for corticosteroids, this will mean prednisone ≥ 20 mg/day or equivalent; inhaled and topical steroids are allowed)
• Planned administration or administration of a vaccine/product not foreseen by the study protocol during the period starting 30 days prior to the first dose of vaccine/placebo until after the visit at Day 56 (if influenza activity warrants vaccination of healthy young adults, influenza vaccination will be encouraged and will not lead to study exclusion)
• Previous or planned administration of any other flavivirus vaccine (approved or investigational) for the entire study duration
• Previous receipt of any investigational dengue virus vaccine
• Concurrently participating in another clinical study, at any time during the study period, in which the subject has been or will be exposed to an investigational or a non-investigational product (pharmaceutical product or device).
• Any confirmed or suspected immunosuppressive or immunodeficient condition, based on medical history and physical examination (no laboratory testing required).
• Family history of congenital or hereditary immunodeficiency
• History of, or current auto-immune disease
• History of any reaction or hypersensitivity likely to be exacerbated by any component of the vaccine/placebo or related to a study procedure
• Major congenital defects or serious chronic illness
• History of any neurological disorders or seizures
• Acute disease and/or fever (≥37.5°C/99.5°F oral body temperature) at the time of enrollment (a subject with a minor illness, i.e., mild diarrhea, mild upper respiratory infection, etc., without fever, may be enrolled at the discretion of the investigator)
• Acute or chronic, clinically significant pulmonary, cardiovascular, hepatic or renal functional abnormality, as determined by physical examination or laboratory screening tests
• Administration of immunoglobulins and/or any blood products during the period starting 90 days preceding the first dose of study vaccine/placebo or planned administration during the study period
• History of chronic alcohol consumption and/or drug abuse
• Pregnant or lactating female or female planning to become pregnant or planning to discontinue contraceptive precautions
• A planned move to a location that will prohibit participating in the trial until study end for the participant
• Any other condition which, in the opinion of the investigator, prevents the subject from participating in the study.
• Subject seropositive for hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (anti-HCV), or human immunodeficiency virus antibodies (anti-HIV)
• Safety laboratory test results that are outside the normal limits for their age, gender, and locality at screening.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

Puerto Rico
Clinical Research Center, 1st Floor University Hospital
San Juan, Puerto Rico, 00936-5067

Sponsors and Collaborators

U.S. Army Medical Research and Materiel Command

GlaxoSmithKline

Walter Reed Army Institute of Research (WRAIR)

Investigators

Principal Investigator:	Clemente Diaz, MD	University of Puerto Rico

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Diaz C, Lin L, Martinez LJ, Eckels KH, Campos M, Jarman RG, De La Barrera R, Lepine E, Toussaint JF, Febo I, Innis BL, Thomas SJ, Schmidt AC. Phase 1 Randomized Study of a Tetravalent Dengue Purified Inactivated Vaccine in Healthy Adults from Puerto Rico. Am J Trop Med Hyg. 2018 Mar 5. doi: 10.4269/ajtmh.17-0627. [Epub ahead of print]

Responsible Party:	U.S. Army Medical Research and Materiel Command
ClinicalTrials.gov Identifier:	NCT01702857 History of Changes
Other Study ID Numbers:	S-12-12; 116614 ( Other Identifier: GSK ); WRAIR 1945 ( Other Identifier: WRAIR ); DPIV-002 ( Other Identifier: GSK Protocol # )
First Posted:	October 10, 2012
Last Update Posted:	May 23, 2017
Last Verified:	May 2017

Keywords provided by U.S. Army Medical Research and Materiel Command:

Dengue; Dengue fever; Dengue Hemorrhagic Fever; Flavivirus

Additional relevant MeSH terms:

Dengue; Arbovirus Infections; Virus Diseases; Flavivirus Infections; Flaviviridae Infections; RNA Virus Infections; Hemorrhagic Fevers, Viral; Vaccines	Aluminum sulfate; Aluminum Hydroxide; Immunologic Factors; Physiological Effects of Drugs; Adjuvants, Immunologic; Antacids; Molecular Mechanisms of Pharmacological Action; Gastrointestinal Agents