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Evaluating the Safety, Tolerability and Immunogenicity of bacTRL-Spike Vaccine for Prevention of COVID-19

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ClinicalTrials.gov Identifier: NCT04334980
Recruitment Status : Not yet recruiting
First Posted : April 6, 2020
Last Update Posted : June 29, 2020
Sponsor:
Information provided by (Responsible Party):
Symvivo Corporation

Tracking Information
First Submitted Date  ICMJE March 31, 2020
First Posted Date  ICMJE April 6, 2020
Last Update Posted Date June 29, 2020
Estimated Study Start Date  ICMJE July 2020
Estimated Primary Completion Date August 31, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 20, 2020)
Frequency of Adverse Events [ Time Frame: Up to12 months post-vaccination ]
Adverse events (specifically including incidence of gastrointestinal-associated events) following administration of oral bacTRL-Spike
Original Primary Outcome Measures  ICMJE
 (submitted: April 2, 2020)
Frequency of Adverse Events [ Time Frame: From the time of administration of oral bacTRL-Spike up to 12 months post-vaccination. ]
Adverse events following administration of oral bacTRL-Spike
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 25, 2020)
  • Immune response against SARS-CoV-2 Spike protein [ Time Frame: Baseline (pre-vaccination), and 1, 3 and 12 months post-vaccination ]
    Antibody against SARS-CoV-2 Spike protein
  • Incidence of COVID-19 infection [ Time Frame: Up to 12 months post-vaccination ]
    Incidence and clinical phenotype of confirmed and probable COVID-19 infection among vaccinated participants, based on current public health definitions
  • bacTRL-Spike in stool post-vaccination [ Time Frame: Days 7, 14, 21, and 1 and 3 months post-vaccination ]
    Isolation of viable bacTRL-Spike from stool post-vaccination
  • Seroconversion of circulating anti-Spike IgG antibodies & stability of serum IgG titers [ Time Frame: Up to 12 months post-vaccination ]
    Collection of biological samples for future studies to understand immunity against SARS-CoV-2.
  • Effectiveness of intestinal colonization of the probiotic-based bacTRL-Spike oral vaccine [ Time Frame: Up to 12 months post-vaccination ]
    Collection of biological samples for future studies to understand immunity against SARS-CoV-2.
Original Secondary Outcome Measures  ICMJE
 (submitted: April 2, 2020)
  • SARS-CoV-2 antibodies [ Time Frame: Baseline (pre-vaccination), and 1, 3 and 12 months post-vaccination ]
    Antibody against SARS-CoV-2 Spike protein
  • Incidence of COVID-19 infection [ Time Frame: Up to 12 months post-vaccination ]
    Incidence and clinical phenotype of confirmed and probable COVID-19 infection among vaccinated participants, based on current public health definitions
  • bacTRL-Spike in stool post-vaccination [ Time Frame: Days 7, 14, 21, and 1 and 3 months post-vaccination ]
    Isolation of viable bacTRL-Spike from stool post-vaccination
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Evaluating the Safety, Tolerability and Immunogenicity of bacTRL-Spike Vaccine for Prevention of COVID-19
Official Title  ICMJE A Phase 1, Randomized, Observer-Blind, Placebo-Controlled Trial to Evaluate the Safety, Tolerability and Immunogenicity of the bacTRL-Spike Oral Candidate Vaccine for the Prevention of COVID-19 in Healthy Adults
Brief Summary Protocol bacTRL-Spike-1 will be the first-in-human study of bacTRL-Spike, and the first-in-human use of orally delivered bacTRL. Each oral dose of bacTRL-Spike contains bacterial medium with either 1 billion (Group 1A), 3 billion (Group 2A) or 10 billion (Group 3A) colony-forming-units of live Bifidobacterium longum, which has been engineered to deliver plasmids containing synthetic DNA encoding spike protein from SARS-CoV-2. Placebo will consist of bacterial medium without bacteria.
Detailed Description

Protocol bacTRL-Spike-1 will be the first-in-human study of bacTRL-Spike, and the first-in-human use of orally delivered bacTRL. The trial is designed to evaluate the safety and tolerability of orally delivered bacTRL-Spike vaccine in healthy adults.

Total anticipated enrollment is n=112, including 84 receiving active vaccine in bacterial medium and 28 receiving placebo (bacterial medium only). The distribution of the sample size will be as follows:

  • Group 1A (n=21): Single dose of bacTRL-Spike, equivalent to 1 billion colony forming units (cfu) of Bifidiobacterium longum (B. longum);
  • Group 1B (n=7): Single dose of placebo;
  • Group 2A (n=21): Single dose of bacTRL-Spike, equivalent to 3 billion cfu of B. longum;
  • Group 2B (n=7): Single dose of placebo;
  • Group 3A (n=21): Single dose of bacTRL-Spike, equivalent to 10 billion cfu of B. longum;
  • Group 3B (n=7): Single dose of placebo
  • Group 4A (n=21): Single Data and Safety Monitoring Board (DSMB)-defined dose of bacTRL-Spike among subjects 56 years of age and older;
  • Group 4B (n=7): Single dose of placebo among subjects 56 years of age and older.

The planned trial duration is 18 months.

Each participant will remain in the trial for 12-13 months, including a screening phase of up to 14 days, intervention phase of 1 day and follow-up phase of 12 months.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Masking Description:
This is an observer-blinded study. Both participants and the study center staff performing outcome measurement are blinded; oral vaccines will be prepared by qualified unblinded study personnel who have no other role in the study. Testing laboratory personnel will also be blinded.
Primary Purpose: Prevention
Condition  ICMJE COVID-19
Intervention  ICMJE
  • Biological: bacTRL-Spike
    Each oral dose of bacTRL-Spike contains bacterial medium with either 1 billion (Group 1A), 3 billion (Group 2A) or 10 billion (Group 3A) colony-forming-units of live Bifidobacterium longum, which has been engineered to deliver plasmids containing synthetic DNA encoding spike protein from SARS-CoV-2.
  • Other: Placebo
    Placebo consists of bacterial medium without bacteria.
Study Arms  ICMJE
  • Experimental: bacTRL-Spike Group 1A
    • Group 1A (n=21): Single dose of bacTRL-Spike, equivalent to 1 billion colony forming units (cfu) of Bifidiobacterium longum;
    Intervention: Biological: bacTRL-Spike
  • Experimental: bacTRL-Spike Group 2A
    • Group 2A (n=21): Single dose of bacTRL-Spike, equivalent to 3 billion colony forming units (cfu) of Bifidobacterium longum;
    Intervention: Biological: bacTRL-Spike
  • Experimental: bacTRL-Spike Group 3A
    • Group 3A (n=21): Single dose of bacTRL-Spike, equivalent to 10 billion colony forming units (cfu) of Bifidobacterium longum;
    Intervention: Biological: bacTRL-Spike
  • Experimental: bacTRL-Spike Group 4A
    • Group 4A (n=21): Single Data and Safety Monitoring Board (DSMB)-defined dose of bacTRL-Spike among subjects 56 years of age and older;
    Intervention: Biological: bacTRL-Spike
  • Placebo Comparator: Placebo Group 1B
    • Group 1B (n=7): Single dose of placebo;
    Intervention: Other: Placebo
  • Placebo Comparator: Placebo Group 2B
    • Group 2B (n=7): Single dose of placebo;
    Intervention: Other: Placebo
  • Placebo Comparator: bacTRL-Spike Group 3B
    • Group 3B (n=7): Single dose of placebo.
    Intervention: Other: Placebo
  • Placebo Comparator: Placebo Group 4B
    • Group 4B (n=7): Single dose of placebo among subjects 56 years of age and older.
    Intervention: Other: Placebo
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Not yet recruiting
Estimated Enrollment  ICMJE
 (submitted: June 25, 2020)
112
Original Estimated Enrollment  ICMJE
 (submitted: April 2, 2020)
84
Estimated Study Completion Date  ICMJE December 31, 2021
Estimated Primary Completion Date August 31, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria

A participant must meet ALL of the following criteria:

  1. Age 18 years inclusive at time of enrollment and older;
  2. Capable to and does provide written informed consent;
  3. Able to understand and agrees to comply with planned study procedures and be available for all study visits;
  4. Body Mass Index 18-35 kg/square meter, inclusive, at screening;
  5. Male or non-pregnant, non-breastfeeding females who agree to comply with applicable contraceptive requirements of the protocol (see Table 1: Acceptable Contraceptive Methods.) Women of childbearing potential must have a negative urine or serum pregnancy test within 24 hours prior to initiation of vaccination;
  6. Pulse no greater than 100 beats per minute;
  7. Systolic blood pressure (BP) is 85 to 150 mmHg, inclusive;
  8. Clinical screening laboratory evaluations:

    • Absolute neutrophil count (ANC) ≥1500 cells/mm3
    • Hemoglobin ≥12.0 g/dL for men and ≥11.0 g/dL for women
    • Platelet count ≥120,000/mm3
    • Creatinine clearance (CrCl) >80 mL/min ); Refer to the calculator located on the Frontier Science and Technology Research Foundation (FSTRF) website (at https://www.frontierscience.org/): Calculated Creatinine Clearance - Cockcroft-Gault Equation (Adult).
    • Aspartate aminotransferase (AST) <1.25 x upper limit of normal (ULN)
    • Alanine aminotransferase (ALT) <1.25 x ULN
    • Alkaline phosphatase <2.0 x ULN
    • Total bilirubin <1.1 x ULN
    • Lipase <1.1 x ULN
    • Prothrombin time (PT) <1.1 x ULN
    • Partial thromboplastin time (PTT) <1.1 x ULN
    • CRP < 2.0 x ULN
  9. Agree to have samples stored for secondary research related to coronaviruses.

Exclusion Criteria

A participant who meets ANY of the following criteria will be excluded from participation in this study:

  1. Positive pregnancy test either at screening or just prior to vaccine administration.
  2. Female participant who is breastfeeding or plans to breastfeed from the time of the study vaccination through 3 months after the study vaccination.
  3. Has acute or chronic inflammatory condition of the gastrointestinal tract including, but not limited to, Crohn's disease, ulcerative colitis, gastritis, proctitis, or any other inflammatory bowel disorder
  4. Has any medical disease, history, or behavior that may predispose to more severe COVID-19 infection, including hypertension, diabetes, current vaping, history of chronic smoking within the prior year, or body mass index of greater than 30
  5. Has any medical disease or condition that, in the opinion of the site PI or appropriate sub-investigator, precludes study participation (including but not limited to acute, subacute, intermittent or chronic medical disease or condition that would place the participant at an unacceptable risk of injury, render the participant unable to meet the requirements of the protocol, or may interfere with the evaluation of responses or the participant's successful completion of this trial.)
  6. Presence of self-reported or medically documented significant medical or psychiatric condition(s).

    Significant medical or psychiatric conditions include but are not limited to:

    • Respiratory disease (e.g., chronic obstructive pulmonary disease, asthma) requiring daily medications currently or any treatment of respiratory disease exacerbations (e.g., asthma exacerbation) in the last 5 years.
    • Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics.
    • Significant cardiovascular disease (e.g., congestive heart failure, cardiomyopathy, ischemic heart disease) or history of myocarditis or pericarditis as an adult.
    • Neurological or neurodevelopmental conditions (e.g., migraines, epilepsy, stroke, seizures in the last 3 years, encephalopathy, focal neurologic deficits, Guillain-Barré syndrome, encephalomyelitis or transverse myelitis).Ongoing malignancy or recent diagnosis of malignancy in the last five years excluding basal cell and squamous cell carcinoma of the skin, which are allowed.
    • An autoimmune disease, including hypothyroidism without a defined non-autoimmune cause, localized or history of psoriasis.
    • An immunodeficiency of any cause.
    • Presence of an indwelling prosthetic device or other foreign material.
  7. Has an acute illness, as determined by the site PI or appropriate sub-investigator, with or without fever (oral temperature >38.0 degrees Celsius [100.4 degrees Fahrenheit]) within 72 hours prior to study vaccination administration.
  8. Has a positive test result for hepatitis B surface antigen, hepatitis C virus antibody, or human immunodeficiency virus (HIV) types 1 or 2 antibodies at screening.
  9. Has participated in another investigational study involving any investigational product (study drug, biologic or device) within 60 days, or 5 half-lives, whichever is longer, before study vaccine administration.
  10. Currently enrolled in or plans to participate in another clinical trial with an investigational agent (including licensed or unlicensed vaccine, drug, biologic, device, blood product, or medication) that will be received during the trial period.
  11. Has a history of hypersensitivity or severe allergic reaction (e.g., anaphylaxis, generalized urticaria, angioedema, other significant reaction) to any previous licensed or unlicensed vaccines.
  12. Chronic use (more than 14 continuous days) or anticipated use within the next 6 months of any medications that may be associated with impaired immune responsiveness. Including, but not limited to the following excluded drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1). The use of low dose topical, ophthalmic, inhaled and intranasal steroid preparations will be permitted.
  13. Received immunoglobulins and/or any blood or blood products within the 4 months before study vaccine administration or at any time during the study.
  14. Has any blood dyscrasias or significant disorder of coagulation.
  15. Has any chronic liver disease, including fatty liver.
  16. Has a history of alcohol abuse or other recreational drug (excluding cannabis) use within 6 months before study vaccine administration.
  17. Received or plans to receive a licensed, live vaccine within 4 weeks before or after each vaccination.
  18. Received or plans to receive a licensed, inactivated vaccine within 2 weeks before or after each vaccination.
  19. Receipt of any other SARS-CoV-2/COVID-19, or other experimental coronavirus vaccine at any time prior to or during the study.
  20. Known current or previous laboratory-confirmed SARS CoV-1 OR SARS-CoV-2/COVID-19 infection as documented by a positive PCR test from a nasal swab.
  21. Known close contact of anyone with laboratory-confirmed SARS-CoV-2/COVID-19 infection within 2 weeks prior to vaccine administration.
  22. Has traveled outside the US for any duration within 30 days before study vaccination.
  23. Currently working in occupation with high risk of exposure to SARS-CoV-2 (e.g., health care worker, emergency response personnel).
  24. Allergy to BOTH amoxicillin (or any penicillin derivative) AND erythromycin
  25. Household contact, including neonates up to the age of 28 days, with any medical condition or taking medications that may result in immunosuppression.
  26. The participant must agree to refrain from donating blood or plasma during the study.
  27. Excluded medications (summarized): Excluded asthma medications: inhaled, oral, or intravenous (IV) corticosteroids, leukotriene modifiers, long and short acting beta agonists, theophylline, ipratropium, biologics; Excluded immunosuppressive drugs: systemic corticosteroids exceeding 10 mg/day of prednisone equivalent, allergy injections, immunoglobulin, interferon, immunomodulators, cytotoxic drugs, or other similar or toxic drugs during the preceding 6-month period prior to vaccine administration (Day 1); Excluded other medications - current use of any antibiotics, probiotic supplements, H2 blockers or proton pump inhibitors within 7 days prior to vaccination and any anticipated use for 7 days post vaccination.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 19 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Alexander Graves, PhD, MBA (604) 428-7474 bd@symvivo.com
Contact: Michelle Jones, RN, M.Sc., MBA 604-428-7474 bd@symvivo.com
Listed Location Countries  ICMJE Canada,   United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04334980
Other Study ID Numbers  ICMJE bacTRL-Spike-1
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Undecided
Responsible Party Symvivo Corporation
Study Sponsor  ICMJE Symvivo Corporation
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Study Director: Eric L Sievers, MD Chief Medical Officer
Study Chair: Manish Sadarangani, MRCPCH, DPHIL Principal Investigator
Principal Investigator: Joanne Langley, MD, FRCPSC Principal Investigator
Principal Investigator: Davey Smith, MD, MAS Principal Investigator
PRS Account Symvivo Corporation
Verification Date June 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP