Clinical trial NCT04435379: Study to Assess VPM1002 in Reducing Hospital Admissions and/or Severe Respiratory Infectious Diseases in Elderly in COVID-19 Pandemic
Official title: A Phase III, Randomized, Double-blind, Placebo-controlled, Multicentre, Clinical Trial to Assess the Efficacy and Safety of VPM1002 in Reducing Hospital Admissions and/or Severe Respiratory Infectious Diseases in Elderly in the SARS-CoV-2 Pandemic by Modulating the Immune System
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Infection, Respiratory Tract
Keywords: infectious respiratory diseases
Lead sponsor: Vakzine Projekt Management GmbH
Sponsor class: INDUSTRY
Collaborators: name: FGK Clinical Research GmbH
First posted: 2020-06-17
Enrollment: 2038
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Subjects who fulfil the inclusion/exclusion criteria will be centrally randomized in a 1:1 ratio to receive a single dose (0.1 ml) of either VPM1002 or Placebo.
Primary purpose: PREVENTION

Brief summary: The aim of this study is to investigate whether vaccination of elderly with VPM1002 could reduce hospital admissions and/or severe respiratory infectious diseases in the SARS-CoV-2 pandemic .

VPM1002 is a vaccine that is a further development of the old Bacillus Calmette-Guérin (BCG) vaccine, which has been used successfully as a vaccine against tuberculosis for about 100 years, especially in developing countries. VPM1002 has been shown in various clinical studies to be significantly safer than the BCG vaccine.

VPM1002 strengthens the body's immune defence and vaccination with BCG reduces the frequency of respiratory diseases. It is therefore assumed that a VPM1002 vaccination could also provide (partial) protection against COVID-19 disease caused by the "new corona virus" SARS-CoV 2.

Detailed description: Based on the evidence that BCG \[Bacille Calmette-Guérin\] vaccine

1. can potentiate immune responses to other vaccines through induction of trained innate immunity and heterologous adaptive immunity, and
2. can reduce the incidence of respiratory infections, exert antiviral effects in experimental models, and reduce viremia in an experimental human model of viral infection, it is hypothesized that BCG vaccination may induce (partial) protection against the susceptibility to and/or severity of SARS-CoV-2 infections.

VPM1002 is being developed with the aim to replace BCG by a vaccine that has a better safety profile and superior efficacy. Evidence from pre-clinical and clinical studies demonstrate that VPM1002 is safer and is more immunogenic than the existing BCG vaccine (for more information, please revert to the IB). It is therefore anticipated that VPM1002 will also perform better in reducing the severity of the symptoms of an infection with the SARS-CoV-2 than the BCG vaccine. Further, manufacturing of VPM1002 using state-of-the-art production methods will help hasten the production of millions of doses in a very short time and thus would be beneficial in the current SARS-CoV-2 pandemic situation.

The current trial will assess the efficacy and safety of VPM1002 to reduce the hospital admissions and clinical consequences of SARS-CoV-2 infections in the elderly population in the SARS-CoV-2 pandemic by modulating the immune system.

A total of 2038 adults aged 60 or above will be enrolled across involved clinical trial sites in Germany. Informed consent will be obtained from the subjects willing to take part in the trial. This will be followed by assessment of the eligibility criteria. Subjects who fulfil the inclusion/exclusion criteria will be centrally randomized in a 1:1 ratio to receive a single dose (0.1 ml) of either VPM1002 or Placebo.

All subjects will be requested to sign into a web-based tool designed for this trial. Every subject is encouraged to name a designated caregiver who may provide follow-up data in case of hospitalisation or severe illness of the study subject. All subjects will be followed-up entirely remotely. The questionnaires will be designed to collect data regarding hospitalisation, adverse events (AE)/serious adverse events (SAE), ICU admissions and other secondary endpoints. The investigators will review the outcome and safety data.

The duration of follow-up will be 240 days. Subjects with confirmed SARS-CoV-2 infection (with or without symptoms) will be followed for at least 6 weeks (from the date of test result), independent of the total trial duration.

Eligibility criteria: Inclusion Criteria:

1. Male or female adult (≥ 60 years)
2. Subject is contractually capable, able to understand information on study and has signed informed consent sheet
3. Subject has access to an internet-enabled electronic device

Exclusion Criteria:

1. Known active or latent Mycobacterium tuberculosis infection
2. Fever (\> 38 °C) or respiratory tract infection within the past 24 hours
3. Current active viral or bacterial infection
4. Expected vaccination during the study period; vaccinations against influenza and pneumococcal disease are allowed with ≥ 4 weeks between these vaccinations and the trial vaccination
5. Participation in another interventional study within 30 days before screening and during this study
6. Known hypersensitivity or allergy to (components of) the VPM1002 vaccine or serious adverse reactions to prior Bacille Calmette-Guérin (BCG) administration
7. Severely immunocompromised subjects, including:

   1. subjects with known infection by the human immunodeficiency virus (HIV-1);
   2. subjects with solid organ transplantation;
   3. subjects with bone marrow transplantation;
   4. subjects under chemotherapy, immunotherapy, or radiotherapy;
   5. subjects with primary immunodeficiency;
   6. treatment with any anti-cytokine therapies;
   7. treatment with oral or intravenous steroids defined as daily doses of 10 mg prednisone or equivalent for longer than 3 months, or likely use of oral or intravenous steroids in the next 4 weeks;
8. History of malignancies, unless the subject has been free of the disease for ≥ 2 years; exception: subjects with adequately treated basal or squamous cell cancer or other localized non-melanoma skin cancer and adequately treated carcinoma in situ of the cervix may participate in the trial
9. Previous positive SARS-CoV-2 test result
10. Person is an employee of the sponsor, a relative of the sponsor or investigator, or is employed in the same department as the investigator

Primary outcomes:
measure: Number of days with severe respiratory disease at hospital and/or at home
timeFrame: From day 0 to day 240
Secondary outcomes:
measure: Cumulative incidence of hospital admissions
timeFrame: From day 0 to day 240
measure: Cumulative incidence of documented SARS-CoV-2 infection
timeFrame: From day 0 to day 240
measure: Number of days with self-reported fever (≥ 38 ºC)
timeFrame: From day 0 to day 240
measure: Number of days with self-reported acute respiratory symptoms
timeFrame: From day 0 to day 240
measure: Cumulative incidence of self-reported acute respiratory symptoms
timeFrame: From day 0 to day 240
measure: Cumulative incidence of death for any reason
timeFrame: From day 0 to day 240
measure: Cumulative incidence of death due to documented SARS-CoV-2 infection
timeFrame: From day 0 to day 240
measure: Cumulative incidence of ICU admission for any reason
timeFrame: From day 0 to day 240
measure: Cumulative incidence of ICU admission due to documented SARS-CoV-2 infection
timeFrame: From day 0 to day 240
measure: Cumulative incidence of hospital admission due to documented SARSCoV- 2 infection
timeFrame: From day 0 to day 240
Other outcomes:
Locations:
city: Stuttgart
country: Germany
facility: Hautarztpraxis Dres. Leitz & Kollegen
state: Baden-Württemberg
city: Cottbus
country: Germany
facility: MECS Cottbus GmbH
state: Brandenburg
city: Frankfurt
country: Germany
facility: Studienzentrum Dr. Keller
state: Hessen
city: Hannover
country: Germany
facility: Klinische Forschung Hannover Mitte GmbH
state: Niedersachsen
city: Hannover
country: Germany
facility: Medizinische Hochschule Hannover
state: Niedersachsen
city: Essen
country: Germany
facility: Medizentrum Essen Borbeck
state: Nordrhein-Westfalen
city: Mainz
country: Germany
facility: BAG Dres. med. Quist PartG
state: Rheinland-Pfalz
city: Leipzig
country: Germany
facility: SIBAmed GmbH & Co. KG
state: Sachsen
city: Erfurt
country: Germany
facility: SocraTec R&D GmbH
state: Thüringen
city: Berlin
country: Germany
facility: emovis GmbH
city: Berlin
country: Germany
facility: Klinische Forschung Berlin GbR
city: Hamburg
country: Germany
facility: Klinische Forschung Hamburg GmbH
Study officials:
affiliation: Vakzine Projekt Management GmbH
name: Leander Grode, Dr. rer. nat.
role: STUDY_DIRECTOR
References:
citation: Blossey AM, Bruckner S, May M, Parzmair GP, Sharma H, Shaligram U, Grode L, Kaufmann SHE, Netea MG, Schindler C. VPM1002 as Prophylaxis Against Severe Respiratory Tract Infections Including Coronavirus Disease 2019 in the Elderly: A Phase 3 Randomized, Double-Blind, Placebo-Controlled, Multicenter Clinical Study. Clin Infect Dis. 2023 Apr 3;76(7):1304-1310. doi: 10.1093/cid/ciac881.