Clinical trial NCT04298138: Dengue 3 Human Infection Model (DENV-3)
Official title: Phase One, Open Label Assessment of a Dengue-3-Virus-Live Virus Human Challenge - (DENV-3-LVHC) Virus Strain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Dengue
Keywords: Dengue
Flavivirus Infections
Virus Diseases
Lead sponsor: State University of New York - Upstate Medical University
Sponsor class: OTHER
Collaborators: name: Walter Reed Army Institute of Research (WRAIR)
name: U.S. Army Medical Research and Development Command
First posted: 2020-03-06
Enrollment: 9
Sex: ALL
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: Nine subjects will be assigned to the low dose group. Twenty-one days post inoculation, data will be reviewed for safety and if performance parameters are met. If safety profile is acceptable but performance parameters have not been met, dose escalation to the medium dose will proceed in nine additional subjects. Twenty-one days post middle dose inoculation, data will be reviewed as above and a determination will be made to proceed to the high dose.
Primary purpose: OTHER

Brief summary: To evaluate the effectiveness of candidate dengue vaccine formulations, it is prudent to develop an appropriate challenge model. This study will examine the safety and effectiveness of the Dengue 3 Live Virus Human Challenge (DENV-3-LVHC) product and assess the ability of this virus strain to elicit an uncomplicated dengue-like illness.

Detailed description: Healthy subjects between 18 and 45 years old will be inoculated with Dengue 3 Live Virus Human Challenge (DENV-3-LVHC) in a dose ranging study. Subjects will be closely monitored for the first 28 days with continued follow up through 6 months. Clinical and laboratory parameters, viremia and antibody levels will be assessed. The goal is to determine the dose that produces uncomplicated dengue-like illness.

Eligibility criteria: Inclusion Criteria:

1. Age 18-45 at the time of consent
2. Ability and willingness to sign informed consent
3. Passing score on comprehension test of at least 75%, with up to 3 attempts
4. Available for the study period
5. Willing to use contraception for the duration of the study
6. Provide consent for release of medical history records from primary care physician, college or university, urgent care or emergency room visit

Exclusion Criteria:

1. Female: pregnant or lactating
2. Heavy menstrual bleeding within the last 6 months- menstrual periods lasting longer than 6 days, or requiring 5 or more pads or tampons per day.
3. Female subjects using an intrauterine device (IUD) or Mirena®
4. Female subjects with fibroids or uterine polyps, endometriosis, adenomyosis, and uterine scarring (e.g., after D\&C)
5. Blood tests confirming infection with human immunodeficiency virus- 1 (HIV-1), hepatitis C, hepatitis B (assessed by HbsAg) virus, or positive antibodies to the flaviviruses (FV) dengue, West Nile, Yellow Fever, Japanese encephalitis, or Zika.
6. Active Diabetes or active peptic ulcer disease (PUD)
7. Chronic obstructive pulmonary disease (COPD) or coronary artery disease (CAD)
8. Known or suspected congenital or acquired immunodeficiency; or receipt of immunomodulation therapy such as anti-cancer chemotherapy or radiation therapy; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months)
9. Current, or a history of, auto-immune disease
10. History of Guillain-Barré syndrome (GBS)
11. Any history of FV infection or FV vaccination; or planned FV vaccination, outside the study protocol, during the study period
12. Diagnosis with Bipolar Disorder or Schizophrenia, hospitalization in the past year for a mental health disorder, or any other psychiatric condition, which in the opinion of the investigator prevents the subject from participating in the study.
13. Planned travel during the study period (180 days) which would interfere with the ability to complete all study visits
14. Recent (in the past 4 weeks) travel to any dengue endemic area. These potential subjects may be eligible for enrollment a minimum of 4 weeks later
15. Any laboratory abnormalities prior to inoculation for the tests specified in Table 18 and Table 19 of the protocol, that are considered by the investigator to be clinically significant except those listed in exclusion criteria 16
16. Subjects with the following grade 2 or greater lab abnormalities: Creatinine; Liver Function Tests - ALT, AST; Hemoglobin (females and males); White Blood Cell (WBC) decrease; Platelets decreased; Prothrombin Time (PT); Partial Thromboplastin Time (PTT); Fibrinogen decrease
17. Significant screening physical examination abnormalities at the discretion of the investigator
18. Women who intend to become pregnant or men who intend to father a child during the study period (approximately 180 days)
19. Hives, shortness of breath, swelling of the lips or throat, or hospitalization related to a previous vaccination or an allergy to specific medications/animals for which antigens may be in the virus preparations to include: shellfish allergy, fetal bovine serum, L-glutamine, neomycin and streptomycin
20. Planning to donate blood in the 1 year following inoculation with dengue
21. Recent blood donation within prior 56 days of inoculation
22. Receipt of blood products or antibodies within 56 days of inoculation or during the study period
23. Participation (active or follow-up phase) or planned participation in another vaccine, drug, medical device, or medical procedure clinical trial in the 4 weeks prior to this trial, during the trial, or 6 months following inoculation in this clinical trial
24. Recent or scheduled receipt of any vaccine 4 weeks prior to or after virus inoculation
25. Beliefs that bar the administration of blood products or transfusions
26. Positive urine screen for cocaine, amphetamines, or opiates
27. Currently taking Methadone or Suboxone
28. Currently taking anti-coagulant medication, aspirin or non-steroidal anti-inflammatory drugs (NSAIDs)
29. Chronic migraine headaches, defined as more than 15 headache days per month over a 3-month period of which more than 8 are migraines, in the absence of medication over use
30. Chronic medical condition that, in the opinion of the investigator, impacts subject safety.

Primary outcomes:
measure: Number of Abnormal Laboratory Measurements
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Intensity of Abnormal Laboratory Measurements
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Duration of Abnormal Laboratory Measurements
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Occurrence of Solicited Injection Site Symptoms
timeFrame: 7 days post virus inoculation
measure: Intensity of Solicited Injection Site Symptoms
timeFrame: 7 days post virus inoculation
measure: Duration of Solicited Injection Site Symptoms
timeFrame: 7 days post virus inoculation
measure: Occurrence of Unsolicited Injection Site Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Intensity of Unsolicited Injection Site Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Duration of Unsolicited Injection Site Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Occurrence of Solicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Intensity of Solicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Duration of Solicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Occurence of Unsolicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Intensity of Unsolicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Duration of Unsolicited Systemic Symptoms
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Number of Serious Adverse Events
timeFrame: 28 days post virus inoculation or 7 days post hospitalization, whichever is later
measure: Number of Serious Adverse Events
timeFrame: 6 months post virus inoculation
Secondary outcomes:
measure: Incubation period before onset of fever
timeFrame: Up to 28 days post virus inoculation
measure: Viremia by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)
timeFrame: Up to 28 days post virus inoculation
measure: Occurence of fever
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Headache
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Headache
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Myalgia
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Myalgia
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Rash
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Rash
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Abnormal Liver Function Test [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)]
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Abnormal Liver Function Test [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)]
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Leukopenia
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Leukopenia
timeFrame: Up to 28 days post virus inoculation
measure: Occurrence of Thrombocytopenia
timeFrame: Up to 28 days post virus inoculation
measure: Grade of Thrombocytopenia
timeFrame: Up to 28 days post virus inoculation
Other outcomes:
Locations:
city: Syracuse
country: United States
facility: State University of New York, Upstate Medical University (SUNY-UMU)
state: New York
Study officials:
affiliation: State University of New York, Upstate Medical University (SUNY-UMU)
name: Stephen J Thomas, MD
role: PRINCIPAL_INVESTIGATOR
References: