Clinical trial NCT00679172: Immunogenicity, Safety and Tolerability of the Typhoid Fever Vaccine Candidate M01ZH09 in Healthy Adults
Official title: A Randomised, Double-blind, Placebo-controlled, Single Dose, Dose Escalation Study to Determine the Immunogenicity, Safety and Tolerability of S. Typhi (Ty2 aroC-ssaV-) ZH9 at Doses of 5.0 x 10E9 CFU, 7.5 x 10E9 CFU, 1.1 x 10E10 and 1.7 x 10E10 CFU and 1.7 x 10E10 CFU, Following Oral Administration to Healthy, Typhoid Vaccine naïve Subjects in the USA.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Typhoid
Lead sponsor: Emergent BioSolutions
Sponsor class: INDUSTRY
First posted: 2008-05-16
Enrollment: 187
Sex: ALL
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: PREVENTION

Brief summary: This study is to investigate the safety, tolerability and immunogenicity of the typhoid fever vaccine candidate M01ZH09 manufactured at commercial scale, at a new manufacturing facility. The vaccine will be delivered as a single oral dose to healthy, typhoid vaccine-naïve adults.

Detailed description: This was a randomised, double-blind, placebo-controlled, single dose, dose escalation study with 4 dosing cohorts. Within each cohort, 45 evaluable subjects were planned (36 subjects receiving M01ZH09, 9 receiving placebo).

Eligibility criteria: Inclusion Criteria:

* healthy adult subjects aged 18 to 50 years inclusive, who are able and willing to give informed consent, following a detailed explanation of participation in protocol
* available for the duration of the study and available for scheduled and potential additional visits

Exclusion Criteria:

* women who are pregnant, breast-feeding or of childbearing potential and unwilling to use a reliable method of contraception throughout the study period
* history of anaphylactic shock following vaccination by any route have phenylketonuria
* hypersensitivity to any component of the vaccine or are hypersensitive to two of the following antibiotics: ciprofloxacin, azithromycin, ampicillin, trimethoprim sulfamethoxazole
* received antibiotic medication within 14 days prior to dosing
* received any vaccine within 4 weeks prior to dosing or plan to receive a vaccine within 4 weeks after dosing
* received any vaccine against Salmonella typhi (licensed or investigational) or ever suffered from typhoid fever
* subjects who test positive for hepatitis B, hepatitis C, HIV or human leucocyte antigen B-27
* known or suspected history of liver or active gall bladder disease, ongoing gastro-intestinal disease or abnormality
* commercial food handlers or health care workers with direct contact with high risk patients or who have household contacts with immuno-compromised individuals, pregnant women or children less than 2 years of age
* subjects who have a clinically significant amount of protein or haemoglobin in their urine or abnormality of their haematology or serum biochemistry parameters
* impairment of immune function or those receiving or have received cytotoxic drugs in the 6 months prior to study entry
* subjects who use antacids, proton pump inhibitors or H2 blockers on a regular basis or have consumed proton pump inhibitors or H2 blockers within 24 hours prior to dosing
* acute infections (including fever of 37.5 degrees Celsius or greater) on the day of dosing.
* subjects with chronic disease (e.g Crohn's disease, inflammatory bowel disease, diabetes) who cannot withstand a 3 hour fast
* substance abuse or a history of substance abuse that might interfere with participation in the study
* body mass index (BMI) is less than 19 or greater than 34 kg per m2
* clinically significant medical condition that precludes participation in the study
* subjects who have participated in an interventional clinical trial within 60 days of dosing

Primary outcomes:
measure: Number and Proportion of Subjects Reporting Suspected Unexpected Serious Adverse Reactions.
timeFrame: From start of dosing to 28 days post-dosing.
measure: Number and Proportion of Subjects Experiencing Symptomatic Fever.
timeFrame: From start of dosing to 14 days post-dosing.
measure: Number of Subjects Having Clinically Significant Changes in Laboratory Test Parameters.
timeFrame: From start of dosing to 28 days post-dosing.
measure: Number of Subjects Reporting Treatment-related TEAEs.
timeFrame: From start of dosing to 28 days post-dosing.
measure: Number and Proportion of Subjects Experiencing Bacteraemia.
timeFrame: From start of dosing to 28 days post-dosing.
measure: Number of Subjects Having Shedding in Stool of Salmonella Typhi (S. Typhi) (Ty2 aroC-ssaV-) ZH9.
timeFrame: Beyond 7 days post-dosing through 14 days post-dosing (Cohorts 1-3) or through 21 days post-dosing (Cohort 4).
measure: Number and Proportion of Subjects Developing an Immune Response as Determined by the Level of IgG and/or IgA Antibodies for S. Typhi Lipopolysaccharide (LPS).
timeFrame: From baseline (pre-dose) to Days 14 or 28 (IgG) or to Days 7 or 14 (IgA).
Secondary outcomes:
measure: Number and Proportion of Subjects Developing an Immune Response as Determined by the Level of IgA Antibodies for S. Typhi LPS.
timeFrame: From baseline (pre-dose) to Days 7 or 14.
measure: Number and Proportion of Subjects Developing an Immune Response as Determined by the Level of IgG Antibodies for S. Typhi LPS.
timeFrame: From baseline (pre-dose) to Days 14 or 28.
measure: Number and Proportion of Subjects Developing an Immune Response as Determined by the Level of IgG Antibodies for S. Typhi LPS.
timeFrame: From baseline (pre-dose) to Days 7, 14, or 28.
measure: Number and Proportion of Subjects Developing an Immune Response at the Target Dose of 7.5 x 10^9 CFU (Cohort 2) as Determined by the Number of Antibody Secreting Cells (ASCs) Secreting IgA and/or Fold Change in IgG.
timeFrame: At Day 7 (IgA); and from baseline (pre-dose) to Day 28 (IgG).
measure: Number and Proportion of Subjects Developing an Immune Response at the Target Dose of 7.5 x 10^9 CFU (Cohort 2) as Determined by the Number of ASCs Secreting IgA.
timeFrame: Day 7.
measure: Number and Proportion of Subjects Developing an Immune Response at the Target Dose of 7.5 x 10^9 CFU (Cohort 2) as Determined by the Fold Change in IgG.
timeFrame: From baseline (pre-dose) to Day 28.
Other outcomes:
Locations:
city: South Miami
country: United States
facility: Miami Research Associates
state: Florida
city: Baltimore
country: United States
facility: John Hopkins Bloomberg School of Public Health
state: Maryland
city: Burlington
country: United States
facility: Unit of Infectious Diseases, University of Vermont College of Medicine
state: Vermont
Study officials:
affiliation: Emergent BioSolutions
name: Stephen Lockhart, DM
role: STUDY_DIRECTOR
References:
citation: Lyon CE, Sadigh KS, Carmolli MP, Harro C, Sheldon E, Lindow JC, Larsson CJ, Martinez T, Feller A, Ventrone CH, Sack DA, DeNearing B, Fingar A, Pierce K, Dill EA, Schwartz HI, Beardsworth EE, Kilonzo B, May JP, Lam W, Upton A, Budhram R, Kirkpatrick BD. In a randomized, double-blinded, placebo-controlled trial, the single oral dose typhoid vaccine, M01ZH09, is safe and immunogenic at doses up to 1.7 x 10(10) colony-forming units. Vaccine. 2010 Apr 30;28(20):3602-8. doi: 10.1016/j.vaccine.2010.02.017. Epub 2010 Feb 24.