Clinical trial NCT00468858: A Study of Two Doses of WRAIR Dengue Vaccine Administered Six Months Apart to Healthy Adults and Children
Official title: Phase II, Randomized, Double-blind, Placebo-controlled Study of Two Doses of WRAIR Live Attenuated Tetravalent Dengue Vaccine Formulations, Administered Six Months Apart, to Healthy Adults and Children
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Dengue Fever
Dengue Hemorrhagic Fever
Dengue Shock Syndrome
Keywords: Dengue
Virus
Live-attenuated
Vaccine
Dengue viral infection
Dengue Vaccine
Lead sponsor: U.S. Army Medical Research and Development Command
Sponsor class: FED
Collaborators: name: GlaxoSmithKline
First posted: 2007-05-03
Enrollment: 636
Sex: ALL
Minimum age (years): 12
Maximum age (years): 50
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The purpose of this study is to evaluate the safety and effectiveness of two different formulations of an investigational dengue vaccine (T-DEN) against a placebo vaccine when two doses are given six months apart to adults and children.

Detailed description: In this study, children and adults at multiple sites in Puerto Rico will be randomly allocated to receive one of two T-DEN formulations or placebo. Subjects will be stratified by age group (a specific number of subjects in each of 4 age groups \[12 months to 50 years of age\] will be enrolled). The study includes 6 scheduled visits and 4 scheduled venipunctures. Safety follow-up for dengue may require unscheduled visits and venipunctures.\> Multiple DEN virus serotypes are endemic in Puerto Rico and all residents are considered to be at risk for dengue. The results of this phase II study will provide a basis for identifying the vaccine formulations which elicit neutralizing antibodies to all four dengue virus serotypes in a high proportion of vaccine recipients. The most immunogenic and well tolerated candidate formulation identified in this study will be considered for advancement to phase III development.\>

Eligibility criteria: Inclusion Criteria:\>

* Subjects who the investigator believes that they and/or their parents/guardians can and will comply with the requirements of the protocol (e.g., completion of the diary cards, return for follow-up visits) should be enrolled in the study.\>
* A healthy male or non-pregnant female between 12 months (mths) and 50 years (yrs) of age at the time of the first vaccination;\>
* Free of obvious health problems as established by medical history and physical examination before entering into the study;\>
* For children: 23mths of age, full compliance with the United States Advisory Committee on Immunization Practices (U.S. ACIP) recommended childhood immunization schedule;\>
* Written informed consent obtained from the subject or a parent/guardian and assent for subjects 7-20 yrs of age;\>
* If the subject is female, she must be of non-childbearing potential, i.e. either pre-menarcheal, surgically sterilized or one year post-menopausal; or, if of childbearing potential, she must be abstinent or have used adequate contraceptive precautions (i.e. intrauterine contraceptive device; condom and spermicide combination, oral contraceptives or other equivalent hormonal contraception, e.g. progestin implantable, cutaneous hormonal patch or injectable contraceptives) for 30 days (dys) prior to vaccination, have a negative pregnancy test within 48 hrs prior to vaccination and must agree to continue such precautions for 60 dys after completion of the vaccination series. Any child who begins menarche during the study period must follow the same precautions listed above, from menarche until 60 dys after the second vaccine dose.\>

Exclusion Criteria:\>

* Pregnant or lactating female;\>
* Female planning to become pregnant or planning to discontinue abstinence or contraceptive precautions;\>
* History of any neurological or behavioral disorder or seizures, with the exception of a single febrile seizure in childhood; \>
* History of allergic disease/reaction likely to be exacerbated by any component of the vaccine;\>
* Acute or chronic, clinically significant pulmonary, cardiovascular, hepatic, renal, hematologic or endocrine functional defect, as determined by physical examination or laboratory tests;\>
* Any confirmed or suspected immunosuppressive or immunodeficient condition;\>
* Acute disease at the time of enrollment (acute disease is defined as the presence of a moderate or severe illness with or without fever); note that vaccine can be administered to persons with a minor illness such as diarrhea, mild upper respiratory infection with or without low-grade febrile illness, i.e., equivalent to an oral temperature \<37.5°C/\<99.5°F.\>
* Chronic hepatomegaly, right upper quadrant abdominal pain or tenderness;\>
* Chronic splenomegaly, left upper quadrant abdominal pain or tenderness;\>
* Use of any investigational or non-registered drug or vaccine other than the study vaccine within 30 dys preceding the first dose of study vaccine/placebo or planned use during the study period;\>
* Planned administration of a vaccine not foreseen by the study protocol during the period starting from 30 dys before each dose of the study vaccine and ending 30 dys after; with the exception of standard infant and children "inactivated" vaccines or the inactivated influenza vaccine administered to adults or children; \>
* A planned move to a location that will prohibit participating in the trial for the 12 mth duration;\>
* Chronic administration (defined as more than 14 dys) of immunosuppressants or other immune-modifying drugs within 90 dys preceding the first dose or planned administration during the study period. For corticosteroids, this will mean prednisone, or equivalent, 0.5 mg/kg/day. Inhaled and topical steroids are allowed;\>
* Administration of immunoglobulins and/or blood products within 90 dys preceding the first dose or planned administration during the study period;\>
* Hypertension;\>
* Chest pain, palpitations, dizziness, shortness of breath unrelated to asthma, arrhythmias or friction rubs;\>
* Any chronic systemic drug therapy to be continued during the study period (except for vitamin/mineral supplements, routine treatment for gastro-esophageal reflux);\>
* Potential adult volunteers, or parents of potential child volunteers, who do not have easy access to a fixed or mobile telephone;\>
* History of chronic alcohol consumption and/or drug abuse.

Primary outcomes:
measure: Safety: Incidence of All and Grade 3 Solicited Local Symptoms
timeFrame: Within 21 days (days 0-20) f/up period after each vaccine dose
measure: Safety: Summary of Unsolicited Adverse Events Within the 31-day Post-vaccination Period
timeFrame: Within the 31-day (days 0-30) follow-up period after each vaccine dose
measure: Safety: Occurrence of Serious Adverse Events (SAEs)
timeFrame: 6 months + 30 day follow-up period after last vaccine dose
Secondary outcomes:
measure: Incidence of Suspected and Laboratory Confirmed Dengue
timeFrame: 31-day (days 0-30) post-vaccination period and after 31-day period
measure: GMTs for Antibody Titer Above the Assay Cut Off to Each DEN Serotype for Unprimed and Primed Subjects
timeFrame: at month 7 (one month post dose 2)
measure: Percent of Subjects With Neut. Antibody Titer Above the Assay Cut-off to All Dengue Serotypes
timeFrame: Pre-vaccination, at post dose 1, months 3 and 6 and post dose 2, month 7
measure: Percent of Subjects With Neut. Sero-response to Each DEN Serotype
timeFrame: Pre-accination, at post dose 1, months 3 and 6 and post dose 2, month 7
measure: Vaccine Response to DEN Antibody at Post Dose 1, Month 3
timeFrame: at month 3, post dose 1
measure: Vaccine Response to DEN Antibody at Post Dose 2, Month 7
timeFrame: at month 7, post dose 2
Other outcomes:
Locations:
city: Caguas
country: Puerto Rico
facility: San Juan Batista Medical School
city: Carolina
country: Puerto Rico
facility: Private Practice
city: Ponce
country: Puerto Rico
facility: St Luke's Memorial Hospital
city: Rio Grande
country: Puerto Rico
facility: Caparra Internal Medicine Research Center
city: Rio Piedras
country: Puerto Rico
facility: Private Practice
city: Rio Piedras
country: Puerto Rico
facility: RCMI Clinical Research Center
city: San German
country: Puerto Rico
facility: Torre Medica San Vicente de Paul
city: San Juan
country: Puerto Rico
facility: Clinical Research PR
city: San Juan
country: Puerto Rico
facility: Centro de Neumologia Pediatricia
city: San Juan
country: Puerto Rico
facility: Private Practice
city: San Juan
country: Puerto Rico
facility: Dept Pediatria, Esc. De Medicina
Study officials:
affiliation: Dept Medicina Interna Seccion Enfermedades Infecciosas
name: Jorge Bertran-Pasarell, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of PR
name: Clemente Diaz-Perez, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of PR
name: Ines O. Esquilin-Rivera, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Caparra Internal Medicine Research Center
name: Evelyn Matta-Fontanet, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Ponce School of Medicine
name: Domingo Chardon-Feliciano, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Clinical Research PR
name: Javier Morales-Ramirez, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Private Practice, PR
name: Luis Rodriguez-Carrasquillo, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Centro de Neumologia pediatrica
name: Jose Rodriguez-Santana, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Private Practice PR
name: Miguel Sosa-Padilla, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Private Practice, PR
name: Jose Tavarez-Valle, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Department of Molecular Medicine
name: Alberto Santiago-Cornier, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: San Juan Batista Medical School
name: Anna Quintero, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bauer K, Esquilin IO, Cornier AS, Thomas SJ, Quintero Del Rio AI, Bertran-Pasarell J, Morales Ramirez JO, Diaz C, Carlo S, Eckels KH, Tournay E, Toussaint JF, De La Barrera R, Fernandez S, Lyons A, Sun W, Innis BL. A Phase II, Randomized, Safety and Immunogenicity Trial of a Re-Derived, Live-Attenuated Dengue Virus Vaccine in Healthy Children and Adults Living in Puerto Rico. Am J Trop Med Hyg. 2015 Sep;93(3):441-453. doi: 10.4269/ajtmh.14-0625. Epub 2015 Jul 14.