Clinical trial NCT02296983: A Study to Find Out if the New Ebola Vaccine is Safe and Stimulates Immunity That Might Protect Adults in Kilifi, Kenya.
Official title: A Phase 1, Open-Label, Dose-Escalation Study to Evaluate the Safety and Immunogenicity of the BPSC1001 (VSVΔG-ZEBOV) Ebola Virus Vaccine Candidate in Healthy Adult Volunteers in Kilifi, Kenya.
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE1
Conditions: Ebola Virus Disease
Lead sponsor: University of Oxford
Sponsor class: OTHER
Collaborators: name: World Health Organization
name: Wellcome Trust
name: Institute of Tropical Medicine, University of Tuebingen
name: Albert Schweitzer Hospital
name: Philipps University Marburg
name: Universitätsklinikum Hamburg-Eppendorf
name: University Hospital, Geneva
First posted: 2014-11-21
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Previous Ebola outbreaks have been limited to individual countries and contained by infection control activities. The current outbreak in West Africa is international, and air travel has resulted in a number of infected travellers crossing national borders. There are currently no specific treatments generally available for Ebola and the mortality is high, particularly in countries with limited intensive care facilities. There is currently no vaccine and the personal protection required by healthcare workers treating patients is cumbersome and requires full compliance to be protective.

There is now a consortium (VEBCON collaboration) of four clinical centres (in Kenya, Gabon, Switzerland and Germany), WHO and New Link Genetics (the vaccine manufacturer) under which this study will be conducted. The investigators are conducting this trial, a Phase I, open-label, dose escalation trial, designed to establish safety, tolerability and immunogenicity of two doses of VSVΔG-ZEBOV, an Ebola Virus Vaccine Candidate for the first time in sub-Saharan African populations.

The investigators plan to vaccinate 40 volunteers in Kenya. The trial will be conducted at the KEMRI-CGMR Coast site where healthcare workers (both clinical and laboratory) will be the primary target population as they are likely to be the recipients of a protective vaccine. The investigators will vaccinate a cohort of 20 volunteers at a low dose and then vaccinate a further cohort of 20 volunteers at full dose. Each volunteer will receive one dose of the vaccine. The investigators will follow them up for a period of one year looking to their safety and immunogenicity endpoints.

Detailed description: This study is being conducted to assess safety and immunogenicity of an experimental ebola vaccine.

An outbreak due to the Ebola Zaire (ZEBOV) strain of unprecedented magnitude and scope and with a high mortality continues to spread across West Africa. No vaccine is currently licensed.

The specific opportunity at hand with rVSVΔG-ZEBOV-GP (BPSC1001) is to achieve long-lasting protective immunity to ZEBOV on a time scale of weeks in humans upon a single-shot vaccination, offering a discrete benefit over prime-boost vaccination protocols. The current outbreak represents a global health emergency and the need for access to therapeutic intervention and vaccines is paramount.

The vaccine investigated in this study might provide a critical tool to suppress future out-breaks of EVD in areas at risk.

This study is 1 of 4 clinical trials currently conducted as part of the WHO-led VEBCON consortium, aiming to generate harmonized data for the rVSVΔG-ZEBOV-GP (BPSC1001) vaccine candidate to allow optimized rapid decisions on dose and safety.

Eligibility criteria: Inclusion Criteria:

* • Have provided written informed consent prior to screening procedures (i.e. participants must be literate).

  * Healthy adult male or non-pregnant, non-lactating female, ages 18 to 55 (inclusive) at the time of screening
  * Free of clinically significant health problems, as determined by pertinent medical history, clinical examination and blood tests at screening
  * Available, able, and willing to participate for all study visits and procedures
  * Negative pregnancy-test for female volunteers
  * Females, of non-childbearing potential who are post-menopausal (i.e. ≥ one year without menses) or surgically sterilized (tubal ligation, bilateral oophorectomy, or hysterectomy)
  * Females, of childbearing potential, who are willing to use effective methods of contraception for 14 days before vaccination and 30 days after vaccination.
  * Males who are willing to use effective contraception following vaccination for a period of one week.
  * Be willing to minimize blood and body fluid exposure of others for 5 days after vaccination

Exclusion Criteria:

* • History of severe local or systemic reactions to any vaccination or a history of severe allergic reactions.

  * Known allergy to the components of the BPSC1001 vaccine product
  * Unable or unwilling to stay in the study area for the period of the study and comply with study procedures.
  * Ongoing participation in another clinical trial
  * Receipt of licensed vaccines within 14 days of planned study immunization (30 days for live vaccines)
  * Acute or chronic, clinically significant psychiatric, hematologic, pulmonary, cardiovascular, or hepatic or renal functional abnormality as determined by the investigator based on medical history, physical exam, and/or laboratory screening test
  * Any serologic evidence of hepatitis B SAg or HIV infection.
  * Any confirmed or suspected immunosuppressive or immunodeficient condition, cytotoxic therapy in the previous 5 years, and/or uncontrolled diabetes
  * Have an active malignancy or history of metastatic or hematologic malignancy
  * Suspected or known alcohol and/or illicit drug abuse within the past 5 years
  * Moderate or severe illness and/or fever \>38°C within 2 weeks prior to vaccination
  * Pregnant or lactating woman or a woman who intends to become pregnant within 30 days following vaccination.
  * Administration of immunoglobulins and/or any blood products within the 120 days preceding study entry or planned administration during the study period
  * Administration of chronic (defined as more than 14 days) immunosuppressant's or other immune modifying drugs within 6 months of study entry
  * Any other significant finding that in the opinion of the investigator would increase the risk of the individual having an adverse outcome from participating in this study

Primary outcomes:
measure: The nature, frequency, and severity of adverse events (AEs) and/or serious adverse events (SAEs) with causal link to the study intervention
timeFrame: Days 0-30
Secondary outcomes:
measure: Incidence and severity of local and systemic reactogenicity signs and symptoms
timeFrame: Day 0-28
measure: Incidence of unsolicited adverse events (AEs)
timeFrame: Days 0-28
measure: Incidence of serious adverse events (SAEs)
timeFrame: Days 0-365
measure: Distribution of values of safety laboratory measures at baseline and at follow-up visits post-vaccination
timeFrame: Day 0-30
measure: Persistence of titres of ZEBOV-specific IgG antibodies
timeFrame: 0-180 days
measure: Detection, magnitude and duration of VSV-ZEBOV viraemia and shedding
timeFrame: Day 1, 3 and 7
measure: Titres of neutralising ZEBOV-specific IgG antibodies
timeFrame: Days 7, 30, 60, 90, 180 and 365
measure: Pattern of ZEBOV specific T cell responses
timeFrame: Days 7, 30, 90, 180 and 365
measure: Titers of ZEBOV-specific IgG antibodies
timeFrame: Days 0-28
Other outcomes:
Locations:
city: Kilifi
country: Kenya
facility: KEMRI Wellcome Trust Research Programme
state: Coast
Study officials:
affiliation: KEMRI-Wellcome Trust Collaborative Research Program
name: Philip Bejon, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Huttner A, Agnandji ST, Combescure C, Fernandes JF, Bache EB, Kabwende L, Ndungu FM, Brosnahan J, Monath TP, Lemaitre B, Grillet S, Botto M, Engler O, Portmann J, Siegrist D, Bejon P, Silvera P, Kremsner P, Siegrist CA; VEBCON; VSV-EBOVAC; VSV-EBOPLUS Consortia. Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2018 Jul;18(7):738-748. doi: 10.1016/S1473-3099(18)30165-8. Epub 2018 Apr 5.
citation: Coller BG, Blue J, Das R, Dubey S, Finelli L, Gupta S, Helmond F, Grant-Klein RJ, Liu K, Simon J, Troth S, VanRheenen S, Waterbury J, Wivel A, Wolf J, Heppner DG, Kemp T, Nichols R, Monath TP. Clinical development of a recombinant Ebola vaccine in the midst of an unprecedented epidemic. Vaccine. 2017 Aug 16;35(35 Pt A):4465-4469. doi: 10.1016/j.vaccine.2017.05.097. Epub 2017 Jun 21.
citation: Medaglini D, Harandi AM, Ottenhoff TH, Siegrist CA; VSV-Ebovac Consortium. Ebola vaccine R&D: Filling the knowledge gaps. Sci Transl Med. 2015 Dec 9;7(317):317ps24. doi: 10.1126/scitranslmed.aad3106.
citation: Agnandji ST, Huttner A, Zinser ME, Njuguna P, Dahlke C, Fernandes JF, Yerly S, Dayer JA, Kraehling V, Kasonta R, Adegnika AA, Altfeld M, Auderset F, Bache EB, Biedenkopf N, Borregaard S, Brosnahan JS, Burrow R, Combescure C, Desmeules J, Eickmann M, Fehling SK, Finckh A, Goncalves AR, Grobusch MP, Hooper J, Jambrecina A, Kabwende AL, Kaya G, Kimani D, Lell B, Lemaitre B, Lohse AW, Massinga-Loembe M, Matthey A, Mordmuller B, Nolting A, Ogwang C, Ramharter M, Schmidt-Chanasit J, Schmiedel S, Silvera P, Stahl FR, Staines HM, Strecker T, Stubbe HC, Tsofa B, Zaki S, Fast P, Moorthy V, Kaiser L, Krishna S, Becker S, Kieny MP, Bejon P, Kremsner PG, Addo MM, Siegrist CA. Phase 1 Trials of rVSV Ebola Vaccine in Africa and Europe. N Engl J Med. 2016 Apr 28;374(17):1647-60. doi: 10.1056/NEJMoa1502924. Epub 2015 Apr 1.