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Influenza VaccinesPhase 1/2CCTA #0005NCT01623232

MAS-1 Adjuvanted Compared to Unadjuvanted Influenza Vaccines in the Elderly

A Phase 1/2 study testing MAS-1 adjuvant and influenza HA antigen and standard dose, inactivated trivalent influenza vaccine (TIV) in people with Influenza Vaccines and Aged, run by US Department of Veterans Affairs at 4 sites in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This is a Phase 1,2 randomized, double-blind, multi-center, clinical trial, in participants aged 65 years and older, evaluating the immunogenicity and safety of a water-in-oil emulsion adjuvant (MAS-1 adjuvant, Mercia Pharma, Inc, Scarsdale, NY) combined with each of the three reduced HA antigen dose levels of… Read more about this study

Who is it for?
Ages 65 years and olderHealthy volunteers can take part
Conditions the study is for
Influenza Vaccines, Aged
What is being tested?
MAS-1 adjuvant and influenza HA antigen and standard dose, inactivated trivalent influenza vaccine (TIV)
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
4 sitesUnited States
Study dates
Oct 2012to Jun 2014
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • Participants must meet all of the following inclusion criteria at Screening/Baseline to participate in this study:
  • Ambulatory persons aged at least 65 years or older on the day of enrollment. Participants will be considered ambulatory if they are not institutionalized, bedridden, or homebound.
  • Written informed consent form and Authorization to Obtain and Release Protected Health Information (HIPAA) form signed.
  • Medically stable. Participants may have clinically stable underlying chronic conditions such as, but not limited to hypertension, diabetes, congestive heart failure, ischemic heart disease, or chronic lung disease, but their symptoms/signs must be controlled, as judged by the investigator, based on physical examination and medical history. Participants with pre-existing stable disease, defined as disease not requiring significant change in therapy or hospitalization for worsening disease 4 weeks before receipt of the test article, are eligible.
  • Body Mass Index (BMI)<40
  • Normal ranges for safety labs including:
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  • WBC count 3,600 - 11,200 cells/mm3
  • Platelets: 150,000-450,000/mm3
  • Hemoglobin >sex-specific institutional lower limit of normal (Female 11 g/dL and Male 12.5 g/dL).
  • Chemistry Panel: ALT, AST, total bilirubin <1.1 times and CPK <1.25 times the upper limit of normal for the study; glucose 65 to 100 mg/dL; creatinine 0.40 to 1.40 mg/dL
  • Absolute neutrophil, lymphocyte and eosinophil counts are within the study normal range.
  • Normal urine dipstick: negative or trace urine protein, negative or trace urine blood.
  • Able to attend all scheduled visits and to comply with all trial procedures.

Who cannot join

  • Participants who meet any of the exclusion criteria at Screening/Baseline will be excluded from study participation. Participants will not be able to participate if they have:
  • Systemic hypersensitivity to eggs, chicken proteins, or any of the other vaccine components, or a history of a life-threatening reaction to TIV or a vaccine containing any of the same substances.
  • History of congenital or acquired immunodeficiency, Human Immunodeficiency Virus infection, hepatitis C or B virus infection, or autoimmune disease, or immunosuppressive therapy or radiation therapy in the preceding six months.
  • Systemic corticosteroid therapy, as follows:
  • Continuous use with a dosage equivalent to >15 mg per day of oral prednisone for 90 days preceding vaccination.
  • Sporadic use with a dosage equivalent to >40 mg per day of oral prednisone for >14 consecutive days in the 90 days preceding vaccination.
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  • Neoplastic disease or any hematologic malignancy (except localized skin or prostate cancer that is stable at the time of vaccination in the absence of therapy, and history of neoplastic disease but disease-free for 5 years).
  • Current alcohol abuse or drug addiction that may interfere with trial procedures.
  • Receipt of blood or blood-derived products in the past three months.
  • Receipt of influenza vaccine in the past six months.
  • Receipt of any other vaccine in the past four weeks.
  • Planned receipt of another vaccine in the four weeks following the trial vaccination.
  • Planned participation in another clinical trial during the present trial period. Concomitant participation in an observational trial (not involving drugs, vaccines, or medical devices) is acceptable.
  • Thrombocytopenia or bleeding disorder contraindicating IM vaccination. Anticoagulation is only a relative contraindication to IM vaccine injections (39). Exclusion from participation on this basis is at the discretion of the participant and the investigator after full discussion of the risks.
  • History of Guillain-Barr syndrome.
  • An acute febrile illness within 24 hours prior to vaccination. Vaccination will be deferred until the participant has been afebrile for at least 24 hours.
  • Signs and symptoms of an acute infectious respiratory ill

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Iowa City VA Health Care System, Iowa City, IA

    Iowa City, Iowa, 52246-2208

  • Minneapolis VA Health Care System, Minneapolis, MN

    Minneapolis, Minnesota, 55417

  • VA Palo Alto Health Care System, Palo Alto, CA

    Palo Alto, California, 94304-1290

  • St. Louis VA Medical Center John Cochran Division, St. Louis, MO

    St Louis, Missouri, 63106

Other trials in United States

About this study

This is a Phase 1,2 randomized, double-blind, multi-center, clinical trial, in participants aged 65 years and older, evaluating the immunogenicity and safety of a water-in-oil emulsion adjuvant (MAS-1 adjuvant, Mercia Pharma, Inc, Scarsdale, NY) combined with each of the three reduced HA antigen dose levels of trivalent influenza virus vaccine compared with licensed, unadjuvanted, standard dose trivalent virus (TIV). Immunogenicity for each of the three viral strains (A/H1N1, A/H3N2, and B virus) in the concurrent influenza seasonal vaccine will be assessed.

Read the detailed description

Many VA patients are at-risk for complications from influenza because of advanced age and underlying chronic diseases. A more effective influenza virus vaccine is needed in older patient populations and high antibody levels are correlated with protection. Vaccine dose-sparing to maximize the number of doses available is a public health goal. The combination of influenza vaccine antigens with an adjuvant could help improve the vaccine. This study will be a phase 1, 2 randomized, observer-blind, multi-center, clinical trial, in patients aged 65 years and older, evaluating the immunogenicity and safety of a water-in-oil emulsion adjuvant (MAS-1) combined with each of three reduced influenza hemagglutinin (HA) antigen dose levels of trivalent influenza virus vaccine compared to unadjuvanted, standard dose trivalent influenza virus vaccine (TIV). Immunogenicity for each of the three viral strains (A/H1N1, A/H3N2, and B virus) in the concurrent seasonal influenza vaccine will be assessed. The hypothesis is that adjuvanted influenza virus vaccine (using reduced doses of influenza HA antigen containing 1 g, 3 g and 5 g of HA) has superior immunogenicity compared to unadjuvanted, standard dose trivalent influenza virus vaccine (containing 15 g HA antigen) for each of three viral strains, and the adjuvanted vaccine has an acceptable safety profile. The primary objectives are to demonstrate 1) acceptable safety for influenza virus vaccine, adjuvanted with MAS-1 compared to unadjuvanted, standard dose TIV, and 2) improved immunogenicity of the adjuvanted influenza virus vaccine compared to unadjuvanted, standard dose TIV for each of the three viral strains. Immunogenicity will be measured by hemagglutination inhibition (HAI) antibody titers. The primary measure of immunogenicity is the seroconversion rate at 1 month post-vaccination for each viral strain. Secondary and exploratory immunogenicity objectives include the seroprotection rate (defined as the proportion of subjects with a post-vaccination HAI antibody titer > 1:40 for a viral strain) at 1, 3 and 6 months post-vaccination for each viral strain; the geometric mean titers (GMTs) of HAI antibody and ratio of GMTs pre-vaccination and at 1, 3 and 6 months post-vaccination between the four vaccine groups for each viral strain; and the geometric mean fold increase (GMFI) at 1, 3 and 6 months post-vaccination compared to pre-vaccination (i.e., GMT of the post-vaccination values divided by the GMT of the pre-vaccination value) for each virus strain within each of the four vaccine groups. The study population of 160 subjects (40 per vaccine group) who provide informed consent and meet eligibility criteria will be enrolled at four clinical sites. Subjects who meet the entry criteria for the study will be randomly assigned to receive one of the three adjuvanted influenza virus vaccine dose levels or unadjuvanted, standard dose TIV. Randomization will be stratified by clinical site (4 sites) and age (65-74 years old or 75 years old). Vaccine preparation will be performed at point-of-use by the site pharmacists according to a standardized procedure. Administration of vaccine will be performed by an unblinded vaccine administrator. Study assessments will be performed by blinded study personnel. Subjects will also be blinded to treatment assignment. Study subjects will each participate for a total of 12 months post-vaccination. The whole study duration of 32 - 32.5 months is expected to include 6 months of startup, 8 - 10 weeks of enrollment, 12 months of follow-up post-vaccination and 12 months of study closure and data analysis. If the objectives of this study are achieved and the hypothesis is correct, the adjuvanted influenza virus vaccine at one or more of the reduced HA antigen doses will induce an improved HAI antibody response compared to unadjuvanted, standard dose TIV with an acceptable safety profile. Results of this trial will inform the design of future clinical trials studying adjuvanted influenza virus vaccines utilizing this novel water-in-oil adjuvant emulsion that could include dose-finding studies for the optimal amount of adjuvant combined with one HA antigen dose, and larger phase 2 and 3 clinical trials.

Being tested
MAS-1 adjuvant and influenza HA antigen, standard dose, inactivated trivalent influenza vaccine (TIV)
Keywords
vaccine, influenzavirus A, influenzavirus B, adjuvant
Medical subject headings
Influenza, Human

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MAS-1 adjuvant and influenza HA antigenBiological

    Also called MER4101

    Vaccines will be administered IM in the deltoid muscle. HA antigen of each of three viral strains at doses of 1 micrograms, 3 micrograms, or 5 micrograms per viral strain adjuvanted with MAS-1 adjuvant and as nonadjuvanted standard dose TIV will be tested.

    1. Treatment Group 1:each 0.3 mL dose will be administered as an emulsion containing 0.186 grams of MAS-1 oil vehicle and 1 micrograms HA of each of three viral strains in 0.08 mL sterile phosphate buffered saline (PBS).
    2. Treatment Group 2:each 0.3 mL dose will be administered as an emulsion containing 0.186 grams of MAS-1 oil vehicle and 3 micrograms HA of each of three viral strains in 0.08 mL sterile PBS.
    3. Treatment Group 3:each 0.3 mL dose will be administered as an emulsion containing 0.186 grams of MAS-1 oil vehicle and 5 micrograms HA of each of three viral strains in 0.08 mL sterile PBS.
  • standard dose, inactivated trivalent influenza vaccine (TIV)Biological

    Vaccine will be administered IM in the deltoid muscle. HA antigen of each of three viral strains as nonadjuvanted standard dose TIV will be tested.

    1. Treatment Group 4:0.5 mL dose of licensed, unadjuvanted, standard dose influenza virus vaccine with 15 micrograms HA of each of 3 viral strains.
Study groups in NCT01623232
Study groupRoleWhat they receive
adjuvant plus 1 �g of HA antigenExperimentalMAS-1-adjuvant-formulated influenza vaccine, at three HA antigen dose levels containing 1 �g of HA antigen
Receives: Biological: MAS-1 adjuvant and influenza HA antigen
adjuvant plus 3 �g of HA antigenExperimentalMAS-1-adjuvant-formulated influenza vaccine, at three HA antigen dose levels containing 3 �g of HA antigen
Receives: Biological: MAS-1 adjuvant and influenza HA antigen
adjuvant plus 5 �g of HA antigenExperimentalMAS-1-adjuvant-formulated influenza vaccine, at three HA antigen dose levels containing 5 �g of HA antigen
Receives: Biological: MAS-1 adjuvant and influenza HA antigen
licensed influenza vaccineActive comparatorlicensed, inactivated, standard dose influenza vaccine without adjuvant
Receives: Biological: standard dose, inactivated trivalent influenza vaccine (TIV)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. safety

    Participants with at least one vaccine-related adverse event (AE) from the following four categories: solicited AEs, unsolicited AEs, serious AEs, and abnormal safety labs for severity grade 2 or higher, grade 3 only, and grade 4 or 5.

    Measured: 12 months

Secondary outcomes (8)
  1. immunogenicity

    The primary immunogenicity outcome is the seroconversion rate at 1 month (day 28) post-vaccination for each of the three virus strains in each vaccine group. Seroconversion rate at 1 month is defined as the proportion of participants with either a pre-vaccination HAI antibody titer <1:10 and a post-vaccination antibody titer = 1:40, or a pre-vaccination HAI antibody titer = 1:10 and a minimum four-fold rise in post-vaccination antibody titer.

    Measured: 6 months

  2. immunogenicity

    The seroprotection rate at 1 month (day 28) post-vaccination for each of the three virus strains in each vaccine group. Seroprotection is defined as the proportion of participants with post-vaccination antibody titer of 1:40 or greater.

    Measured: 1 month

  3. immunogenicity

    The geometric mean titers of antibody and ratios of geometric mean antibody titers at 1 month (28 days) post-vaccination for each virus strain and vaccine group.

    Measured: 1 month

  4. immunogenicity

    The seroprotection rates up to 6 months post-vaccination for each virus strain and vaccine group.

    Measured: 6 months

  5. immunogenicity

    The rates of antibody titers at serum dilutions of at least 1:80, at least 1:160, and at least 1:320.

    Measured: 6 months

  6. immunogenicity

    The geometric mean antibody titers and ratios of geometric mean antibody titers up to 6 months post-vaccination for each virus strain and vaccine group.

    Measured: 6 months

  7. safety

    Participants in each vaccine group experiencing an individual adverse event (AE) by severity grade, relatedness to vaccine, for solicited AEs, unsolicited AEs, serious AEs and abnormal safety labs.

    Measured: 12 months

  8. safety

    Participants in each vaccine group experiencing at least one abnormal symptom with any severity grade, grade 2 or higher, grade 3 or higher, and grades 4 and 5, by relatedness to vaccine, for solicited adverse events (AE), serious AEs and safety labs.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jun 2012 (estimated)
  2. Study startOct 2012
  3. Primary completionNov 2013 (estimated)
  4. Study completionJun 2014 (estimated)

Why it stopped: FDA hold on the project

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01623232
Sponsor's protocol ID
CLIN-07-11S
Other IDs
1 I01 CX000633-01
Acronym
CCTA #0005
Status last verified
Sep 2012
First submitted
15 Jun 2012
Last updated
26 Sep 2012
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing MAS-1 adjuvant and influenza HA antigen and standard dose, inactivated trivalent influenza vaccine (TIV) in people with Influenza Vaccines and Aged, run by US Department of Veterans Affairs at 4 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 26 Sep 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

safety (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Sep 2012.

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