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SmallpoxPhase 2NCT01827371

Phase II Trial to Assess Safety and Immunogenicity of IMVAMUNE®

A Phase 2 study testing MVA Smallpox Vaccine in people with Smallpox, run by National Institute of Allergy and Infectious Diseases (NIAID) at 6 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Imvamune (licensed name of MVA being developed as a smallpox vaccine) has been tested in over 2,000 individuals and is on path for licensure. This study will be a Phase II to evaluate three different immunization schedules and two different modes of delivery. The study will look at condensed schedules. Read more about this study

Who is it for?
Ages 18 to 40 yearsHealthy volunteers can take part
Conditions the study is for
Smallpox
What is being tested?
MVA Smallpox Vaccine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
435 participants
Where
6 sitesUnited States
Study dates
Jun 2013to Apr 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 18 to 40 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • 18 to 40 years of age, inclusive.
  • Read, signed, and dated informed consent document.
  • Available for follow-up for the planned duration of the study (six months after last immunization).
  • Acceptable medical history by screening evaluation and limited physical assessment.
  • If the subject is female and of childbearing potential, negative serum or urine pregnancy test at screening and within 24 hours prior to vaccination.
  • If the subject is female and of childbearing potential*, she agrees to practice abstinence or use acceptable contraception* through 56 days after the last vaccination in order to avoid pregnancy:
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  • a woman is considered of childbearing potential unless post-menopausal (>/= 1 year without menses) or surgically sterilized (tubal ligation, bilateral oophorectomy, or hysterectomy)
  • No sexual intercourse with men (vaginal penetration by a penis, coitus)
  • Acceptable contraception methods are restricted to effective devices (IUDs, NuvaRing®) or licensed hormonal products with use of method for a minimum of 30 days prior to vaccination, condoms with spermicidal agents, monogamous relationship with a vasectomized partner who has been vasectomized for 6 months or more prior to study entry, or successful Essure placement with documented confirmation test at least 3 months after the procedure, and any other FDA-approved contraceptive method
  • Negative test for HIV.
  • Alanine Aminotransferase (ALT) <1.25 times the central lab upper limit of normal.
  • Negative hepatitis B surface antigen and negative antibody to hepatitis C virus.
  • Negative urine glucose and negative or trace urine protein by dipstick or urinalysis.
  • Adequate renal function (defined as a serum creatinine not exceeding the central lab's upper limit of normal).
  • Electrocardiogram (ECG) with no clinically significant abnormalities*
  • e.g., complete left or right bundle branch block, incomplete left bundle branch block or sustained ventricular arrhythmia, or two PVC's in a row, or ST elevation consistent with ischemia)
  • Acceptable hematology parameters:
  • Hemoglobin (Hgb) equal or above the lower limit of central lab normal (sex-specific);
  • White Blood Cell (WBC) > 3,800 and < 10,900/mm^3;
  • Platelets >/=120,000/mm^3
  • Body mass index >/=18.5-< 35.
  • Be able to understand and comply with planned study procedures.

Who cannot join

  • History of immunodeficiency.
  • Typical vaccinia scar.
  • Known or suspected history of smallpox vaccination including MVA alone or as a vector, as well as other investigational smallpox vaccines.
  • Military service prior to 1991 or after January 2003.
  • Known or suspected significant underlying illness including, but not limited to, clinically significant liver disease, diabetes mellitus, or moderate to severe kidney impairment.
  • Malignancy (not including squamous cell skin cancer or basal cell skin cancer unless at the vaccination site) or history of skin cancer at the vaccination site.
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  • Active autoimmune disease. Persons with vitiligo or thyroid disease (e.g., taking thyroid hormone replacement) are not excluded.
  • History of myocardial infarction, angina, congestive heart failure, cardiomyopathy, stroke or transient ischemic attack, or other heart condition under the care of a doctor*
  • Subjects with a not clinically relevant heart murmur, i.e., without any pathological ECG/arrhythmias or under treatment are not excluded.
  • Systolic blood pressure >/= 150mmHg or diastolic blood pressure >/= 100mmHg.
  • Ten percent or greater risk of developing a myocardial infarction or coronary death within the next 10 years using the National Cholesterol Education Program's (NCEP) risk assessment tool*
  • NOTE that this criterion applies only to subjects 20 years of age and older AND only if at least one of the following apply:
  • have smoked a cigarette in the past month, and/or
  • have hypertension (defined as systolic blood pressure >140 mm Hg) or are on antihypertensive medication, and/or
  • have a family history of coronary heart disease in male first-degree relative (father or brother) <55 years of age or a female first-degree relative (mother or sister) <65 years of age
  • URL for NCEP risk assessment tool: http://cvdrisk.nhlbi.nih.gov/calculator.asp (if a subject has an HDL of greater than 100mg/dl please enter 100 in the tool)
  • High-dose corticosteroid use for greater than 2 weeks duration within three months prior to vaccination or current use of immunosuppressive medication:
  • >5 mg prednisone or equivalent is considered high dose and immunosuppressive
  • Corticosteroid nasal sprays for allergic rhinitis are permissible
  • Persons who are using a topical steroid for mild uncomplicated dermatitis such as poison ivy or contact dermatitis may be enrolled the day after their therapy is completed
  • Inhaled steroids for asthma are not permissible
  • Oral/parenteral corticosteroids given for non-chronic conditions not expected to recur are permissible if the length of therapy was </= 14 days with completion at least 30 days prior to enrollment.
  • Medical or psychiatric condition or occupational responsibilities that preclude subject compliance with the protocol.
  • Any history of illegal injection drug use.
  • Receipt or planned receipt of inactivated vaccine from 14 days prior to the first vaccination through 14 days post second vaccination.
  • Receipt or planned receipt of any other live attenuated vaccine within 30 days prior to the first vaccination through 30 days post second vaccination.
  • Use of any other experimental agent within 30 days prior to vaccination and for the duration of the subject's participation in the study.
  • Receipt of blood products or immunoglobulin, including Rhogam, within six months prior to vaccination.
  • Donation of a unit of blood within 56 days prior to vaccination or planned donation prior to 28-days following the last vaccination.
  • Pregnant or breastfeeding women.
  • Active exfoliative skin disorders/conditions, current varicella zoster virus infection, or any acute skin disorders of large magnitude, e.g., laceration requiring sutures, burn greater than 2×2 cm.
  • Any condition that, in the opinion of the investigator, might interfere with assessing the study objectives.
  • Known allergy to egg, aminoglycoside (including gentamicin) or chicken.
  • Study personnel.
  • Allergic reaction to any vaccine.

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United States6 sites

  • University of Maryland Medical System - General Clinical Research Center (GCRC)

    Baltimore, Maryland, 21201-1544

  • Emory Vaccine Center - The Hope Clinic

    Decatur, Georgia, 30030-1705

  • Baylor College of Medicine - Molecular Virology and Microbiology

    Houston, Texas, 77030-3411

  • University of Iowa - Vaccine Research and Education Unit

    Iowa City, Iowa, 52242-2600

  • Group Health Research Institute - Seattle - Vaccines and Infectious Diseases

    Seattle, Washington, 98101-1466

  • Saint Louis University - Center for Vaccine Development

    St Louis, Missouri, 63104-1015

Other trials in United States

About this study

Official title: A Phase II, Randomized, Open-Label Study to Evaluate the Safety and Immunogenicity of IMVAMUNE® Using Three Immunization Schedules and Two Modes of Delivery

Imvamune (licensed name of MVA being developed as a smallpox vaccine) has been tested in over 2,000 individuals and is on path for licensure. This study will be a Phase II to evaluate three different immunization schedules and two different modes of delivery. The study will look at condensed schedules. Study will randomize subjects to one of four arms.

Read the detailed description

This is a Phase II, randomized, open-label immunogenicity and safety study of different immunization schedules and delivery systems (syringe and needle vs. the Stratis™) in healthy, vaccinia-naïve adults 18 years to 40 years of age, inclusive. Approximately 352 subjects will be enrolled and randomized to one of four study arms. Study Arm A (N=88) will receive a two dose regimen of IMVAMUNE® (1x10^8 TCID50/0.5 mL per dose) via the SC route using a syringe and needle on Day 1 and 29. Study Arm B (N=88) will receive a two dose regimen of IMVAMUNE® (1x10^8 TCID50/0.5 mL per dose) via the SC route using a syringe and needle on Day 1 and 15. Study Arm C (N=88) will receive a two dose regimen of IMVAMUNE® (1x10^8 TCID50/0.5 mL) via the SC route using a syringe and needle on Day 1 and 22. Study Arm D (N=88) will receive a two dose regimen of IMVAMUNE® (1x10^8 TCID50/0.5 mL) via the SC route using the Stratis™ on Day 1 and 29. Immunogenicity assessments will be performed using ELISA and PRNT. Safety assessments will be done via solicited injection site and systemic reactions. Unsolicited AEs will be collected until 28 days post last injection and SAEs for the duration of the subjects' study participation. Safety laboratory assessments will be performed at baseline and 14 days after each vaccination. Primary outcome measures: For each subject, the peak PRNT will be defined as the highest titer among all available measurements post second vaccination; Occurrence of solicited local injection site reactions in subjects receiving vaccine via the Stratis™ compared to syringe and needle administration as collected on the memory aid and by in clinic assessment. Parent protocol to sub-study 13-0027.

Conditions
Smallpox
Being tested
MVA Smallpox Vaccine
Keywords
Smallpox, vaccine, IMVAMUNE, Stratis, parent protocol
Medical subject headings
Smallpox

What participants receive

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

  • MVA Smallpox VaccineBiological

    Subjects receive two dose regimen of IMVAMUNE® (1x10^8 TCID50/0.5 mL per dose) via the SC route using either a syringe and needle or the Stratis™ system. Arm A receives doses via syringe and needle on days 1 and 29; Arm B receives doses via syringe and needle on days 1 and 15, Arm C receives doses via syringe and needle on days 1 and 22, Arm D receives doses via Stratis on days 1 and 29.

Study groups in NCT01827371
Study groupRoleWhat they receive
Arm CExperimental88 subjects receive IMVAMUNE® 1x10^8 TCID50/0.5 mL subcutaneously (SC) via syringe and needle on Days 1 and 22.
Receives: Biological: MVA Smallpox Vaccine
Arm BExperimental88 subjects receive IMVAMUNE® 1x10^8 TCID50/0.5 mL subcutaneously (SC) via syringe and needle on Days 1 and 15.
Receives: Biological: MVA Smallpox Vaccine
Arm AExperimental88 subjects receive IMVAMUNE® 1x10^8 TCID50/0.5 mL subcutaneously (SC) via syringe and needle on Days 1 and 29.
Receives: Biological: MVA Smallpox Vaccine
Arm DExperimental88 subjects receive IMVAMUNE® 1x10^8 TCID50/0.5 mL subcutaneously (SC) via Stratis™ on Days 1 and 29.
Receives: Biological: MVA Smallpox Vaccine

What is being measured

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

  1. Geometric Mean Peak Plaque Reduction Neutralization Titer (PRNT) After Second Vaccination

    Blood was collected from all participants at 8, 15, 22 and 29 days after receipt of the second vaccination for assessment of plaque reduction neutralization titers. The peak titer for each participant was defined as the highest titer among all available measurements post second vaccination. The geometric mean for each group was then assessed from individual participants' peak titers.

    Measured: Day 7 through Day 31 after 2nd vaccination

  2. Percentage of Participants Reporting Moderate or Severe Solicited Local Injection Site Reactions After Receiving Vaccine Via the Stratis™ Compared to Syringe and Needle Administration

    Participants maintained a memory aid to record daily the occurrence of local injection site reactions for 15 days after vaccination based on their interference with daily activities (pain and itchiness at injection site, underarm pain and swelling) or based on a quantitative measurement of the reaction (redness, swelling). In the subjective grading scale, severe reactions prevented daily activities, moderate reactions interfered with but did not prevent daily activities, and mild reactions were present but did not interfere with daily activities. For the quantitative scale, severe reactions greater than 30 millimeters (mm), moderate reactions were 15-30mm, and mild reactions were 1-15mm. Participants are counted by the maximum severity on any of the 15 days, and for this outcome measure, only those reporting moderate or severe events are counted. Formal comparisons by Fisher's Exact test were conducted for Arm D (Stratis, Day 1,29) compared to A

    Measured: 15 days after each vaccination

Secondary outcomes (2)

  1. Geometric Mean Peak ELISA Titer After Second Vaccination

    Blood was collected from all participants at 8, 15, 22 and 29 days after receipt of the second vaccination for assessment of antibody titers by ELISA. The peak titer for each participant was defined as the highest titer among all available measurements post second vaccination. The geometric mean for each group was then assessed from individual participants' peak titers.

    Measured: Day 7 through 31 after the 2nd vaccination

  2. Number of Subjects Experiencing Serious Adverse Events (SAEs) Associated With IMVAMUNE

    Serious adverse events included any untoward medical occurrence that resulted in death; was life threatening; was a persistent/significant disability/incapacity; required inpatient hospitalization or prolongation thereof; was a congenital anomaly/birth defect; or may have jeopardized the participant, or required intervention to prevent one of the outcomes. Association with IMVAMUNE was determined by the investigator and defined as "Related", meaning a reasonable possibility that the study product caused the adverse event. Reasonable possibility was defined as there being evidence to suggest a causal relationship between the study product and the adverse event.

    Measured: Day 1 after the first vaccination through 180 days after the 2nd vaccination.

Timeline

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

  1. First posted9 Apr 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionApr 2015
  4. Study completionApr 2015

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 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
435 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01827371
Sponsor's protocol ID
11-0021
Other IDs
HHSN272200800004C
Status last verified
May 2015
First submitted
4 Apr 2013
Last updated
7 Sep 2016

Publications

  • Jackson LA, Frey SE, El Sahly HM, Mulligan MJ, Winokur PL, Kotloff KL, Campbell JD, Atmar RL, Graham I, Anderson EJ, Anderson EL, Patel SM, Fields C, Keitel W, Rouphael N, Hill H, Goll JB. Safety and immunogenicity of a modified vaccinia Ankara vaccine using three immunization schedules and two modes of delivery: A randomized clinical non-inferiority trial. Vaccine. 2017 Mar 23;35(13):1675-1682. doi: 10.1016/j.vaccine.2017.02.032. Epub 2017 Feb 27.

    PubMed 28256358

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing MVA Smallpox Vaccine in people with Smallpox, run by National Institute of Allergy and Infectious Diseases (NIAID) at 6 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 22 inclusion and 35 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: finished, as of the sponsor's last update on 7 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 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 phase mean?

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?

Yes. Results are posted in the registry (first posted 11 Dec 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Geometric Mean Peak Plaque Reduction Neutralization Titer (PRNT) After Second Vaccination (time frame: Day 7 through Day 31 after 2nd vaccination). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01827371, which also lists 1 linked publication.

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 7 Sep 2016.

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