MalariaPhase 1NCT02115516
Safety and Protective Efficacy of Intravenous Immunization With Cryopreserved Plasmodium Falciparum Sporozoites Under Chemoprophylaxis
A Phase 1 study testing PfSPZ Challenge in people with Malaria and Plasmodium Falciparum Malaria, run by Sanaria Inc. at 1 site in Germany.
Trial summary
TÜCHMI-002 is a single center, randomized, placebo-controlled, double-blinded, PfSPZ Challenge dose finding trial with two chemoprophylactic regimens and subsequent controlled human malaria infection (CHMI). Read more about this study
- Who is it for?
- Ages 18 to 45 yearsHealthy volunteers can take part
- Conditions the study is for
- Malaria, Plasmodium Falciparum Malaria
- What is being tested?
- PfSPZ Challenge
- Type of treatment
- Vaccines, Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 67 participants
- Where
- 1 siteGermany
- Study dates
- Apr 2014to Apr 2016
- Phase
- Phase 1
- 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 18 to 45 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- The volunteer must satisfy all the following criteria to be eligible for the study:
- Healthy adults aged 18 to 45 years.
- Able and willing (in the Investigator's opinion) to comply with all study requirements.
- Willing to allow the investigators to discuss the volunteer's medical history with their general practitioner ('Hausarzt') if required.
- Residence in Tübingen or surroundings for the period of the trial.
- Women only: Must agree to practice continuous effective contraception for the duration of the study (a method which results in a low failure rate; i.e. less than 1% per year).
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- Agreement to refrain from blood donation during the course of the study and after the end of their involvement in the study according to the local and national blood banking eligibility criteria (currently four years in Germany).
- Written informed consent to receive PfSPZ Challenge for immunization and subsequently for CHMI.
- Reachable (24/7) by mobile phone during the immunization and CHMI period.
- Willingness to take CQ and ER-AZ during immunization and a curative antimalarial regimen following CHMI.
- Agreement to stay overnight for observation during the period of intensive follow-up post-challenge if required.
- Answer all questions on the informed consent quiz correctly.
- A body mass index <35.
- A hemoglobin concentration ≥12 g/dl for women and ≥13.5 g/dl for men.
Who cannot join
- The volunteer may not enter the study if any of the following apply:
- History of Pf malaria.
- Planned travel to malaria endemic areas.
- Use of systemic antibiotics with known antimalarial activity within 30 days of study enrollment (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, or azithromycin).
- Receipt of an investigational product in the 30 days preceding enrollment, or planned receipt during the study period.
- Prior receipt of an investigational malaria vaccine.
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- Immunization with more than 3 other vaccines within the past month.
- HIV infection.
- Any confirmed or suspected immunosuppressive or immunodeficient state, asplenia, recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
- Use of immunoglobulins or blood products within 3 months prior to enrolment.
- Presence of sickle cell anemia, sickle cell trait, thalassemia or thalassemia trait, glucose-6-phosphate dehydrogenase deficiency.
- Pregnancy, lactation or intention to become pregnant during the study.
- A history of allergic disease or reactions likely to be exacerbated by malaria.
- Contraindications to the use of the following antimalarial medications: atovaquone/proguanil, artemether-lumefantrine, mefloquine, azithromycin and chloroquine.
- History of cancer (except basal cell carcinoma of the skin and cervical carcinoma in situ).
- History of serious psychiatric condition that may affect participation in the study (including but not restricted to organic, including symptomatic, mental disorders [ICD-10 code: F00-F09], schizophrenia, schizotypal and delusional disorders [F20-F29], mood (affective) disorders [F30-F39], mental retardation [F70-F79], Disorders of psychological development [F80-F89] or any other psychiatric condition that required hospitalization or psychiatric treatment over an extended period).
- Any other serious chronic illness requiring hospital specialist supervision.
- Suspected or known current alcohol abuse as defined by an alcohol intake of greater than 60 g (men) or 40 g (women) per day or a carbohydrate deficient transferrin (CDT) level ≥2.5%.
- Suspected or known injecting drug abuse in the 5 years preceding enrollment.
- Positive for hepatitis B surface antigen (HBs-antigen).
- Seropositive for hepatitis C virus (antibodies to HCV).
- Falling in moderate risk or higher categories for fatal or non-fatal cardiovascular event within 5 years (>10%) determined by non-invasive criteria for cardiac risk.
- Abnormal electrocardiogram on screening: pathologic Q wave and significant ST-T wave changes, left ventricular hypertrophy, non-sinus rhythm except isolated premature atrial contractions, right of left bundle branch block, advanced A-V heart block (secondary or tertiary).
- A QT/QTc interval >450 ms.
- Volunteers unable to be closely followed for social, geographic or psychological reasons.
- Any clinically significant abnormal finding on biochemistry or hematology blood tests, urine analysis or clinical examination.
- Retinal abnormalities.
- History of seizure.
- Any other significant disease, disorder or finding which, in the opinion of the investigator, may significantly increase the risk to the volunteer because of participation in the study, affect the ability of the volunteer to participate in the study or impair interpretation of the study data.
- In case of inconclusive results of laboratory tests or other diagnostic procedures, test will be repeated. If doubts about the results persist, volunteers will be considered ineligible.
Trial locations and contacts
1 site in 1 country.
Germany1 site
Institute of Tropical Medicine, University of Tuebingen, Wilhelmstr. 27
Tübingen, D-72074
About this study
TÜCHMI-002 is a single center, randomized, placebo-controlled, double-blinded, PfSPZ Challenge dose finding trial with two chemoprophylactic regimens and subsequent controlled human malaria infection (CHMI).
Read the detailed description
TÜCHMI-002 is a single center, randomized, placebo-controlled, double-blinded, PfSPZ Challenge dose finding trial with two chemoprophylactic regimens and subsequent controlled human malaria infection (CHMI), designed to establish a regimen of PfSPZ Challenge under chemoprophylaxis, with PfSPZ Challenge administered IV, that:
- Is safe and well tolerated.
- Provides consistent sterile protection against CHMI with homologous sporozoites in healthy adult subjects.
- Is a practical regimen for PfSPZ Challenge chemoprophylaxis.
Volunteers will receive three immunizing PfSPZ Challenge IV injections 4 weeks apart under oral chemoprophylaxis. The trial is sequential and has two stages:
- In the first stage, the PfSPZ Challenge dose is increased sequentially from 3,200 to 51,200 PfSPZ among the three groups. Controls for the three groups will receive 0.9% Sodium Chloride (NaCl) as placebo. All volunteers will receive a standard chemoprophylactic regimen of chloroquine (CQ) for 10 weeks. Briefly, 10 mg/kg CQ base will be given as loading dose followed by weekly doses of 5 mg/kg CQ base. Homologous CHMI is done with 3,200 PfSPZ Challenge IV eight weeks after the last immunizing PfSPZ Challenge injection.
- In Stage B, accelerated regimens with CQ and CQ plus ER-AZ will be assessed. Initiation of Stage B of the trial is dependent upon demonstration of at least 75% (6 out of 8) protective efficacy against homologous CHMI in Stage A, no PfSPZ Challenge related SAEs and approval by the Safety Monitoring Committee (SMC). CHMI is done with 3,200 PfSPZ Challenge (NF54) IV ten weeks after the last immunization with PfSPZ Challenge under chemoprophylaxis. Injections are either done over 28 or 10 days, chemoprophylaxis is given for 5 weeks and 15 days, respectively. Control groups will receive 0.9% NaCl IV as placebo under the respective chemoprophylactic regimen.
Transition from Stage A to Stage B depends on a positive safety and efficacy review and approval by an independent SMC. Safety and efficacy data will also be submitted to the regulatory authorities (FDA in the U.S. and Paul-Ehrlich-Institute in Germany) as well as to the Ethics Committee. Sponsor, SMC and principal investigator will select PfSPZ dose after review of safety and efficacy data. In case of 100% efficacy of more than one dose regimen and comparable tolerability and safety, the higher PfSPZ dose will be used. Information about the selected dose together with the updated volunteer information document stating the dose will be submitted to the ethics committee for approval before initiation of Stage B. In case that PfSPZ Challenge related SAEs occur or efficacy of the best regimen is below 75% the study will not proceed to Stage B.
- Conditions
- Malaria, Plasmodium Falciparum Malaria
- Being tested
- PfSPZ Challenge, 0.9% Sodium Chloride (Placebo)
- Keywords
- Malaria, Plasmodium falciparum malaria, Antimalarial chemoprophylaxis, PfSPZ Challenge, Cryopreserved Plasmodium Falciparum Sporozoites, PfSPZ-CVac
- Medical subject headings
- Malaria, Malaria, Falciparum
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PfSPZ ChallengeBiological
Aseptic, purified, vialed, cryopreserved, infectious P. falciparum sporozoites, strain NF54
0.9% Sodium Chloride (Placebo)Biological
| Study group | Role | What they receive |
|---|---|---|
| Stage A: Grp A1 - 3,200 PfSPZ Challenge | Experimental | Group A1 (PfSPZ Challenge) (n=9) receives three injections of 3,200 PfSPZ Challenge intravenous (IV) at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 19, if required. All groups in Stage A are scheduled to be unblinded on Week 27. Receives: Biological: PfSPZ Challenge |
| Stage A: Grp A2 - 12,800 PfSPZ Challenge | Experimental | Group A2 (PfSPZ Challenge) (n=9) starts when Group A1 receives the second immunization. Group A2 receives three injections of 12,800 PfSPZ Challenge IV at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 23, if required. All groups in Stage A are scheduled to be unblinded on Week 27. Receives: Biological: PfSPZ Challenge |
| Stage A: Grp A3 - 51,200 PfSPZ Challenge | Experimental | Group A3 (PfSPZ Challenge) (n=9) starts when Group A2 receives the second immunization. Group A3 receives three injections of 51,200 PfSPZ Challenge IV at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. This group is scheduled to be unblinded with all other groups in Stage A Week on 27. Receives: Biological: PfSPZ Challenge |
| Stage A: Grp A1 - 0.9% Sodium Chloride | Placebo comparator | Group A1 (placebo) (n=5) receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 19, if required. All groups in Stage A are scheduled to be unblinded on Week 27. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
| Stage A: Grp A2 - 0.9% Sodium Chloride | Placebo comparator | Group A2 (placebo) (n=5) starts when Group A1 receives the second immunization. Group A2 receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 23, if required. All groups in Stage A are scheduled to be unblinded on Week 27. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
| Stage A: Grp A3 - 0.9% Sodium Chloride | Placebo comparator | Group A3 (placebo) (n=5) starts when Group A2 receives the second immunization. Group A3 receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. This group is scheduled to be unblinded with all other groups in Stage A on Week 27. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
| Stage B: Grp B1 - 51,200 PfSPZ Challenge | Experimental | Group B1 (n=5) will receive the optimal PfSPZ Challenge immunizing dose from the dose-escalation phase (Stage A; 51,200 PfSPZ Challenge (NF54)), using the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), but for five instead of ten weeks. Group B1 will receive 3 injections of 51,200 PfSPZ Challenge (NF54) on days 0, 14 and 28. All volunteers in Group B1 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. Receives: Biological: PfSPZ Challenge |
| Stage B: Group B1 - 0.9% Sodium Chloride | Placebo comparator | Group B1 (placebo) (n=2) will receive three injections of 0.9% Sodium Chloride on days 0, 14 and 28. This group will follow the the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), but for five instead of ten weeks. All volunteers in Group B1 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
| Stage B: Grp B2 - 51,200 PfSPZ Challenge | Experimental | Group B2 (n=5) will receive 3 injections of 51,200 PfSPZ Challenge on days 0, 14 and 28, using same std chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), for 5 instead of 10 wks. But Group B2 will receive extended-release azithromycin (ER-AZ, 2g) on the day of 1st PfSPZ Challenge and monitored for parasitemia by quantitative real time polymerase reaction (qPCR). In case that all CQ+ER-AZ treated volunteers are parasite-free until Day 11 following first PfSPZ Challenge injection, it will indicate that ER-AZ effectively killed the parasites in the liver prior to development of parasitemia. With demonstration of the effectiveness of ER-AZ, the 2nd and 3rd immunizations will be done under ER-AZ alone, otherwise CQ prophylaxis will continue and ER-AZ will not be administered for the 2nd and 3rd injections. Group B2 will undergo homologous CHMI with PfSPZ Challenge, 10 weeks after the last immunization. Receives: Biological: PfSPZ Challenge |
| Stage B: Group B2 - 0.9% Sodium Chloride | Placebo comparator | Group B2 (placebo) (n=2) will receive three injections of 0.9% Sodium Chloride on days 0, 14 and 28, using the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), for 5 instead of 10 wks. But Group B2 will receive ER-AZ, 2g on the day of 1st placebo injection and monitored for parasitemia by qPCR. In case that all CQ+ER-AZ treated volunteers are parasite-free until Day 11 following 1st injection, it will indicate that ER-AZ effectively killed the parasites in the liver prior to the development of parasitemia. With demonstration of the effectiveness of ER-AZ, the 2nd and 3rd immunizations will be done under ER-AZ alone, otherwise CQ prophylaxis will be continued and ER-AZ will not be administered for 2nd and 3rd injections. Group B2 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after last immunization. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
| Stage B: Grp B3 - 51,200 PfSPZ Challenge | Experimental | Group B3 (n=9) volunteers will receive CQ and PfSPZ Challenge simultaneously every five days with one additional dose of CQ five days after the third PfSPZ Challenge injection. A 10 mg/kg CQ base loading dose is given at the time of first PfSPZ Challenge inoculation, followed by 5 mg/kg CQ base on the day of second and third inoculation and five days after the last PfSPZ Challenge inoculation. Group B3 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. Receives: Biological: PfSPZ Challenge |
| Stage B: Group B3 - 0.9% Sodium Chloride | Placebo comparator | Group B3 (placebo) (n=2) volunteers will receive CQ and 0.9% Sodium Chloride simultaneously every five days with one additional dose of CQ five days after the third placebo injection. A 10 mg/kg CQ base loading dose is given at the time of first placebo injection, followed by 5 mg/kg CQ base on the day of second and third injections and five days after the last placebo injection. Group B3 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. Receives: Biological: 0.9% Sodium Chloride (Placebo) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of volunteers who become parasitemic, detected by thick blood film microscopy, within 21 days following CHMI after immunization using PfSPZ Challenge or placebo under chemoprophylaxis [PfSPZ Challenge Vaccine (PfSPZ-CVac) approach].
Measured: Within 21 days following CHMI
Occurrence of related Grade 3 adverse events (AEs) and SAEs from time of first administration of an immunizing regimen (chemoprophylactic antimalarial and PfSPZ Challenge) until the end of the study.
Measured: 19 months
Secondary outcomes (2)
Time to microscopically detectable parasitemia (pre-patent period) in volunteers who become parasitemic within 21 days following CHMI after immunization using PfSPZ Challenge or placebo and an antimalarial.
Measured: Within 21 days following CHMI
Occurrence of any related AE from time of first administration of an immunizing regimen (chemoprophylactic antimalarial and PfSPZ Challenge) until the end of the study.
Measured: 19 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Apr 2014 (estimated)
- Study startApr 2014
- Primary completionDec 2015
- Study completionApr 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for MalariaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 67 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanaria Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Institute of Tropical Medicine, University of Tuebingen, German Federal Ministry of Education and Research
- Responsible party
- Sponsor
- Investigators
- Benjamin Mordmüller, MD, Principal investigator, Institute of Tropical Medicine, University of Tuebingen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02115516
- Sponsor's protocol ID
- TUCHMI-002
- Other IDs
- 2013-003900-38
- Status last verified
- Feb 2016
- First submitted
- 11 Apr 2014
- Last updated
- 15 May 2017
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Mordmuller B, Surat G, Lagler H, Chakravarty S, Ishizuka AS, Lalremruata A, Gmeiner M, Campo JJ, Esen M, Ruben AJ, Held J, Calle CL, Mengue JB, Gebru T, Ibanez J, Sulyok M, James ER, Billingsley PF, Natasha KC, Manoj A, Murshedkar T, Gunasekera A, Eappen AG, Li T, Stafford RE, Li M, Felgner PL, Seder RA, Richie TL, Sim BK, Hoffman SL, Kremsner PG. Sterile protection against human malaria by chemoattenuated PfSPZ vaccine. Nature. 2017 Feb 23;542(7642):445-449. doi: 10.1038/nature21060. Epub 2017 Feb 15.
PubMed 28199305Requena P, Gomez-Perez GP, McCall MBB, Barrios D, Aguilar R, Fernandez-Morata J, Vidal M, Campo JJ, Sanchez C, Yazdabankhsh M, Sim BKL, Hoffman SL, Kremsner P, Lell B, Mordmuller B, Dobano C, Moncunill G. Effect of controlled human Plasmodium falciparum infection on B cell subsets in individuals with different levels of malaria immunity. Med Microbiol Immunol. 2025 Sep 27;214(1):47. doi: 10.1007/s00430-025-00847-x.
PubMed 41014333Mouwenda YD, Jochems SP, Van Unen V, Betouke Ongwe ME, de Steenhuijsen Piters WAA, Stam KA, Massinga Loembe M, Sim BKL, Esen M, Hoffman SL, Kremsner PG, Fendel R, Mordmuller B, Yazdanbakhsh M. Immune responses associated with protection induced by chemoattenuated PfSPZ vaccine in malaria-naive Europeans. JCI Insight. 2024 May 8;9(9):e170210. doi: 10.1172/jci.insight.170210.
PubMed 38716733
Study at a glance
From the registry record, last updated by the sponsor on 15 May 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Safety and Protective Efficacy of Intravenous Immunization With Cryopreserved Plasmodium Falciparum Sporozoites Under Chemoprophylaxis
- ClinicalTrials.gov ID
- NCT02115516
- Acronym / sponsor ID
- TUCHMI-002
- Conditions
- Malaria, Plasmodium Falciparum Malaria
- Keywords
- Malaria, Plasmodium falciparum malaria, Antimalarial chemoprophylaxis, PfSPZ Challenge, Cryopreserved Plasmodium Falciparum Sporozoites, PfSPZ-CVac
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 67 participants (actual)
- Lead sponsor
- Sanaria Inc.Industry (pharma, biotech, devices)
- Collaborators
- Institute of Tropical Medicine, University of Tuebingen, German Federal Ministry of Education and Research
- Study start
- Apr 2014
- Primary completion
- Dec 2015 (actual)
- Study completion
- Apr 2016 (actual)
- First posted
- 16 Apr 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
TÜCHMI-002 is a single center, randomized, placebo-controlled, double-blinded, PfSPZ Challenge dose finding trial with two chemoprophylactic regimens and subsequent controlled human malaria infection (CHMI).
Detailed description
TÜCHMI-002 is a single center, randomized, placebo-controlled, double-blinded, PfSPZ Challenge dose finding trial with two chemoprophylactic regimens and subsequent controlled human malaria infection (CHMI), designed to establish a regimen of PfSPZ Challenge under chemoprophylaxis, with PfSPZ Challenge administered IV, that:
- Is safe and well tolerated.
- Provides consistent sterile protection against CHMI with homologous sporozoites in healthy adult subjects.
- Is a practical regimen for PfSPZ Challenge chemoprophylaxis.
Volunteers will receive three immunizing PfSPZ Challenge IV injections 4 weeks apart under oral chemoprophylaxis. The trial is sequential and has two stages:
- In the first stage, the PfSPZ Challenge dose is increased sequentially from 3,200 to 51,200 PfSPZ among the three groups. Controls for the three groups will receive 0.9% Sodium Chloride (NaCl) as placebo. All volunteers will receive a standard chemoprophylactic regimen of chloroquine (CQ) for 10 weeks. Briefly, 10 mg/kg CQ base will be given as loading dose followed by weekly doses of 5 mg/kg CQ base. Homologous CHMI is done with 3,200 PfSPZ Challenge IV eight weeks after the last immunizing PfSPZ Challenge injection.
- In Stage B, accelerated regimens with CQ and CQ plus ER-AZ will be assessed. Initiation of Stage B of the trial is dependent upon demonstration of at least 75% (6 out of 8) protective efficacy against homologous CHMI in Stage A, no PfSPZ Challenge related SAEs and approval by the Safety Monitoring Committee (SMC). CHMI is done with 3,200 PfSPZ Challenge (NF54) IV ten weeks after the last immunization with PfSPZ Challenge under chemoprophylaxis. Injections are either done over 28 or 10 days, chemoprophylaxis is given for 5 weeks and 15 days, respectively. Control groups will receive 0.9% NaCl IV as placebo under the respective chemoprophylactic regimen.
Transition from Stage A to Stage B depends on a positive safety and efficacy review and approval by an independent SMC. Safety and efficacy data will also be submitted to the regulatory authorities (FDA in the U.S. and Paul-Ehrlich-Institute in Germany) as well as to the Ethics Committee. Sponsor, SMC and principal investigator will select PfSPZ dose after review of safety and efficacy data. In case of 100% efficacy of more than one dose regimen and comparable tolerability and safety, the higher PfSPZ dose will be used. Information about the selected dose together with the updated volunteer information document stating the dose will be submitted to the ethics committee for approval before initiation of Stage B. In case that PfSPZ Challenge related SAEs occur or efficacy of the best regimen is below 75% the study will not proceed to Stage B.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 12
| Arm | Type | Receives |
|---|---|---|
| Stage A: Grp A1 - 3,200 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup A1 (PfSPZ Challenge) (n=9) receives three injections of 3,200 PfSPZ Challenge intravenous (IV) at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 19, if required. All groups in Stage A are scheduled to be unblinded on Week 27. |
| Stage A: Grp A2 - 12,800 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup A2 (PfSPZ Challenge) (n=9) starts when Group A1 receives the second immunization. Group A2 receives three injections of 12,800 PfSPZ Challenge IV at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 23, if required. All groups in Stage A are scheduled to be unblinded on Week 27. |
| Stage A: Grp A3 - 51,200 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup A3 (PfSPZ Challenge) (n=9) starts when Group A2 receives the second immunization. Group A3 receives three injections of 51,200 PfSPZ Challenge IV at 4-week intervals. Immunizations are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first PfSPZ Challenge injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last immunization, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. This group is scheduled to be unblinded with all other groups in Stage A Week on 27. |
| Stage A: Grp A1 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group A1 (placebo) (n=5) receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 19, if required. All groups in Stage A are scheduled to be unblinded on Week 27. |
| Stage A: Grp A2 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group A2 (placebo) (n=5) starts when Group A1 receives the second immunization. Group A2 receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. Early unblinding for this group may be done on Week 23, if required. All groups in Stage A are scheduled to be unblinded on Week 27. |
| Stage A: Grp A3 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group A3 (placebo) (n=5) starts when Group A2 receives the second immunization. Group A3 receives three injections of 0.9% Sodium chloride IV at 4 week intervals. Placebo injections are given under a standard chemoprophylactic regimen with chloroquine. Two days before the first placebo injection volunteers receive one oral dose of 10 mg/kg CQ base. On Day 5 volunteers will receive 5 mg/kg CQ base. Subsequently, volunteers will receive 5 mg/kg CQ base in weekly intervals for a total of ten doses. Eight weeks after the last placebo injection, volunteers will undergo homologous CHMI with 3,200 PfSPZ Challenge IV. This group is scheduled to be unblinded with all other groups in Stage A on Week 27. |
| Stage B: Grp B1 - 51,200 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup B1 (n=5) will receive the optimal PfSPZ Challenge immunizing dose from the dose-escalation phase (Stage A; 51,200 PfSPZ Challenge (NF54)), using the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), but for five instead of ten weeks. Group B1 will receive 3 injections of 51,200 PfSPZ Challenge (NF54) on days 0, 14 and 28. All volunteers in Group B1 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. |
| Stage B: Group B1 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group B1 (placebo) (n=2) will receive three injections of 0.9% Sodium Chloride on days 0, 14 and 28. This group will follow the the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), but for five instead of ten weeks. All volunteers in Group B1 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. |
| Stage B: Grp B2 - 51,200 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup B2 (n=5) will receive 3 injections of 51,200 PfSPZ Challenge on days 0, 14 and 28, using same std chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), for 5 instead of 10 wks. But Group B2 will receive extended-release azithromycin (ER-AZ, 2g) on the day of 1st PfSPZ Challenge and monitored for parasitemia by quantitative real time polymerase reaction (qPCR). In case that all CQ+ER-AZ treated volunteers are parasite-free until Day 11 following first PfSPZ Challenge injection, it will indicate that ER-AZ effectively killed the parasites in the liver prior to development of parasitemia. With demonstration of the effectiveness of ER-AZ, the 2nd and 3rd immunizations will be done under ER-AZ alone, otherwise CQ prophylaxis will continue and ER-AZ will not be administered for the 2nd and 3rd injections. Group B2 will undergo homologous CHMI with PfSPZ Challenge, 10 weeks after the last immunization. |
| Stage B: Group B2 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group B2 (placebo) (n=2) will receive three injections of 0.9% Sodium Chloride on days 0, 14 and 28, using the same standard chemoprophylactic regimen with CQ (10 mg/kg CQ base loading dose, followed by weekly dosing with 5 mg/kg CQ base), for 5 instead of 10 wks. But Group B2 will receive ER-AZ, 2g on the day of 1st placebo injection and monitored for parasitemia by qPCR. In case that all CQ+ER-AZ treated volunteers are parasite-free until Day 11 following 1st injection, it will indicate that ER-AZ effectively killed the parasites in the liver prior to the development of parasitemia. With demonstration of the effectiveness of ER-AZ, the 2nd and 3rd immunizations will be done under ER-AZ alone, otherwise CQ prophylaxis will be continued and ER-AZ will not be administered for 2nd and 3rd injections. Group B2 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after last immunization. |
| Stage B: Grp B3 - 51,200 PfSPZ Challenge | Experimental | Biological: PfSPZ ChallengeGroup B3 (n=9) volunteers will receive CQ and PfSPZ Challenge simultaneously every five days with one additional dose of CQ five days after the third PfSPZ Challenge injection. A 10 mg/kg CQ base loading dose is given at the time of first PfSPZ Challenge inoculation, followed by 5 mg/kg CQ base on the day of second and third inoculation and five days after the last PfSPZ Challenge inoculation. Group B3 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. |
| Stage B: Group B3 - 0.9% Sodium Chloride | Placebo comparator | Biological: 0.9% Sodium Chloride (Placebo)Group B3 (placebo) (n=2) volunteers will receive CQ and 0.9% Sodium Chloride simultaneously every five days with one additional dose of CQ five days after the third placebo injection. A 10 mg/kg CQ base loading dose is given at the time of first placebo injection, followed by 5 mg/kg CQ base on the day of second and third injections and five days after the last placebo injection. Group B3 will undergo homologous CHMI with PfSPZ Challenge 10 weeks after the last immunization. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (14 listed)
- Healthy adults aged 18 to 45 years.
- Able and willing (in the Investigator's opinion) to comply with all study requirements.
- Willing to allow the investigators to discuss the volunteer's medical history with their general practitioner ('Hausarzt') if required.
- Residence in Tübingen or surroundings for the period of the trial.
- Women only: Must agree to practice continuous effective contraception for the duration of the study (a method which results in a low failure rate; i.e. less than 1% per year).
Key exclusion criteria (30 listed)
- History of Pf malaria.
- Planned travel to malaria endemic areas.
- Use of systemic antibiotics with known antimalarial activity within 30 days of study enrollment (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones, or azithromycin).
- Receipt of an investigational product in the 30 days preceding enrollment, or planned receipt during the study period.
- Prior receipt of an investigational malaria vaccine.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PfSPZ ChallengeAseptic, purified, vialed, cryopreserved, infectious P. falciparum sporozoites, strain NF54 | Biological | Stage A: Grp A1 - 3,200 PfSPZ Challenge, Stage A: Grp A2 - 12,800 PfSPZ Challenge, Stage A: Grp A3 - 51,200 PfSPZ Challenge, Stage B: Grp B1 - 51,200 PfSPZ Challenge, Stage B: Grp B2 - 51,200 PfSPZ Challenge, Stage B: Grp B3 - 51,200 PfSPZ Challenge |
| 0.9% Sodium Chloride (Placebo) | Biological | Stage A: Grp A1 - 0.9% Sodium Chloride, Stage A: Grp A2 - 0.9% Sodium Chloride, Stage A: Grp A3 - 0.9% Sodium Chloride, Stage B: Group B1 - 0.9% Sodium Chloride, Stage B: Group B2 - 0.9% Sodium Chloride, Stage B: Group B3 - 0.9% Sodium Chloride |
Primary outcome
Proportion of volunteers who become parasitemic, detected by thick blood film microscopy, within 21 days following CHMI after immunization using PfSPZ Challenge or placebo under chemoprophylaxis [PfSPZ Challenge Vaccine (PfSPZ-CVac) approach].
Time frame: Within 21 days following CHMI
Occurrence of related Grade 3 adverse events (AEs) and SAEs from time of first administration of an immunizing regimen (chemoprophylactic antimalarial and PfSPZ Challenge) until the end of the study.
Time frame: 19 months
2 secondary outcomes
Time to microscopically detectable parasitemia (pre-patent period) in volunteers who become parasitemic within 21 days following CHMI after immunization using PfSPZ Challenge or placebo and an antimalarial.
Time frame: Within 21 days following CHMI
Occurrence of any related AE from time of first administration of an immunizing regimen (chemoprophylactic antimalarial and PfSPZ Challenge) until the end of the study.
Time frame: 19 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 May 2017.
- Results publication: PubMed 28199305Mordmuller B, Surat G, Lagler H, Chakravarty S, Ishizuka AS, Lalremruata A, Gmeiner M, Campo JJ, Esen M, Ruben AJ, Held J, Calle CL, Mengue JB, Gebru T, Ibanez J, Sulyok M, James ER, Billingsley PF, Natasha KC, Manoj A, Murshedkar T, Gunasekera A, Eappen AG, Li T, Stafford RE, Li M, Felgner PL, Seder RA, Richie TL, Sim BK, Hoffman SL, Kremsner PG. Sterile protection against human malaria by chemoattenuated PfSPZ vaccine. Nature. 2017 Feb 23;542(7642):445-449. doi: 10.1038/nature21060. Epub 2017 Feb 15.
- Derived from this study: PubMed 41014333Requena P, Gomez-Perez GP, McCall MBB, Barrios D, Aguilar R, Fernandez-Morata J, Vidal M, Campo JJ, Sanchez C, Yazdabankhsh M, Sim BKL, Hoffman SL, Kremsner P, Lell B, Mordmuller B, Dobano C, Moncunill G. Effect of controlled human Plasmodium falciparum infection on B cell subsets in individuals with different levels of malaria immunity. Med Microbiol Immunol. 2025 Sep 27;214(1):47. doi: 10.1007/s00430-025-00847-x.
- Derived from this study: PubMed 38716733Mouwenda YD, Jochems SP, Van Unen V, Betouke Ongwe ME, de Steenhuijsen Piters WAA, Stam KA, Massinga Loembe M, Sim BKL, Esen M, Hoffman SL, Kremsner PG, Fendel R, Mordmuller B, Yazdanbakhsh M. Immune responses associated with protection induced by chemoattenuated PfSPZ vaccine in malaria-naive Europeans. JCI Insight. 2024 May 8;9(9):e170210. doi: 10.1172/jci.insight.170210.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Benjamin Mordmüller, MD principal investigator
Institute of Tropical Medicine, University of Tuebingen
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing PfSPZ Challenge in people with Malaria and Plasmodium Falciparum Malaria, run by Sanaria Inc. at 1 site in Germany.
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 14 inclusion and 30 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 15 May 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Germany. 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. Some participants in this study may receive a placebo. 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 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.
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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Proportion of volunteers who become parasitemic, detected by thick blood film microscopy, within 21 days following CHMI after immunization using PfSPZ Challenge or placebo under chemoprophylaxis [PfSPZ Challenge Vaccine (PfSPZ-CVac) approach]. (time frame: Within 21 days following CHMI). 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 NCT02115516, which also lists 3 linked publications.
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 15 May 2017.