Experimental PfSPZ Vaccine in Adults Without Malaria

NCT01441167 | Completed Phase 1

• 2 other identifiers: 11025711-I-0257
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

Background:

• Malaria parasites are carried by mosquitoes, which spread the infection by biting people. Currently, there is no effective malaria vaccine. However, studies show that volunteers bitten many times by mosquitoes that carry weakened malaria parasites could fight off getting sick with malaria when later exposed to normal malaria parasites. Malaria parasites are weakened by exposing them to radiation when they are in the stage of development called sporozoites . Only the mosquitoes are irradiated and study volunteers are not exposed to radiation. The radiation stops the parasites from being able to cause disease but still promote protection. For many years, it was not possible to give these sporozoites to people as a vaccine since they could not be adequately purified from the mosquito. Scientists have recently figured out how to produce and isolate the weakened sporozoites so that they can be given in an injected vaccine. This vaccine is known as the "PfSPZ vaccine".
• A malaria challenge will be used to test whether the vaccine will prevent infection. In a malaria challenge, mosquitoes that have the malaria parasite will be allowed to bite a participant's arm. In the event that the vaccine does not work, the malaria parasite used for the challenge can be treated completely with common anti-malaria medications. Participants will be treated immediately if they develop malaria symptoms. Objectives: \- To test the safety and effectiveness of the PfSPZ vaccine. Eligibility: \- Healthy volunteers between 18 to 45 years of age. Design:
• Participants will be screened with a physical exam, medical history, and blood tests. There will be five different groups of study participants, all of whom will be monitored with frequent blood tests.
• Group 1 will have two vaccines with the lowest amount of the vaccine given 4 weeks apart, with regular clinic visits up to 24 weeks after the second vaccine. This group will not have a malaria challenge.
• Group 2 will have four or six vaccines given 4 weeks apart at a higher dose than group 1. A malaria challenge will be given about 3 weeks after the last vaccine. Follow-up visits will continue through 24 weeks after the last vaccine.
• Group 3 will have four or six vaccines given 4 weeks apart at a higher dose than group 2. A malaria challenge will be given about 3 weeks after the last vaccination, as for Group 2. Follow-up visits will continue through 24 weeks after last vaccine.
• Group 4 will have four or six vaccines given 4 weeks apart at a higher dose than group 3. A malaria challenge will be given about 3 weeks after the last vaccination. Follow up visits will continue through 24 weeks after last vaccine.
• Group 5 will serve as a control group and will not receive the vaccine, but will have the malaria challenge. Follow-up visits will continue through 8 weeks after the challenge. All participants from any group who receive a malaria challenge will be treated promptly for malaria when it develops.

Conditions

Malaria; Prevention and Control; Acquired Immunity

Keywords

Healthy Subjects; Immunogenicity; Vaccine-Mediated Protection; Sporozoites; Parasitemia; Healthy Volunteer; HV

Outcome Measures

Primary Outcomes (1)

• The primary objectives of the study are related to the safety and tolerability of the vaccine at the 4 dosage levels when administered IV.

Secondary Outcomes (1)

• The secondary objectives are related to PfSPZ vaccine-mediated protection against Plasmodium falciparum (Pf) challenge at the 3 higher dosage levels.

Interventions

PfSPZ BIOLOGICAL

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• A volunteer must meet all of the following criteria to be included:
• to 45 years old adults.
• Able and willing to participate for the duration of the study.
• Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process.
• Able and willing to complete the informed consent process.
• Willing to donate blood for sample storage to be used for future research.
• Willing to refrain from blood donation to blood banks for 3 years following P. falciparum challenge.
• Agree not to travel to a malaria endemic region during the entire course of study participation.
• Physical examination and laboratory results without clinically significant findings and a body mass index (BMI) less than or equal to 35 for Groups 1, 2, 3 and 4 or BMI less than or equal to 40 for Group 5.
• LABORATORY CRITERIA WITHIN 56 DAYS PRIOR TO ENROLLMENT:
• Hemoglobin greater than or equal to 11.2 g/dL for women; greater than or equal to 13.0 g/dL for men.
• Differential and platelet count either within institutional normal range or accompanied by site physician approval.
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) less than or equal to 1.25 times upper limit of normal (ULN) for Groups 1, 2, 3 and 4 or less than or equal to 1.75 ULN for Group 5.
• Serum creatinine less than or equal to upper limit of normal.
• Negative for HIV infection.

You may not qualify if:

• A volunteer will be excluded if one or more of the following conditions apply:
• Woman who is breast-feeding or planning to become pregnant during the time interval needed to complete the study.
• Receipt of a malaria vaccine in a prior clinical trial.
• Any history of malaria infection.
• Evidence of increased cardiovascular disease risk; defined as \>10% five year risk by the non-laboratory method.
• Screening EKG showing pathologic Q waves and significant ST-T wave changes; left ventricular hypertrophy; any non-sinus rhythm (except isolated premature atrial contractions); left bundle branch block; or advanced (secondary or tertiary) A-V heart block.
• Current use of systemic immunosuppressant pharmacotherapy.
• History of a splenectomy, sickle cell disease or sickle cell trait.
• Plan for major surgery between enrollment and challenge.
• Known allergy to any component of the vaccine formulation; history of anaphylactic response to mosquito-bites; or known allergy to chloroquine phosphate, atovaquone or proguanil.
• Participation in any study involving another investigational vaccine or drug within 12 weeks prior to enrollment, or plan to participate in another investigational vaccine/drug research during the study.
• Personal beliefs that prohibit the receiving of vaccine product containing human serum albumin within the diluent.
• Use or planned use of any drug with anti-malarial activity that would coincide with study vaccination or challenge.
• History of psoriasis or porphyria, which may be exacerbated after treatment with chloroquine.
• Anticipated use of medications known to cause drug reactions with chloroquine or atovaquone-proguanil (Malarone) such as cimetidine, metoclopramide, antacids, and kaolin.

Sponsors & Collaborators

• National Institute of Allergy and Infectious Diseases (NIAID): lead
• Sanaria Incorporated: collaborator
• U.S. Military Malaria Vaccine Program: collaborator

Study Sites (1)

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, Maryland, 20892, United States

Location

Related Publications (4)

• Sachs J, Malaney P. The economic and social burden of malaria. Nature. 2002 Feb 7;415(6872):680-5. doi: 10.1038/415680a.

  PMID: 11832956 BACKGROUND

• Breman JG. Eradicating malaria. Sci Prog. 2009;92(Pt 1):1-38. doi: 10.3184/003685009X440290.

  PMID: 19544698 BACKGROUND

• Nussenzweig RS, Vanderberg J, Most H, Orton C. Protective immunity produced by the injection of x-irradiated sporozoites of plasmodium berghei. Nature. 1967 Oct 14;216(5111):160-2. doi: 10.1038/216160a0. No abstract available.

  PMID: 6057225 BACKGROUND

• Seder RA, Chang LJ, Enama ME, Zephir KL, Sarwar UN, Gordon IJ, Holman LA, James ER, Billingsley PF, Gunasekera A, Richman A, Chakravarty S, Manoj A, Velmurugan S, Li M, Ruben AJ, Li T, Eappen AG, Stafford RE, Plummer SH, Hendel CS, Novik L, Costner PJ, Mendoza FH, Saunders JG, Nason MC, Richardson JH, Murphy J, Davidson SA, Richie TL, Sedegah M, Sutamihardja A, Fahle GA, Lyke KE, Laurens MB, Roederer M, Tewari K, Epstein JE, Sim BK, Ledgerwood JE, Graham BS, Hoffman SL; VRC 312 Study Team. Protection against malaria by intravenous immunization with a nonreplicating sporozoite vaccine. Science. 2013 Sep 20;341(6152):1359-65. doi: 10.1126/science.1241800. Epub 2013 Aug 8.

  PMID: 23929949 DERIVED

MeSH Terms

Conditions

Malaria; Parasitemia

Condition Hierarchy (Ancestors)

Protozoan Infections; Parasitic Diseases; Infections; Mosquito-Borne Diseases; Vector Borne Diseases; Sepsis; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Robert A Seder, M.D.

  National Institute of Allergy and Infectious Diseases (NIAID)

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: NIH

Study Record Dates

• First Submitted: September 24, 2011
• First Posted: September 27, 2011
• Study Start: September 14, 2011
• Primary Completion: June 5, 2013
• Study Completion: June 5, 2013
• Last Updated: July 5, 2018

Record last verified: 2013-06-05

Locations

US (1)