NCT03813108

Brief Summary

This is an open label, randomized, controlled clinical trial. The primary aim of this project is to determine the safety and tolerability of NF135.C10 sporozoite immunization under chemoprophylaxis against homologous and heterologous challenge infection.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
43

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Apr 2019

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 17, 2019

Completed
6 days until next milestone

First Posted

Study publicly available on registry

January 23, 2019

Completed
2 months until next milestone

Study Start

First participant enrolled

April 1, 2019

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2021

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

May 11, 2022

Completed
Last Updated

May 26, 2023

Status Verified

May 1, 2023

Enrollment Period

1.8 years

First QC Date

January 17, 2019

Results QC Date

October 28, 2021

Last Update Submit

May 25, 2023

Conditions

Keywords

Mosquito bitesSporozoiteImmunizationMalariaFalciparum

Outcome Measures

Primary Outcomes (2)

  • Frequency of Adverse Events After NF135.C10 CPS Immunization

    The number of adverse events will be recorded by the trial clinicians for all participants.

    Cohort A: Inclusion until 35 days after challenge infection (35 weeks) Cohort B: Inclusion - premature end of study (22 weeks)

  • Magnitude of Adverse Events After NF135.C10 CPS Immunization

    The severity of adverse events will be recorded (mild/moderate/severe) for each adverse event

    Cohort A: Inclusion until 35 days after challenge infection (35 weeks) Cohort B: Inclusion - premature end of study (22 weeks)

Secondary Outcomes (1)

  • Time to Parasitemia

    Day 1 - 28 after malaria challenge infection (28 days)

Study Arms (7)

1: NF135 CPS-immunization challenged by NF135

EXPERIMENTAL

10 volunteers will receive three immunizations with 15 NF135.C10 infected Anopheles mosquitoes under mefloquine prophylaxis. Volunteers will be challenged by the bites of 5 NF135.C10 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: CPS-immunizationBiological: malaria challenge infection, P. falciparum NF135.C10Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

2: Low dose NF135 CPS-immunization challenged by NF135

EXPERIMENTAL

10 volunteers will receive three immunizations with 5 NF135.C10 infected Anopheles mosquitoes under mefloquine prophylaxis. Volunteers will be challenged by the bites of 5 NF135.C10 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: CPS-immunizationBiological: malaria challenge infection, P. falciparum NF135.C10Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

3: NF135 CPS-immunization (A/L) challenged by NF135

EXPERIMENTAL

10 volunteers will receive three immunizations with 15 NF135.C10 infected Anopheles mosquitoes and are presumptively treated with artemether/lumefantrine starting on day 7 after each immunization. Volunteers will be challenged by the bites of 5 NF135.C10 infected Anopheles mosquitoes.

Biological: malaria challenge infection, P. falciparum NF135.C10Biological: CPS-immunization (A/L)Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

4: NF135 CPS-immunization (A/L) challenged by NF54

EXPERIMENTAL

10 volunteers will receive three immunizations with 15 NF135.C10 infected Anopheles mosquitoes and are presumptively treated with artemether/lumefantrine starting on day 7 after each immunization. Volunteers will be challenged by the bites of 5 NF54 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: malaria challenge infection, P. falciparum NF54Biological: CPS-immunization (A/L)Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

5: Control group challenged by NF135.C10 Cohort A

OTHER

Challenge infection control group: 3 volunteers will receive no immunization and will be challenged by the bites of 5 NF135.C10 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: malaria challenge infection, P. falciparum NF135.C10Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

6: Control group challenged by NF54 Cohort B

OTHER

Challenge infection control group: 3 volunteers will receive no immunization and will be challenged by the bites of 5 NF54 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: malaria challenge infection, P. falciparum NF54Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

7: Control group challenged by NF135 Cohort B

OTHER

Challenge infection control group: 3 volunteers will receive no immunization and will be challenged by the bites of 5 NF135.C10 infected Anopheles mosquitoes 19 weeks after the last immunization.

Biological: malaria challenge infection, P. falciparum NF135.C10Drug: Atovaquone / Proguanil Oral Tablet [Malarone]

Interventions

Subjects will be immunized 3 times by exposure to the bites of P. falciparum NF135.C10 infected mosquitoes while taking mefloquine prophylaxis.

Also known as: Plasmodium falciparum NF135.C10 sporozoites, Mefloquine
1: NF135 CPS-immunization challenged by NF1352: Low dose NF135 CPS-immunization challenged by NF135

Subjects will receive bites from 5 Anopheles mosquitoes infected with Plasmodium falciparum NF135.C10 sporozoites.

Also known as: Plasmodium falciparum NF135.C10 sporozoites
1: NF135 CPS-immunization challenged by NF1352: Low dose NF135 CPS-immunization challenged by NF1353: NF135 CPS-immunization (A/L) challenged by NF1355: Control group challenged by NF135.C10 Cohort A7: Control group challenged by NF135 Cohort B

Subjects will receive bites from 5 Anopheles mosquitoes infected with Plasmodium falciparum NF54 sporozoites.

Also known as: Plasmodium falciparum NF54 sporozoites
4: NF135 CPS-immunization (A/L) challenged by NF546: Control group challenged by NF54 Cohort B

Subjects will be immunized 3 times by exposure to the bites of P. falciparum NF135.C10 infected mosquitoes and receive presumptive treatment with artemether/lumefantrine initiated on day 7 after each immunization.

Also known as: Plasmodium falciparum NF135.C10 sporozoites, Artemether/lumefantrine (A/L)
3: NF135 CPS-immunization (A/L) challenged by NF1354: NF135 CPS-immunization (A/L) challenged by NF54

All participants will be treated with atovaquone/proguanil (1000/400 mg (= 4 tablets) 1×/day during 3 consecutive days) when they develop a malaria infection or on day 28 after malaria challenge infection.

1: NF135 CPS-immunization challenged by NF1352: Low dose NF135 CPS-immunization challenged by NF1353: NF135 CPS-immunization (A/L) challenged by NF1354: NF135 CPS-immunization (A/L) challenged by NF545: Control group challenged by NF135.C10 Cohort A6: Control group challenged by NF54 Cohort B7: Control group challenged by NF135 Cohort B

Eligibility Criteria

Age18 Years - 35 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Subject is aged ≥ 18 and ≤ 35 years and in good health.
  • Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  • Subject is able to communicate well with the investigator and is available to attend all study visits.
  • The subject will remain within the Netherlands during the challenge period, not travel to a malaria-endemic area during the study period, and is reachable (24/7) by mobile telephone throughout the entire study period.
  • Subject agrees to inform his/her general practitioner about participation in the study and to sign a request to release by the General Practitioner (GP), and medical specialist when necessary, any relevant medical information concerning possible contra- indications for participation in the study.
  • The subject agrees to refrain from blood donation throughout the study period and for a defined period thereafter according to current guidelines.
  • For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study. Acceptable forms of contraception include: established use of oral, injected or implanted hormonal contraceptives; intrauterine device or intrauterine system; barrier methods (condoms or diaphragm with additional spermicide); male partner's sterilisation (with appropriate post-vasectomy documentation of absence of sperm in the ejaculate); true abstinence when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
  • Subject agrees to refrain from intensive physical exercise (disproportionate to the subjects usual daily activity or exercise routine) during the malaria challenge period.
  • Subject agrees to avoid additional triggers that may cause elevations in liver enzymes including alcohol from baseline up to 1 week post treatment.
  • Subject has signed informed consent.

You may not qualify if:

  • Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immunodeficient, psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following.
  • Body weight \<50 kg or Body Mass Index (BMI) \<18 or \>30 kg/m2 at screening. 1.2 A heightened risk of cardiovascular disease, as determined by: an estimated ten year risk of fatal cardiovascular disease of ≥5% at screening, as determined by the Systematic Coronary Risk Evaluation (SCORE); history, or evidence at screening, of clinically significant arrhythmia's, prolonged QT-interval or other clinically relevant ECG abnormalities; or a positive family history of cardiovascular events (including ischemia and myocarditis) in 1st or 2nd degree relatives \<50 years old.
  • A medical history of functional asplenia, sickle cell trait/disease, thalassaemia trait/disease or G6PD deficiency.
  • History of epilepsy in the period of five years prior to study onset, even if no longer on medication.
  • Screening tests positive for Human Immunodeficiency Virus (HIV), or active Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV).
  • Chronic use of i) immunosuppressive drugs, ii) antibiotics or antimalarials, iii) or other immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period.
  • History of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years.
  • Any history of malaria, positive serology for P. falciparum, or previous participation in any malaria (vaccine) study.
  • Known hypersensitivity to or contra-indications (including co-medication) for use of Mefloquine, Malarone or artemether-lumefantrine, or history of severe (allergic) reactions to mosquito bites.
  • Receipt of any vaccinations in the 3 months prior to the start of the study or plans to receive any other vaccinations during the study period or up to 90 days thereafter.
  • Participation in any other clinical study in the 30 days prior to the start of the study or during the study period.
  • Being an employee or student of the department of Medical Microbiology of the Radboudumc or the department of Internal Medicine.
  • Any other condition or situation that would, in the opinion of the investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Radboud university medical centre

Nijmegen, Gelderland, 6525 GA, Netherlands

Location

Related Publications (1)

  • van der Boor SC, Alkema M, van Gemert GJ, Teelen K, van de Vegte-Bolmer M, Walk J, van Crevel R, de Mast Q, Ockenhouse CF, Sauerwein RW, McCall MBB. Whole sporozoite immunization with Plasmodium falciparum strain NF135 in a randomized trial. BMC Med. 2023 Apr 7;21(1):137. doi: 10.1186/s12916-023-02788-9.

MeSH Terms

Conditions

Malaria, FalciparumInfectionsMalaria

Interventions

MefloquineArtemether, Lumefantrine Drug CombinationAtovaquoneProguanilatovaquone, proguanil drug combination

Condition Hierarchy (Ancestors)

Protozoan InfectionsParasitic DiseasesMosquito-Borne DiseasesVector Borne Diseases

Intervention Hierarchy (Ancestors)

QuinolinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsArtemetherArtemisininsReactive Oxygen SpeciesFree RadicalsInorganic ChemicalsOrganic ChemicalsLumefantrineFluorenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsSesquiterpenesTerpenesPolycyclic CompoundsDrug CombinationsPharmaceutical PreparationsNaphthoquinonesQuinonesNaphthalenesBiguanidesGuanidinesAmidines

Limitations and Caveats

\- Early termination of cohort B; heterologous protection could not be assessed.

Results Point of Contact

Title
Matthew McCall, MD, PhD
Organization
Radboud university medical center

Study Officials

  • Matthew BB McCall, MD PhD DTMH

    Radboud University Medical Center

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
dr. MBB McCall

Study Record Dates

First Submitted

January 17, 2019

First Posted

January 23, 2019

Study Start

April 1, 2019

Primary Completion

February 1, 2021

Study Completion

February 1, 2021

Last Updated

May 26, 2023

Results First Posted

May 11, 2022

Record last verified: 2023-05

Locations