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临床试验/NCT04329104
NCT04329104已完成2 期

Safety and Efficacy of VRC-MALMAB0100-00-AB (CIS43LS), a Human Monoclonal Antibody Against Plasmodium Falciparum, in a Dose-Escalation Trial and a Randomized, Double-Blind Trial of Adults in Mali

National Institute of Allergy and Infectious Diseases (NIAID)2 个研究点 分布在 1 个国家目标入组 348 人开始时间: 2021年2月15日最近更新:
适应症
干预措施

试验速览

阶段
2 期
状态
已完成
入组人数
348
试验地点
2
主要终点
Participants With Local Adverse Events (AEs)

研究概览

简要总结

The purpose of this study is to evaluate the safety, tolerability, and efficacy of VRC MALMAB0100-00-AB (CIS43LS), a human monoclonal antibody, against naturally occurring Plasmodium falciparum (Pf) infection.

详细描述

This study will evaluate the safety, tolerability, and efficacy of VRC MALMAB0100-00-AB (CIS43LS), a human monoclonal antibody, against naturally occurring Plasmodium falciparum (Pf) infection.

The first part of the study is an open-label dose-escalation study for safety and tolerability. Participants will be assigned to one of three dose arms. Dosing will begin in the lowest dose arm. Once all participants in that arm reach Day 7 post-infusion, if no safety concerns have arisen, dosing will begin at the subsequent dose level. This process will be repeated until participants complete the third dose arm. Participants will be followed for safety to assess adverse events (AEs) at study visits 1, 3, 7, 14, 21, and 28 days after administration, then monthly through 24 weeks after administration.

After the last subject in the highest dose arm reaches Day 7 safety follow-up, an interim safety evaluation will be performed before enrollment begins for the second part of the study.

The second part of the study is a randomized, double-blind, placebo-controlled trial to assess safety and protective efficacy of CIS43LS and placebo. Participants in the efficacy study will receive the study agent and be followed at study visits 1, 3, 7, 14, 21, and 28 days later, and once every 2 weeks thereafter through 24 weeks. Primary study assessments include physical examinations and blood collection for identification of Pf infection and other research laboratory evaluations.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Sequential
主要目的
Prevention
盲法
Double (Participant, Investigator)

入排标准

年龄范围
18 Years 至 55 Years(Adult)
性别
All
接受健康志愿者

入选标准

  • Aged ≥18 and ≤55 years.
  • Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process.
  • In good general health and without clinically significant medical history.
  • Able to provide informed consent.
  • Willing to have blood samples and data stored for future research.
  • Resides in or near Kalifabougou or Torodo, Mali, and available for the duration of the study.
  • Females of childbearing potential must be willing to use reliable contraception from 21 days prior to study day 0 through the final study visit as described below.
  • Reliable methods of birth control include 1 of the following: confirmed pharmacologic contraceptives via parenteral delivery or intrauterine or implantable device.
  • Nonchildbearing women will be required to report date of last menstrual period, history of surgical sterility (i.e., tubal ligation, hysterectomy) or premature ovarian insufficiency, and will have urine or serum pregnancy test performed per protocol.

排除标准

  • Pregnancy, as determined by a positive urine or serum beta-human choriogonadotropin (β-hCG) test (if female).
  • Currently breastfeeding.
  • Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and comply with the study protocol.
  • Study comprehension examination score of <80% correct or per investigator discretion.
  • Hemoglobin, white blood cell, absolute neutrophil, or platelet count outside the local laboratory-defined limits of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.)
  • Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.)
  • Infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV).
  • Known or documented sickle cell disease by history. (Note: Known sickle cell trait is NOT exclusionary.)
  • Clinically significant abnormal electrocardiogram (ECG; corrected QT interval [QTc] >460 or other significant abnormal findings, including unexplained tachycardia or bradycardia).
  • Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, oncologic, or renal disease by history, physical examination, and/or laboratory studies including urinalysis.
  • Receipt of any investigational product within the past 30 days.
  • Participation or planned participation in an interventional trial with an investigational product until the last required protocol visit. (Note: Past, current, or planned participation in observational studies is NOT exclusionary.)
  • Medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
  • History of a severe allergic reaction or anaphylaxis.
  • Severe asthma (defined as asthma that is unstable or required emergent care, urgent care, hospitalization, or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years).
  • Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjögren's syndrome, or autoimmune thrombocytopenia.
  • Known immunodeficiency syndrome.
  • Known asplenia or functional asplenia.
  • Use of chronic (≥14 days) oral or IV corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone >10 mg/day) or immunosuppressive drugs within 30 days of day
  • Receipt of a live vaccine within the past 4 weeks or a killed vaccine within the past 2 weeks prior to study agent administration.
  • Receipt of immunoglobulins and/or blood products within the past 6 months.
  • Previous receipt of an investigational malaria vaccine in the last 5 years.
  • Known allergies or contraindication against artemether-lumefantrine.
  • Other condition(s) that, in the opinion of the investigator, would jeopardize the safety or rights of a subject participating in the trial, interfere with the evaluation of the study objectives, or render the subject unable to comply with the protocol.

研究组 & 干预措施

Dose-escalation study: Arm 1: 5 mg/kg of CIS43LS

Experimental

Participants receive 5 mg/kg of CIS43LS as one time intravenous infusion on Day 0.

干预措施: VRC-MALMAB0100-00-AB (CIS43LS) (Biological)

Dose-escalation study: Arm 2: 10 mg/kg of CIS43LS

Experimental

Participants receive 10 mg/kg of CIS43LS as one time intravenous infusion on Day 0.

干预措施: VRC-MALMAB0100-00-AB (CIS43LS) (Biological)

Dose-escalation study: Arm 3: 40 mg/kg of CIS43LS

Experimental

Participants receive 40 mg/kg of CIS43LS as one time intravenous infusion on Day 0.

干预措施: VRC-MALMAB0100-00-AB (CIS43LS) (Biological)

Efficacy study: Arm 1: 10 mg/kg of CIS43LS

Experimental

Participants receive 10 mg/kg of CIS43LS as one time intravenous infusion on Day 0.

干预措施: VRC-MALMAB0100-00-AB (CIS43LS) (Biological)

Efficacy study: Arm 2: 40 mg/kg of CIS43LS

Experimental

Participants receive 40 mg/kg of CIS43LS as one time intravenous infusion on Day 0.

干预措施: VRC-MALMAB0100-00-AB (CIS43LS) (Biological)

Efficacy study: Arm 3: Placebo

Placebo Comparator

Participants receive placebo as one time intravenous infusion on Day 0.

干预措施: Normal saline (Other)

结局指标

主要结局

Participants With Local Adverse Events (AEs)

时间窗: Within 7 days after administration of CIS43LS

Participants with incidence of local adverse events occurring within 7 days after administration of CIS43LS. Local reactogenicity included pain/tenderness, swelling, redness, bruising, and pruritus at the site of infusion.

Severity of Local Adverse Events (AEs)

时间窗: Within 7 days after the administration of CIS43LS

The severity of local AEs was graded using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Clinical Trials. Grade 1: Pain = does not interfere with activity; Tenderness = mild discomfort to touch; Erythema/Redness = 2.5-5 cm; Induration/Swelling = 2.5-5 cm and does not interfere with activity. Grade 2: Pain = Repeated use of non-narcotic pain reliever \> 24 hours or interferes with daily activity; Tenderness = Discomfort with movement; Erythema/Redness = 5.1-10 cm; Induration/Swelling = 5.1-10 cm and interferes with activity. Grade 3: Pain = Any use of narcotic pain reliever or prevents daily activity; Tenderness = Significant discomfort at rest; Erythema/Redness = \> 10 cm; Induration/Swelling = \> 10 cm or prevents daily activity. Grade 4: Pain = Emergency room (ER) visit or hospitalization; Tenderness = ER visit or hospitalization; Erythema/Redness = Necrosis or exfoliative dermatitis; Induration/Swelling = Necrosis Grade 5: Death

Participants With Systemic Adverse Events (AEs)

时间窗: Within 7 days after the administration of CIS43LS

Participants with incidence of systemic adverse events occurring within 7 days after product administration of CIS43LS. Systemic reactogenicity events included fever, feeling unusually tired or unwell, muscle aches, headache, chills, nausea, and joint pain.

Participants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination

时间窗: Day 7 through week 24 (168 days) after administration of intervention

Number of participants with Plasmodium falciparum (Pf) blood stage infection defined as blood smear-positive for Pf was assessed by microscopic examination of thick blood smear collected from participants from day 7 through week 24 (168 days) after administration of CIS43LS or placebo. Sample was collected every two weeks until week 24.

Severity of Systemic Adverse Events (AEs)

时间窗: Within 7 days after the administration of CIS43LS

The severity of systemic AEs occurring after the administration of CIS43LS was assessed using the grading scale below: Grade 1: Fever = 37.5\^oC-37.9\^oC; Fatigue, Headache, Myalgia = No interference with activity; Nausea = no interference with activity or 1-2 episodes/hour Grade 2: Fever = 38\^oC-38.4\^oC; Fatigue, Myalgia = Some interference with activity; Headache = Repeated use of non-narcotic pain reliever \> 24 hours or some interference with activity; Nausea = Some interference with activity or \> 2 episodes/24 hours Grade 3: Fever = 38.5\^oC-39.5\^oC; Fatigue = Prevents daily activity; Headache =Significant; any use of narcotic pain reliever or prevents daily activity; Myalgia =Significant; prevents daily activity; Nausea = Prevents daily activity, requires outpatient intravenous hydration Grade 4: Fever = \> 39.5\^oC; Fatigue, Headache, Myalgia = Emergency room (ER) visit or hospitalization; Nausea = ER visit or hospitalization for hypotensive shock Grade 5: Death

次要结局

  • Participants With Plasmodium Falciparum (Pf) Infection Detected by Reverse Transcription Polymerase Chain Reaction (RT-PCR)(Day 21 through week 24 (168 days) after administration of intervention)
  • Maximum Serum Concentration (Cmax) for CIS43LS(Measured through Week 24)
  • Time to Maximum Serum Concentration (Tmax) for CIS43LS(One to 24 hours post-infusion)

研究者

申办方类型
Nih
责任方
Sponsor

研究点 (2)

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