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临床试验/NCT04206332
NCT04206332已完成1 期

A Phase 1, Dose Escalation, Open-Label Clinical Trial With Experimental Controlled Human Malaria Infections (CHMI) to Evaluate Safety and Protective Efficacy of an Anti-Malaria Human Monoclonal Antibody, VRC-MALMAB0100-00-AB (CIS43LS), in Healthy, Malaria-Naive Adults

National Institute of Allergy and Infectious Diseases (NIAID)2 个研究点 分布在 1 个国家目标入组 71 人开始时间: 2020年1月7日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
1 期
状态
已完成
入组人数
71
试验地点
2
主要终点
Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following CIS43LS Product Administration

研究概览

简要总结

Background:

People get malaria when they are bitten by an infected mosquito. Malaria can be serious and sometimes deadly. Although there are medicines to treat malaria, there is no vaccine that fully prevents infection. Researchers want to test if an experimental drug can help.

Objective:

To test the safety and effectiveness of a drug called CIS43LS that could prevent malaria infection.

Eligibility:

Healthy people ages 18-50 who have never been infected with malaria

Design:

Participants were enrolled on the basis of eligibility criteria, evaluated by clinical laboratory tests, self-reported medical history, and physical examination.

Participants received CIS43LS either infused into a vein in their arm or injected into the fat under the skin. They were monitored for side effects for up to 4 hours after they received the drug. Participants received a thermometer and recorded their temperature and symptoms every day on/with/via a diary card for 7 days after administration. The administration site was checked for redness, swelling, itching or bruising.

Participants had up to 12 follow-up visits. At follow-up visits, participants had blood drawn and were checked for health changes or problems.

Most participants who received CIS43LS took part in a Controlled Human Malaria Infection Challenge (CHMI) along with control participants who did not receive CIS43LS. During the CHMI, mosquitoes carrying the malaria parasite bit participants in a controlled setting. The participants had clinic visits every day for up to 12 days starting 7 days after the CHMI. Participants were treated right away with antimalarial medication if they tested positive for malaria. Approximately 21 days after the CHMI, participants were treated with antimalarial medication for 3 days.

The study lasted 2-6 months depending on the participant's study group.

详细描述

This was a multicenter, three-part, first-in-human, Phase 1, open-label, dose escalation study to evaluate the dose, safety, tolerability and protective efficacy of an anti-malaria human monoclonal antibody, VRC-MALMAB0100-00-AB (CIS43LS). The primary objective was to evaluate the safety and tolerability of CIS43LS when administered by either intravenous (IV) or subcutaneous (SC) routes. The secondary objectives were to evaluate the pharmacokinetics of CIS43LS at each dose level, determine if IV or SC administration will confer protection following a controlled human malaria infection (CHMI), and estimate the lowest protective dose of CIS43LS.

Part A: Part A evaluated the doses and routes in an open-label, dose escalation design.

Part B: Part B evaluated CIS43LS doses and routes prior to CHMI in participants previously enrolled in Part A and new Part B enrollees. A subgroup of participants from Part A continued to Part B, and some received a second CIS43LS dose intravenously. Additional participants were enrolled in Part B and received CIS43LS intravenously.

Part C: Part C evaluated CIS43LS doses and routes needed to reach a threshold of protection by assessing serum concentration prior to CHMI in a dose down design.

Study Product:

研究设计

研究类型
Interventional
分配方式
Non Randomized
干预模型
Sequential
主要目的
Prevention
盲法
None

入排标准

年龄范围
18 Years 至 50 Years(Adult)
性别
All
接受健康志愿者

入选标准

  • 未提供

排除标准

  • 未提供

研究组 & 干预措施

Part A, Group 1: CIS43LS (5 mg/kg IV)

Experimental

CIS43LS (5 mg/kg) administered by intravenous (IV) infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part A, Group 2: CIS43LS (5 mg/kg SC)

Experimental

CIS43LS (5 mg/kg) administered by subcutaneous (SC) injection (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part A, Group 3: CIS43LS (20 mg/kg IV)

Experimental

CIS43LS (20 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part A, Group 4A: CIS43LS (40 mg/kg IV)

Experimental

CIS43LS (40 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part A, Group 4B: CIS43LS (40 mg/kg IV)

Experimental

CIS43LS (40 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part B, Group 6: CIS43LS (5 mg/kg SC)

Experimental

CIS43LS (5 mg/kg) administered by SC injection (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part B, Group 6: CIS43LS (5 mg/kg SC)

Experimental

CIS43LS (5 mg/kg) administered by SC injection (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part B, Group 7: CIS43LS (20 mg/kg IV)

Experimental

CIS43LS (20 mg/kg) administered by IV infusion (Day 0)

Part B, Group 7 participants included participants previously enrolled in Part A who received either 5 mg/kg IV (1), 5 mg/kg SC (1) or 20 mg/kg IV (2) in the first part of the study and newly enrolled Part B participants

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part B, Group 7: CIS43LS (20 mg/kg IV)

Experimental

CIS43LS (20 mg/kg) administered by IV infusion (Day 0)

Part B, Group 7 participants included participants previously enrolled in Part A who received either 5 mg/kg IV (1), 5 mg/kg SC (1) or 20 mg/kg IV (2) in the first part of the study and newly enrolled Part B participants

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part B, Group 8: CHMI [CIS43LS (40 mg/kg IV) in Part A]

Other

Part B, Group 8 participants included participants previously enrolled in Part A who received CIS43LS (40 mg/kg IV) in the first part of the study but did not receive CIS43LS in Part B of the study. Group 8 participants were enrolled to complete the controlled human malaria infection (CHMI).

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part B, Group 9: CIS43LS (40 mg/kg IV)

Experimental

CIS43LS (40 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part B, Group 9: CIS43LS (40 mg/kg IV)

Experimental

CIS43LS (40 mg/kg) administered by IV infusion (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part B, Group 10: CHMI Controls

Other

Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 11: CIS43LS (1 mg/kg IV)

Experimental

CIS43LS (1 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part C, Group 11: CIS43LS (1 mg/kg IV)

Experimental

CIS43LS (1 mg/kg) administered by IV infusion (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 12: CIS43LS (5 mg/kg IV)

Experimental

CIS43LS (5 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part C, Group 12: CIS43LS (5 mg/kg IV)

Experimental

CIS43LS (5 mg/kg) administered by IV infusion (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 13: CIS43LS (5 mg/kg SC)

Experimental

CIS43LS (5 mg/kg) administered by SC injection (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part C, Group 13: CIS43LS (5 mg/kg SC)

Experimental

CIS43LS (5 mg/kg) administered by SC injection (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 14: CIS43LS (10 mg/kg IV)

Experimental

CIS43LS (10 mg/kg) administered by IV infusion (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part C, Group 14: CIS43LS (10 mg/kg IV)

Experimental

CIS43LS (10 mg/kg) administered by IV infusion (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 15: CIS43LS (10 mg/kg SC)

Experimental

CIS43LS (10 mg/kg) administered by SC injection (Day 0)

干预措施: VRC-MALMAB0100-00-AB (Drug)

Part C, Group 15: CIS43LS (10 mg/kg SC)

Experimental

CIS43LS (10 mg/kg) administered by SC injection (Day 0)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

Part C, Group 16: CHMI Controls

Other

Control participants who did not receive CIS43LS and were enrolled to complete the controlled human malaria infection (CHMI)

干预措施: Plasmodium falciparum (P. falciparum) sporozoite challenge (Other)

结局指标

主要结局

Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following CIS43LS Product Administration

时间窗: Day 0 through 4 weeks after CIS43LS product administration

Unsolicited adverse event (AE) data collection included AEs of all severities from the date of product administration through the Day 28 post-product administration visit. At other time periods between study product administration and when greater than 4 weeks after the study product administration, only serious AEs (SAEs reported as a separate outcome and in the AE module) and new chronic medical conditions that required ongoing medical management (reported as a separate outcome) were recorded through the last study visit. The relationship between an AE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Number of Participants Reporting Local Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration

时间窗: 7 days after CIS43LS product administration, at approximately Week 1

Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Local Symptom" is the number of participants reporting any local symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.

Number of Participants With One or More Unsolicited Non-Serious Adverse Events (AEs) Following Controlled Human Malaria Infection (CHMI)

时间窗: Day 0 through 4 weeks after CHMI

Unsolicited adverse event (AE) data collection included AEs of all severities from CHMI through the Day 28 post-CHMI visit. The relationship between an AE and CHMI was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Number of Participants With New Chronic Medical Conditions Following CIS43LS Product Administration

时间窗: Day 0 after CIS43LS product administration through the study participation, up to Week 24

New chronic medical conditions that required ongoing medical management were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a new chronic medical condition and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Number of Participants With Abnormal Laboratory Measures of Safety Following CIS43LS Product Administration

时间窗: Day 0 through 4 weeks after CIS43LS product administration

Abnormal laboratory results recorded as unsolicited adverse events (AEs) are summarized. Safety lab parameters included hematology (hemoglobin, hematocrit, mean corpuscular volume (MCV) platelets, and white blood cell (WBC), red blood cell (RBC), neutrophil, lymphocyte, monocyte, eosinophil and basophil counts) and chemistry (alanine aminotransferase (ALT) and creatinine). Complete Blood Count (CBC) with differential and Chemistry (ALT and creatinine) results were collected at different timepoints in Parts A, B and C throughout the study per the protocol's schedule of evaluations. Institutional laboratory normal ranges as well as the DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1 were used.

Number of Participants With Serious Adverse Events (SAEs) Following CIS43LS Product Administration

时间窗: Day 0 after CIS43LS product administration through the study participation, up to Week 24

SAEs were recorded from receipt of first study product administration through the last expected study visit at Week 24. The relationship between a SAE and the study product was assessed by the investigator based on clinical judgment and the definitions outlined in the protocol. A participant with multiple experiences of the same event is counted once using the event of worst severity.

Number of Participants Reporting Systemic Reactogenicity Signs and Symptoms Within 7 Days of CIS43LS Product Administration

时间窗: 7 days after CIS43LS product administration, at approximately Week 1

Participants recorded the occurrence of solicited symptoms on a diary card for 7 days after study product administration and reviewed the diary card with clinic staff at a follow up visit. Participants were counted once for each symptom at the worst severity if they indicated experiencing the symptom more than one time at any severity during the reporting period. The number reported for "Any Systemic Symptom" is the number of participants reporting any systemic symptom at the worst severity. Reactogenicity grading (Mild, Moderate, Severe) was done using the U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events, Corrected Version 2.1.

次要结局

  • Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part A and Part B)(Baseline through 24 weeks after CIS43LS product administration)
  • Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part B)(Up to 21 days after CHMI)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Maximum Observed Serum Concentration (Cmax) - (Part C)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part A and Part B)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Time to Reach Maximum Observed Serum Concentration (Tmax) - (Part C)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part A and Part B)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Beta Half-life (T1/2b) - (Part C)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part A and Part B)(Baseline through 24 weeks after CIS43LS product administration)
  • Pharmacokinetic (PK) Parameters of CIS43LS: Clearance Rate - (Part C)(Baseline through 24 weeks after CIS43LS product administration)
  • Number of Participants Who Developed Plasmodium Falciparum (P. Falciparum) Parasitemia Following Controlled Human Malaria Infection (CHMI) Challenge (Part C)(Up to 21 days after CHMI)

研究者

申办方类型
Nih
责任方
Sponsor

研究点 (2)

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