Clinical Trial Details
— Status: Active, not recruiting
Administrative data
| NCT number |
NCT04566484 |
| Other study ID # |
InternationalVaccineI |
| Secondary ID |
|
| Status |
Active, not recruiting |
| Phase |
Phase 2/Phase 3
|
| First received |
|
| Last updated |
|
| Start date |
August 1, 2021 |
| Est. completion date |
December 2023 |
Study information
| Verified date |
April 2023 |
| Source |
International Vaccine Institute |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
This study has a Phase II with part A and part B and a Phase III with part C. This Adaptive
seamless design will prospectively include planned modifications and incorporate both dose
selection (parts A and B) and confirmation of the selected dose (part C) based on the
accumulation of subjects' data within the entire study period as shown below. Part C will be
randomized for immunogenicity subset and will be open label for safety cohort. The
participants assigned to the control group from all parts (i.e, Part A, B and C) will be
continuously followed up from the enrollment until the end of the study.
Description:
Protocol Number: IVI-CHIK-001
Study Sites: Study participants will be enrolled from the following sites:
- Centro de Vacunacion Internacional S.A. CEVAXIN, Panama
- Centro de Estudios en Infectologia Pediatrica (CEIP), Colombia
- Centro de Atencion y Diagnostico de Enfermedades Infecciosas (CDI), Colombia
- Centro de Atención e Investigación Médica S.A.S.(CAIMED) Colombia
- Clinica de la Costa,Colombia.
- Centro de Estudios Clínicos Salud Avanzada. (CECLISA),Guatemala.
- Clinica Clínica San Agustín,Costa Rica.
- Tropical Medicine, Mahidol University, Thailand
Site Principal Investigators:
- Dr Xavier Saez-Llorens, MD Centro de Vacunacion Internacional S.A. CEVAXIN,Ciudad de
Panama, Panama
- Dr Alexandra Sierra ,MD Centro de Estudios en Infectologia Pediatrica (CEIP), Cali,
Colombia
- Dr Luis Angel Villar, MD Centro de Atencion y Diagnostico de Enfermedades Infecciosas
(CDI), Colombia
- Myriam Tatiana Medina Bernal, MD. Centro de Atención e Investigación Médica
S.A.S.(CAIMED) Colombia
- Dr Andrés Angelo Cadena Bonfanti Clinica de la Costa,Colombia.
- Dr Mario Melgar,MD. Centro de Estudios Clínicos Salud Avanzada. (CECLISA),Guatemala.
- Dr Javier Cespedes, MD Clinica Clínica San Agustín,Costa Rica.
- Prof Punnee Pitisuttithum,MD Tropical Medicine, Mahidol University, Bangkok,Thailand
Study Hypothesis
- The study is designed as a Phase II/III Adaptative Seamless study in healthy subjects
aged 12 to 65 years to establish immunogenicity and safety profiles of 2-dose regimen of
inactivated BBV87 chikungunya vaccine in 3 endemic countries in Asia and Latin America
and to select the optimal dose strength for confirmatory study phase (i.e., pivotal
phase III based on immunogenicity endpoint), for licensure. This study design is
composed of parts A and B (i.e., 20µg and 40µg) to support the selection of the optimal
dose in part C.Thus, there will be 3 partsin the study.
- The vaccine regimen is safe and induces neutralizing antibody response to CHIK based on
the phase 1 study conducted in India assessing 10µg, 20µg, and 30µg dose strengths. An
additional safety study is being conducted in India with higher dose strength (i.e.,
40µg).
Objectives
Primary Objectives :
- To evaluate the safety and tolerability of the 40µg BBV87 administered in 2 doses at 0-6
M schedule (applicable to part A) and to evaluate the safety and tolerability of the
20µg and 40µg BBV87 administered in 2 doses at 0-28 days schedule (applicable to parts B
and C).
- To evaluate the immunogenicity interms of GMTs of the 20µg and 40µg BBV87 at 28 days PD2
administered at 0-28 days interval (applicable to parts B and C).
Secondary Objectives
- To evaluate the immunogenicity in terms of seroconversionof the 20µg and 40µg BBV87 at
28 days and 6 months PD2. (Applicable to parts B and C).
- To evaluate the immunogenicity in terms of GMTs and seroconversion of the 40µg BBV87 at
28 days PD2 administered at 0-6 M. (Applicable to part A).
- To evaluate the immunogenicity in terms of GMTs and seroconversion of the 20µg and 40µg
of BBV87 28 days PD1.(Applicable to parts A, B, and C).
Exploratory Objectives
- To describe the number of confirmed Chikungunya cases in vaccine and placebo recipients
during the 6 month-follow-up period PD2. (Applicable to 3 parts, A, B, and C).
- To explore the early immune response at D14 PD1 in phase II for potential outbreak use
of the vaccine in future. (Applicable to part A 1st component only).
Methodology :This is an adaptative seamless phase II/III study. This study design combines
the objectives of the phase II investigational stage with safety and dose strength finding,
before moving to the phase III as confirmatory stage using immunogenicity endpoint, into a
single study protocol moving from one stage to the subsequent stages after the regular
reviews of safety by DSMB with Go/No Go decisions defined for each part.
It will be a multicentre, randomized clinical trial to evaluate immunogenicity and safety of
BBV87 vaccine in Panama, Colombia, and Thailand and it will be planned in three parts as
mentioned below :
Phase II Part A: An observer-blind, randomized controlled safety study of 0-6M schedule with
40µg in 12-65 year old subjects. Age stratification (i.e., 12-17 yrs and 18-65 yrs) is
planned. Part A is aimed at testing dose strength of 40µg at 0-6M schedule before moving into
a larger safety and immunogenicity study. The sample size calculation of Part A is based on
the safety endpoint and the randomization ratio 2:1 with 2 treatment groups (i.e., Group 1:
test vaccine with 40µg of BBV87 and Group 2: placebo).
Phase II Part B: Anobserver-blind, randomized, controlled trial comparing two doses, 20µg and
40µg to assess immunogenicity and safety in healthy volunteers aged 12-65 years. Part B will
include 3 study arms (20µg, 40µg, and placebo) to compare 40µg versus 20µg at 0-28 days apart
schedule. Randomization ratio will be 2:2:1.The data collected from D0 toone month post dose
2 (8 weeks PD1), will be reviewed by the DSMB at week 13 PD1, and this board will review
safety and immunogenicity data and provide recommendation for go/no go decision to proceed to
Part C. The "go" decision from DSMB will allow proceeding with the part C with the confirmed
optimal dose strength and regimen (i.e., 0-28 days apart).
Phase III Part C: Phase III is aimed to evaluate safety and Immunogenicity of BBV87 at the
selected dose from part B, in two dose regimen (0-28 days apart). The Immunogenicity subset
will be randomized, observer-blind controlled cohort and the safety cohort will be open
label.
The investigational vaccine is administered as 2-dose series: BBV87 will be administered
intramuscularly on days 0 and 28 days.
This clinical strategy is designed to reach safety sample size requirement (~3000 vaccine
exposed participants) for WHO prequalification. For this purpose,in the first component of
Part A, 90 participants will be recruited and will be followed for 1 week for safety
assessment after the first dose. After the 7th day safety follow-up PD1 (Post-dose 1) data
obtained, there will be a DSMB review of safety data.
The "go" decision from DSMB will trigger the following: second component of Part A and
recruitment for part B. In the second component of part A, additional participants will be
enrolled. All of the participants from both components of part A will receive second dose at
6 months and will be followed-up for 6 months after the second dose. Part A may provide data
for a potential emergency use regimen with 6 month- interval.
In part B, a safety analysis will be carried out by DSMB at Week 13 based on data obtained in
Week 8 PD1. The "go" decision from DSMB will trigger the recruitment for part C with the
selected dose strength. Participants from part B will receive second dose at D28 PD1 and will
be followed for 6 months after the second dose.
Participants from part C will receive second dose at D28 PD1 and will be followed-up for 6
months after the second dose.
DSMB
-Go/No Go decision will be determined by DSMB to move from part A to B and then to C using
the single dose strength (i.e., 20µg or 40µg). Part B will primarily determine dose and part
C will serve to confirm the safety and immunogenicity profile of the selected dose in the
0-28days schedule. Safety data will be reviewed on a regular basis as defined per DSMB
charter. Formal sequential stopping rules will be set up and could be formed using a defined
statistical method once discussed with DSMB.
Safety monitoring committee (SMC) Safety monitoring committee (SMC) from IVI will review the
safety data on a regular basis during the conduct of the study.
Statistical Methods There are two primary comparisons to demonstrate superiority of BBV87
40µg compared to BBV87 20µg in Part B and superiority of BBV87 selected optimal dose compared
to placebo in Part C.
The statistical hypotheses for these two comparisons are:
To demontrate superiority of BBV87 40µg compared to BBV87 20µg • GMT of neutralization
antibody measured by plaque reduction neutralization test (PRNT50) at 28 days post second
dose of BBV87 40µg is superior to GMT at 28 days post second dose of BBV87 20µg vaccination
using superiority ratio margin of one (1).
To demontrate superiority of BBV87 selected optimal dose compared to placebo
• GMT of neutralization antibody measured by plaque reduction neutralization test (PRNT50) at
28 days post second dose of BBV87 selected optimal dose is superior to GMT at 28 days post
second dose of placebo using superiority ratio margin of two (2) The optiomal dose selection
in Part B and confirmation of the selected dose in Part C are considered separately. No
multiplicity adjustment is taken relative to these two comparisons. The superiority test of
BBV87 40µg vs. BBV87 20µg in Part B will be performed at a 0.025 significance level using
one-sided test (which is equivalent to significant level of 0.05 using a two-sided test). The
superiority test of BBV87 selected optimal dose vs. placebo in Part C will be performed at
the 0.025 significance level using a one-sided test.
Laboratory Methods
- Titres of neutralizing antibodies persistence assessment against Chikungunya virus will
be quantified using the PRNT50. Chikungunya-binding IgG will be quantified by ELISA.
- For Chikungunya suspected cases: CHIKV (RT-PCR) will be used to confirm Chikungunya
cases (blood sample will be taken during the acute phase of the disease as soon as
possible and within 7 days of the onset of fever).
In addition, qRT-PCR for DENV and ZIKV may be performed by study site based on the local
practice to rule out these aetiologies according to investigator's judgment. Alternatively,
site-specific CHKV clinical diagnostic algorithm will be applied.
Estimated Number of participants to Enroll: A total of 3,210 participants will be enrolled in
the study.
The sample sizes distribution by parts and age strata is as follows:
N (Part A)= 450 participants (40µg; 0-6M schedule, 300 with BBV87 vaccine and 150 with
placebo); N (Part B)= 400 participants (40µg and 20 µg; 0-28 days schedule; 320 with BBV87
vaccine and 80 with placebo); N (Part C)=2,360 participants (Selected dose; 0-28 days
schedule, 2,270 with BBV87 vaccine and 90 with placebo)
No formal power analysis if applicable to the safety data in Part A, as descriptive
statistics will be used to summarize the safety data. A sample size of 30 in placebo of the
initial phase of Part A among Estimated Number of participants to Enroll: A total of 3,210
participants will be enrolled in the study.
The sample sizes distribution by parts and age strata is as follows:
N (Part A)= 450 participants (40µg; 0-6M schedule, 300 with BBV87 vaccine and 150 with
placebo); N (Part B)= 400 participants (40µg and 20 µg; 0-28 days schedule; 320 with BBV87
vaccine and 80 with placebo); N (Part C)=2,360 participants (Selected dose; 0-28 days
schedule, 2,270 with BBV87 vaccine and 90 with placebo)
No formal power analysis if applicable to the safety data in Part A, as descriptive
statistics will be used to summarize the safety data. A sample size of 30 in placebo of the
initial phase of Part A among adults (18 to 65 yrs) will provide 95% confident that the
incidence of SAEs is <10% if no vaccine-related SAEs are observed in a study group. Further
sample size of 120 in placebo of the second phase of Part A among adults (18 to 65 yrs) and
adolescent (12 to 17 yrs) will provide 95% confident that the incidence of SAEs is <2% if no
vaccine related SAEs are observed in a study group. With 2:1 ratio in BBV87 40µg group and
placebo group. The total sample size of Part A is 450 paticipants (300 participants in BBV87
40µg group and 150 participants in placebo group).
Using superiority test for the ratio between two GMTs from parallel-group design (1:1 ratio
in BBV87 40µg vs. 20µg) in Part B, a total sample size of 320 participants (160 participants
per BBV87 vaccine group) would provide >90% power at a one-sided significance level of 2.5%
to detect a mean rato (GMT 40µg to GMT 20µg) is greater than one (1). The coefficient of
variation on immune response is assumed as 3.0. In the ratio 2:1 between BBV87 40µg (or 20µg)
group and placebo group, a sample size of 240 participants [160 participants in BBV87 40µg
(or 20µg) group and 80 participants in placebo group] would provide >80% power at a one-sided
significance level of 2.5% to detect superiority with margin mean ratio of two (2). The total
sample size of Part B is 400 paticipants in a 2:2:1 ratio (160 participants in BBV87 40µg
group, 160 participants in BBV87 20µg group, and 80 participants in comparator group).
In the pivotal immunogenicity sub-cohort in Part C, a total of 360 participants in a 3:1
ratio (270 BBV87 vaccinees and 90 placebo recipients) would provide >90% power at a one-sided
significance level of 2.5% to detect superiority with margin mean rato of two (2). The
coefficient of variation on immune response is assumed as 3.0. In the sample size
calculations, a 10% drop out rate is assumed.
In safety cohort, a total of 2,000 participants will receive BBV87 vaccine to have safety
data of optimal selected dose.
The total sample size of Part C is 2,360 paticipants: the immunogenicity sub-cohort with 360
participants (270 in BBV87 selected dose group and 90 in the placebo group) and the safety
cohort with 2,000 participants receiving the BBV87 selected dose.
