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The Phase 1 trial is a single-center, randomized, double blind, placebo-controlled, dose-ranging out-patient study designed to provide the first clinical data on the safety, tolerability and immunogenicity of XRX-001 inactivated yellow fever vaccine in 60 healthy male and female volunteers, 18-49 years of age. Subjects will receive two inoculations of one of two dose levels of XRX-001 vaccine. A control group will receive placebo.
Safety will be determined by the incidence and severity of adverse events in each treatment group and in the combined cohorts in the double blind treatment period up to 42 days post-vaccination. Subjects will also be followed-up at 3, 6 and 12 months to determine severe adverse events (SAEs) and changes in health status.
Efficacy will be assessed by neutralizing antibody response to the vaccine. The co-primary immunogenicity endpoints will be the dose-response analysis of seroconversion rates (fourfold or greater increase in neutralizing antibody titer between baseline and Day 42) and of the 50% plaque reduction neutralization test (PRNT50) geometric mean titers (GMT) at Day 42.
Secondary immunogenicity endpoints will include:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High dose | Active Comparator |
| |
| Mid Dose | Active Comparator |
| |
| Placebo | Placebo Comparator | NaCl Injectable 0.9% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| XRX-001 Inactivated yellow fever vaccine | Biological | Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Incidence and Severity of Adverse Events in Each Treatment Group in the Double-blind Treatment Period up to 42 Days Post-vaccination. | Subjects were observed for 60 minutes (greater than of equal to 60 minutes and less than of equal to 90 minutes) after vaccine adminstration for any signs or symptoms or local and/or systematic intolerance to the test articles and vital signs were to be checked within the same observation timeframe. After vaccination, subjects were to complete a memory aid to record daily temperature, symptoms, and concomitant medications from Day-0 to Day-42. Subjects were to return to the clinic on Days 3, 10, 21, 24, 31, and 42 with a second vaccination given on Day 21. At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Measured from 0 up to 21 Days |
| The Incidence and Severity of Adverse Events in Each Treatment Group in the Double-blind Treatment Period up to 42 Days Post-vaccination. | Subjects were observed for 60 minutes (greater than of equal to 60 minutes and less than of equal to 90 minutes) after vaccine adminstration for any signs or symptoms or local and/or systematic intolerance to the test articles and vital signs were to be checked within the same observation timeframe. After vaccination, subjects were to complete a memory aid to record daily temperature, symptoms, and concomitant medications from Day-0 to Day-42. Subjects were to return to the clinic on Days 3, 10, 21, 24, 31, and 42 with a second vaccination given on Day 21. At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Measured from 22 up to 42 Days. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Subjects With Seroconversions or Who Are Seropositive Using 2 Dose Levels of XRX-001 | Secondary immunogenicity endpoints will use 2 dose levels of XRX-001 inactivated yellow fever vaccine determined by 50% plaque reduction neutralization test (PRNT50). Dose groups were to be compared for neutralizing antibody seroconverison rate, distribution of antibody titers, and geometric mean antibody titers (GMTs) to yellow fever 17D virus. The seroconversion rates and GMT neutralizing antibody titers for each dose group and all dose groups combined; The reverse cumulative distribution curve of antibody titers; |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Amanada Culliton | GE Healthcare Bio-Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johnson County Clin-Trials | Lenexa | Kansas | 66219 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21470010 | Derived | Monath TP, Fowler E, Johnson CT, Balser J, Morin MJ, Sisti M, Trent DW. An inactivated cell-culture vaccine against yellow fever. N Engl J Med. 2011 Apr 7;364(14):1326-33. doi: 10.1056/NEJMoa1009303. |
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60 Subjects enrolled in this study. 3 Subjects discontinued in this study.
2 of the Subjects in the High-Dose made it thru the study, however, it was later found that those 2 subjects vaccinated prior to joining this study. One (1) subject in the "Placebo" went thru the the study, but was later lost to follow-up.
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| ID | Title | Description |
|---|---|---|
| FG000 | High Dose | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL |
| FG001 | Mid Dose | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL |
| FG002 | Placebo | NaCl Injectable 0.9% Placebo: NaCl Injectable 0.9% |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | High Dose Group | Two groups of 24 subjects each, (one arm called a high dose group, the other a Mid-Dose group) were to receive two intramuscular (IM) injections (0.5mL) of XRX-001 vaccine containing either greater than or equal to 8.0 log10 VE/dose (viral equivalent) (high dose) or 1/10th of the high dose for the (mid dose). |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Incidence and Severity of Adverse Events in Each Treatment Group in the Double-blind Treatment Period up to 42 Days Post-vaccination. | Subjects were observed for 60 minutes (greater than of equal to 60 minutes and less than of equal to 90 minutes) after vaccine adminstration for any signs or symptoms or local and/or systematic intolerance to the test articles and vital signs were to be checked within the same observation timeframe. After vaccination, subjects were to complete a memory aid to record daily temperature, symptoms, and concomitant medications from Day-0 to Day-42. Subjects were to return to the clinic on Days 3, 10, 21, 24, 31, and 42 with a second vaccination given on Day 21. At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Subjects were to return to the clinic on Days 3,10, 21, 24, 31,and 42 with the second vaccination given on Day 21. At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Posted | Number | participants | Measured from 0 up to 21 Days |
Two intramuscular injections at an interval of 21 days
Two intramuscular injections at an interval of 21 days. First injection administered on day with an interval of 21 days followed by a second injection on day 22.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | High Dose First Injection | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL. First injection. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pain at Injection site | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment | General pain at the site of injection |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Amanda Culliton | GE Healthcare- Life Sciences | 1-508-683-2232 | Amanda.Culliton@ge.com |
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| ID | Term |
|---|---|
| D015004 | Yellow Fever |
| ID | Term |
|---|---|
| D000096724 | Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
| D007239 | Infections |
| D001102 | Arbovirus Infections |
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| Placebo | Biological | NaCl Injectable 0.9% |
|
| Days 21 and 42, 12 months |
| Distribution of Geometric Mean Antibody Titers (GMTs) to Yellow Fever 17D Virus. | Geometric mean antibody titers (GMT) neutralizing antibody titers for each dose groups. | GMT titers measured at days 21, 31 and 42 for different dose rates. |
| Mid-Dose Group |
Two groups of 24 subjects each were to receive two intramuscular (IM) injections (0.5mL) of XRX-001 vaccine containing either greater than or equal to 8.0 log10 VE/dose (viral equivalent) (high dose) or 1/10th of the high dose for this (mid dose) group. |
| BG002 | Placebo Group | This third group of 12 subjects were to receive a placebo (0.9% normal saline for injection). |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| ID | Title | Description |
|---|---|---|
| OG000 | High Dose Group | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL. 24 Subjects were examined in this group. |
| OG001 | Mid Dose Group | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL |
| OG002 | Placebo Group | Subjects were administered with NaCl Injectable 0.9%. 12 Subjects were examined in this group. |
|
|
| Secondary | Percentage of Subjects With Seroconversions or Who Are Seropositive Using 2 Dose Levels of XRX-001 | Secondary immunogenicity endpoints will use 2 dose levels of XRX-001 inactivated yellow fever vaccine determined by 50% plaque reduction neutralization test (PRNT50). Dose groups were to be compared for neutralizing antibody seroconverison rate, distribution of antibody titers, and geometric mean antibody titers (GMTs) to yellow fever 17D virus. The seroconversion rates and GMT neutralizing antibody titers for each dose group and all dose groups combined; The reverse cumulative distribution curve of antibody titers; | Seropositive was to show a significant level of serum antibodies, or other immunologic marker in the serum, indicating previous exposure to the infectious agent being tested. In immunology, seroconversion is the time period during which a specific antibody develops and becomes detectable in the blood. | Posted | Number | 95% Confidence Interval | Percentage of subjects | Days 21 and 42, 12 months |
|
|
|
| Secondary | Distribution of Geometric Mean Antibody Titers (GMTs) to Yellow Fever 17D Virus. | Geometric mean antibody titers (GMT) neutralizing antibody titers for each dose groups. | Posted | Geometric Mean | 95% Confidence Interval | Geometric Antibody titers | GMT titers measured at days 21, 31 and 42 for different dose rates. |
|
|
|
| Primary | The Incidence and Severity of Adverse Events in Each Treatment Group in the Double-blind Treatment Period up to 42 Days Post-vaccination. | Subjects were observed for 60 minutes (greater than of equal to 60 minutes and less than of equal to 90 minutes) after vaccine adminstration for any signs or symptoms or local and/or systematic intolerance to the test articles and vital signs were to be checked within the same observation timeframe. After vaccination, subjects were to complete a memory aid to record daily temperature, symptoms, and concomitant medications from Day-0 to Day-42. Subjects were to return to the clinic on Days 3, 10, 21, 24, 31, and 42 with a second vaccination given on Day 21. At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Subjects were to combined at days 22 to 42 . At each visit, study personnel were to conduct a structured adverse event (AE) interview, and subject were to use their memory aid to assist with the recall of symptoms experiences and daily oral temperatures. | Posted | Number | participants | Measured from 22 up to 42 Days. |
|
|
|
| 0 |
| 24 |
| 24 |
| 24 |
| EG001 | Mid Dose First Injection | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL. First injection. | 0 | 24 | 24 | 24 |
| EG002 | Placebo First Injection | NaCl Injectable 0.9% Placebo: NaCl Injectable 0.9% First injection. | 0 | 12 | 12 | 12 |
| EG003 | High Dose Second Injection | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL. Second injection at an interval of 21 days | 0 | 24 | 24 | 24 |
| EG004 | Mid Dose Second Injection | XRX-001 Inactivated yellow fever vaccine: Inactivated yellow fever vaccine, alum adsorbed, High dose = 2.3 x 10^8 VE/0.5mL and Mid dose = 2.2 x 10^7 VE/0.5mL. Second injection. | 0 | 24 | 24 | 24 |
| EG005 | Placebo Second Injection | NaCl Injectable 0.9% Placebo: NaCl Injectable 0.9% Second injection. | 0 | 12 | 12 | 12 |
|
| Tenderness at injection site | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment | Tenderness at the site of injection |
|
| Redness at Site of Inection | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment | Redness at the site of injection |
|
| Swelling at site of injection | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment | Swelling at the site of injection |
|
| Itching at site of ijnection | Skin and subcutaneous tissue disorders | MedDRA 11.1 | Systematic Assessment | Itching a the site of injection |
|
| Diarrhea | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment | Diarrhea |
|
| Malaise | General disorders | MedDRA 11.1 | Systematic Assessment | Malaise |
|
| Headache | General disorders | MedDRA 11.1 | Systematic Assessment | Headache |
|
| Tiredness | General disorders | MedDRA 11.1 | Systematic Assessment | Tiredness |
|
| Nausea | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment | Nausea |
|
| Vomiting | Gastrointestinal disorders | MedDRA 11.1 | Systematic Assessment | Vomiting |
|
| Muscle Ache | Musculoskeletal and connective tissue disorders | MedDRA 11.1 | Systematic Assessment | Muscle Ache |
|
| Feverishness | General disorders | MedDRA 11.1 | Systematic Assessment | Feverishness |
|
| Chills | General disorders | MedDRA 11.1 | Systematic Assessment | Chills |
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| Drowsiness | General disorders | MedDRA 11.1 | Systematic Assessment | Drowsiness |
|
| Shortness of Breath | Respiratory, thoracic and mediastinal disorders | MedDRA 11.1 | Systematic Assessment | Shortness of Breath |
|
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| D014777 |
| Virus Diseases |
| D018177 | Flavivirus Infections |
| D018178 | Flaviviridae Infections |
| D012327 | RNA Virus Infections |
| D006482 | Hemorrhagic Fevers, Viral |
|
| Seropositivity-Day 31 (10 Days after second Inj) |
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| Seroconvert- Day 31 (10 Days after second Inj) |
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| Seropositivity -Day 42 (21 Days after 2nd Inj) |
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| Seroconvert-Day 42 (21 Days after 2nd Inj) |
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| Geometric mean titer Day 42--21 Days after 2nd Inj |
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| Days 22-42 (2nd injection)-Redness |
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| Days 22-42 (2nd injection)-Swelling |
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| Days 22-42 (2nd injection)-Vomiting |
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| Days 22-42 (2nd injection)-Malaise |
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| Days 22-42 (2nd injection)-Headache |
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| Days 22-42 (2nd injection)-Muscle Ache |
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| Days 22-42 (2nd injection)-Feverishness |
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| Days 22-42 (2nd injection)-Chills |
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| Days 22-42 (2nd injection)-Tiredness |
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| Days 22-42 (2nd injection)-Nausea |
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| Days 22-42 (2nd injection)-Drowsiness |
|
| Days 22-42 (2nd injection)-Shortness of Breath |
|