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Study rBV A/B-CL-001 is a Phase 2b, 2-part, open-label, uncontrolled study to evaluate safety, tolerability, and immunogenicity of a single dose of recombinant botulinum vaccine A/B (rBV A/B) for the production of BabyBIG in volunteers previously immunized with the pentavalent botulinum (PBT) toxoid. This study is designed to determine neutralizing antibody levels for botulinum toxin types A and B in healthy subjects who were previously immunized with the PBT for occupational protection and who receive the rBV A/B. Subjects with titers of the neutralizing antibodies against the toxins would be candidates for plasma donation for BabyBIG production.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vaccine | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rBV A/B | Biological | rBV A/B injections will consist of a single 40 µg injection of total antigen (20 µg of Antigen A and 20 µg of Antigen B) adsorbed to 0.2% (wt/vol) Alhydrogel™, in a total dose volume of 0.5 mL. The vaccine will be administered by intramuscular injection in the deltoid muscle, preferably in the nondominant arm. |
| Measure | Description | Time Frame |
|---|---|---|
| Four-Fold Increase in Neutralizing Antibody Concentration (NAC) | Proportion of participants achieving a four-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success). | Week 0 to Week 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Three-Fold Increase in Neutralizing Antibody Concentration (NAC) | Proportion of participants achieving a three-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success) | Week 0 to Week 4 |
| Two-Fold Increase in the Area Under the Neutralizing Antibody Concentration (NAC) Curve |
| Measure | Description | Time Frame |
|---|---|---|
| Collected Plasma Volume | Measurement of the volume of source plasma containing neutralizing antibodies against botulinum toxin type A and type B collected by plasmapheresis in Part 2. | Week 1 to Week 12 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stephen S. Arnon, M.D. | California Department of Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| California Department of Public Health | Richmond | California | 94804 | United States | ||
| Battelle Biomedical Research Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29475762 | Derived | Khouri JM, Motter RN, Arnon SS. Safety and immunogenicity of investigational recombinant botulinum vaccine, rBV A/B, in volunteers with pre-existing botulinum toxoid immunity. Vaccine. 2018 Apr 5;36(15):2041-2048. doi: 10.1016/j.vaccine.2018.02.042. Epub 2018 Feb 21. |
| Label | URL |
|---|---|
| Related Info | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Initial Safety and Immunogenicity (Part 1) | Part 1 included scheduled assessments of the safety and immunogenicity of a single 40 µg dose of rBV A/B over a 12-week period with a safety follow-up at 6 months. |
| FG001 | Safety, Immunogenicity, and Plasma Collection (Part 2) |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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Proportion of participants achieving a two-fold increase in the area under the plasma NAC-time curve between Week 0 and Week 12 in comparison with a straight-line extension of the Week 0 NAC to Week 12 for both botulinum toxin A and toxin B. A proportion ≥ 0.50 was considered a success. |
| Week 0 to Week 12 |
| West Jefferson |
| Ohio |
| 43162 |
| United States |
Part 2 was conducted to collect source plasma for potential use in the production of BabyBIG® and to assess safety and immunogenicity of a single 40 µg dose of over a 12-week period; Part 2 included a follow-up for safety assessment at 6 months. Participants in Part 2 did not participate in Part 1. |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Initial Safety and Immunogenicity (Part 1) | Part 1 included scheduled assessments of the safety and immunogenicity of a single 40 µg dose of rBV A/B over a 12-week period with a safety follow-up at 6 months. |
| BG001 | Safety, Immunogenicity, and Plasma Collection (Part 2) | Part 2 was conducted to collect source plasma for potential use in the production of BabyBIG® and to assess safety and immunogenicity of a single 40 µg dose of over a 12-week period; Part 2 included a follow-up for safety assessment at 6 months. Participants in Part 2 did not participate in Part 1. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | 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 | Four-Fold Increase in Neutralizing Antibody Concentration (NAC) | Proportion of participants achieving a four-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success). | Posted | Number | proportion of participants | Week 0 to Week 4 |
|
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| Secondary | Three-Fold Increase in Neutralizing Antibody Concentration (NAC) | Proportion of participants achieving a three-fold or greater increase in NAC up to Week 4 compared with Week 0 for both botulinum toxin A and toxin B (a proportion ≥ 0.50 was considered a success) | Posted | Number | proportion of participants | Week 0 to Week 4 |
|
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Two-Fold Increase in the Area Under the Neutralizing Antibody Concentration (NAC) Curve | Proportion of participants achieving a two-fold increase in the area under the plasma NAC-time curve between Week 0 and Week 12 in comparison with a straight-line extension of the Week 0 NAC to Week 12 for both botulinum toxin A and toxin B. A proportion ≥ 0.50 was considered a success. | Posted | Number | proportion of participants | Week 0 to Week 12 |
|
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| Other Pre-specified | Collected Plasma Volume | Measurement of the volume of source plasma containing neutralizing antibodies against botulinum toxin type A and type B collected by plasmapheresis in Part 2. | Participants in Part 1 were only analyzed for safety data, and one participant in Part 2 was excluded from plasma collection due to not meeting the plasma donor minimum weight requirement. | Posted | Mean | Standard Deviation | mL | Week 1 to Week 12 |
|
|
Six months following rBV A/B administration
Adverse events (AEs) indicated with * were largely classified as treatment-related reactions (TRRs). Of the 32 and 186 total AEs in Parts 1 and 2, respectively, 21 (65.6%) and 117 (62.9%) were TRRs within the indicated categories. Also, of the 21 and 117 TRRs in Parts 1 and 2, respectively, 19 (90.5%) and 97 (82.9%) occurred within 7 days of the rBV A/B injection, and 8 of 8 participants in Part 1 (100%) and 30 of 37 in Part 2 (81.1%) had at least one TRR within 7 days of the rBV A/B injection.
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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 | Initial Safety and Immunogenicity (Part 1) | Part 1 included scheduled assessments of the safety and immunogenicity of a single 40 µg dose of rBV A/B over a 12-week period with a safety follow-up at 6 months. | 0 | 8 | 8 | 8 | ||
| EG001 | Safety, Immunogenicity, and Plasma Collection (Part 2) | Part 2 was conducted to collect source plasma for potential use in the production of BabyBIG® and to assess safety and immunogenicity of a single 40 µg dose of over a 12-week period; Part 2 included a follow-up for safety assessment at 6 months. Participants in Part 2 did not participate in Part 1. | 0 | 37 | 34 | 37 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Lymphopenia | Blood and lymphatic system disorders | MedDRA, Version 16.0 |
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| Neutropenia | Blood and lymphatic system disorders | MedDRA, Version 16.0 |
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| Constipation | Gastrointestinal disorders | MedDRA, Version 16.0 |
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| Diarrhoea | Gastrointestinal disorders | MedDRA, Version 16.0 |
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| Nausea* | Gastrointestinal disorders | MedDRA, Version 16.0 |
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| Chills* | General disorders | MedDRA, Version 16.0 |
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| Injection site anaesthesia* | General disorders | MedDRA, Version 16.0 |
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| Injection site erythema* | General disorders | MedDRA, Version 16.0 |
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| Injection site induration* | General disorders | MedDRA, Version 16.0 |
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| Injection site nodule* | General disorders | MedDRA, Version 16.0 |
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| Injection site pain* | General disorders | MedDRA, Version 16.0 |
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| Injection site papule | General disorders | MedDRA, Version 16.0 |
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| Injection site pruritus* | General disorders | MedDRA, Version 16.0 |
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| Injection site reaction* | General disorders | MedDRA, Version 16.0 |
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| Injection site swelling* | General disorders | MedDRA, Version 16.0 |
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| Injection site urticaria* | General disorders | MedDRA, Version 16.0 |
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| Malaise* | General disorders | MedDRA, Version 16.0 |
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| Pain* | General disorders | MedDRA, Version 16.0 |
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| Pyrexia* | General disorders | MedDRA, Version 16.0 |
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| Swelling* | General disorders | MedDRA, Version 16.0 |
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| Nasopharyngitis | Infections and infestations | MedDRA, Version 16.0 |
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| Staphylococcal infection | Infections and infestations | MedDRA, Version 16.0 |
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| Tonsillitis | Infections and infestations | MedDRA, Version 16.0 |
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| Tooth infection | Infections and infestations | MedDRA, Version 16.0 |
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| Upper respiratory tract infection | Infections and infestations | MedDRA, Version 16.0 |
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| Infusion site hematoma | Injury, poisoning and procedural complications | MedDRA, Version 16.0 |
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| Injection site swelling* | Injury, poisoning and procedural complications | MedDRA, Version 16.0 |
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| Procedural complication* | Injury, poisoning and procedural complications | MedDRA, Version 16.0 |
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| Procedural pain | Injury, poisoning and procedural complications | MedDRA, Version 16.0 |
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| Aspartate aminotransferase increased* | Investigations | MedDRA, Version 16.0 |
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| Blood potassium increased | Investigations | MedDRA, Version 16.0 |
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| Blood urea increased | Investigations | MedDRA, Version 16.0 |
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| Blood urine present | Investigations | MedDRA, Version 16.0 |
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| Body temperature increased* | Investigations | MedDRA, Version 16.0 |
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| Haematocrit decreased | Investigations | MedDRA, Version 16.0 |
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| Haemaglobin decreased | Investigations | MedDRA, Version 16.0 |
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| Haemaglobin increased | Investigations | MedDRA, Version 16.0 |
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| Platelet count decreased | Investigations | MedDRA, Version 16.0 |
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| Protein total decreased | Investigations | MedDRA, Version 16.0 |
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| Urine ketone body present | Investigations | MedDRA, Version 16.0 |
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| Muscle spasms* | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Muscular weakness* | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Musculoskeletal pain* | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Myalgia* | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Sensation of heaviness* | Musculoskeletal and connective tissue disorders | MedDRA, Version 16.0 |
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| Dizziness | Nervous system disorders | MedDRA, Version 16.0 |
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| Headache* | Nervous system disorders | MedDRA, Version 16.0 |
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| Paraesthesia* | Nervous system disorders | MedDRA, Version 16.0 |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA, Version 16.0 |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA, Version 16.0 |
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| Pulmonary congestion | Respiratory, thoracic and mediastinal disorders | MedDRA, Version 16.0 |
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| Dermatitis contact | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Erythema* | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Petechiae | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Rash erythematous* | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Rash maculo-papular | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Rash papular | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Skin lesion | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Sunburn | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Urticaria* | Skin and subcutaneous tissue disorders | MedDRA, Version 16.0 |
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| Hypertension | Vascular disorders | MedDRA, Version 16.0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Jessica Khouri | California Department of Public Health | 510-231-7600 | Jessica.Khouri@cdph.ca.gov |
| ID | Term |
|---|---|
| D001906 | Botulism |
| ID | Term |
|---|---|
| D003015 | Clostridium Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D020511 | Neuromuscular Junction Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D020258 | Neurotoxicity Syndromes |
| D005517 | Foodborne Diseases |
| D011041 | Poisoning |
| D064419 | Chemically-Induced Disorders |
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