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The purpose of this study is to evaluate 2 vaccine candidates against anthrax compared to the positive (vaccine) control as studied in normal healthy volunteers.
A Phase 1, randomized, double-blind, positive controlled, increasing dose clinical trial in healthy adult subjects at multiple sites. The study will assess safety and immunogenicity of two adenovirus vaccine candidates against anthrax compared to the positive control, Anthrax Vaccine Adsorbed (AVA). The trial will enroll 108 subjects in the anthrax vector vaccine arms and 12 subjects in the AVA positive control subjects. The study will look at three different dose of oral dosages of Ad4-PA (protective antigen) and Ad4-PA-GPI (10^9, 10^10, 10^11 vp/dose)as well as 3 vaccine administration schedules (1 and 15 days; 1 and 29 days; 1, 15, and 29 days); 2 of 3 schedules will include an intramuscular (IM) AVA booster immunization, 1 schedule will include 3 vaccine administrations of Ad4-PA or Ad4-PA-GPI (glycosylphosphatidylinositol) alone, and 1 schedule will include 3 vaccine administrations of AVA alone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AVA | Active Comparator | Anthrax Vaccine Adsorbed (0.5 mL) as the placebo control on Days 1, 15 and 29 |
|
| Ad4-PA-1 | Experimental | Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Day 1 + oral placebo on Day 15 + AVA boost at Day 29 |
|
| Ad4-PA-2 | Experimental | Given at 10^9, 10^10 and 10^11 vp Ad4-PA at Days 1, 15 and 29 |
|
| Ad4-PA-3 | Experimental | Ad4 given at 10^9, 10^10 and 10^11 vp Ad4 PA-GPI at Day 1 + AVA boost at Day 15 + placebo on Day 29 |
|
| Ad4-PA-GPI-1 | Experimental | Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + oral placebo on Day 29 + AVA boost at Day 15 |
|
| Ad4 PA-GPI-2 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AVA | Biological | Anthrax Vaccine Adsorbed (0.5 mL) as the placebo control on Days 1, 15 and 29 |
|
| Measure | Description | Time Frame |
|---|---|---|
| The safety, tolerability and immunogenicity of the Ad4 PA and Ad4 PA GPI vaccines across a range of dosages and schedules. | Safety will be measured by looking at safety labs, Adverse Events (AEs) and vaccine reactogenicity data from Baseline through Day 211. Immunogenicity will be measured by the peak serum antibody response to the PA transgene defined as the highest toxin-neutralizing antibody (TNA) titer achieved by a subject at any time between the first post-vaccination visit though Day 85 (and Day 211 if Day 85 is positive). | Day 1 through Day 211 |
| Measure | Description | Time Frame |
|---|---|---|
| Antibody response of the Ad4-PA formulation to Ad4 PA GPI | Antibody response will be tested via enzyme-linked immunosorbent assay (ELISA) and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85 | Day 1 through Day 85 (Day 211 if Day 85 is positive) |
| Measure | Description | Time Frame |
|---|---|---|
| Systemic PA-specific cellular immune response induced by Ad4-PA and Ad4-PA-GPI | The systemic PA-specific cellular immune response induced by Ad4-PA and Ad4-PA-GPI will be measured via cell-based assay on peripheral blood mononuclear cells(PBMCs). The tests will be performed on Days 1, 15, 29 and 43. | Days 1 through 43 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marc Gurwith, MD | Emergent BioSolutions | Principal Investigator |
| Jakub Simon, MD | Emergent BioSolutions | Study Director |
| Mo Elsafy, MD, MSc | National Institutes of Health (NIH) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Center for Pharmaceutical Research | Kansas City | Kansas | 64114 | United States | ||
| Walter Reed Army Institute for Research |
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| ID | Term |
|---|---|
| D000881 | Anthrax |
| ID | Term |
|---|---|
| D016863 | Bacillaceae Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
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| ID | Term |
|---|---|
| D022122 | Anthrax Vaccines |
| C493276 | Biothrax |
| ID | Term |
|---|---|
| D001428 | Bacterial Vaccines |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + placebo on Day 15 + AVA boost at Day 29 |
|
| Ad4-PA-GPI -3 | Experimental | Given at 10^9, 10^10 and 10^11 viral particles Ad4-PA-GPI at Days 1, 15 and 29 |
|
|
| Ad4-PA-1 | Biological | Ad4-PA will be given at 10^9, 10^10 and 10^11 on Day, followed by an oral placebo on Day 15 and an AVA boost on Day 29 |
|
|
| Ad4-PA-GPI-1 | Biological | Given at 10^9, 10^10 and 10^11 viral particles Ad4 PA-GPI at Day 1 + oral placebo on Day 29 + AVA boost at Day 15 |
|
|
| Antibody response of the Ad4-PA and Ad4-PA-GPI vaccination regimens to the anticipated AVA PEP regimen. |
Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85. |
| Days 1 through 85 (Day 211 if Day 85 is positive) |
| Antibody response induced by 3 different dosages of Ad4 PA and Ad4 PA GPI. | Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85 and titers will be compared across the 3 different dosages of Ad4 PA and Ad4 PA GPI (10^9, 10^10, 10^11). | Days 1 through 85 (Day 211 if Day 85 is positive) |
| TNA and antibody response induced by Ad4 PA and Ad4 PA GPI on 3 different vaccination schedules. | Antibody response will be tested via ELISA and the peak PA-ELISA titer defined as the highest ELISA titer achieved by a subject at any time between the first post-vaccination visit and Day 85, and compared among 3 vaccine schedules:
| Days 1 through 85 (Day 211 if Day 85 is positive) |
| Pre-existing Ad4 immunity on TNA and PA-ELISA response induced by Ad4 PA and Ad4 PA GPI. | Antibody response will be tested via ELISA and the impact of pre-existing Ad4 serostatus (positive/negative) on TNA and PA-ELISA will be evaluated | Days 1 through 85 (Day 211 if Day 85 is positive) |
| Evaluate the kinetics of the TNA and PA-ELISA antibody response induced by 3 different doses of Ad4 PA and Ad4 PA GPI on 3 different administration schedules. | TNA and PA-ELISA titer at each post-vaccination visit as measured by ELISA will be compared across each dose group (10^9, 10^10 and 10^11 vp) and dosing schedule. In addition, the time to peak pre-boost TNA titer and to peak pre-boost PA-ELISA titer will be compared across each dose group and dosing schedule. Cumulative TNA and PA-ELISA seroconversion through each post-vaccination visit and through Day 85 | Days 1 through 85 (Day 211 if Day 85 is positive) |
| In vivo replication/excretion of the Ad4 PA and Ad4 PA GPI vaccines | The duration of in vivo replication/excretion will be measured by the Ad4 MN seroconversion and titer measured via ELISA testing. Vaccine take defined as either Ad4 micro-neutralizing (MN) seroconversion and/or detection of vaccine shedding measured by polymerase chain reaction (PCR) and confirmed by culture at any time point from Day 1 through Day 211 | Days 1 through 211 |
| Mucosal PA-ELISA antibody responses induced by Ad4-PA and Ad4 PA-GPI |
PA antibody titers from mucosal samples will be obtained on Days 1 and 29 and titers will be compared among the 2 vaccine candidates. |
| Days 1 through 29 |
| Silver Spring |
| Maryland |
| 20910 |
| United States |
| St. Louis University | St Louis | Missouri | 63104 | United States |
| Coastal Carolina Research Center | Mt. Pleasant | South Carolina | 29464 | United States |
| D007239 | Infections |