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Study of Co-administered Na-APR-1 (M74) and Na-GST-1 in Gabonese Children

Randomized, Controlled, Phase 1 Study to Assess Safety and Immunogenicity of Co-administered Hookworm Vaccine Candidates Na-APR-1 (M74)/Alhydrogel® and Na-GST-1/ Alhydrogel® in Gabonese Children

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02839161
Enrollment
60
Registered
2016-07-20
Start date
2017-01-31
Completion date
2019-03-28
Last updated
2025-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hookworm Disease, Hookworm Infection

Keywords

Hookworm, Vaccine, Na-GST-1, Na-APR-1, Necator americanus

Brief summary

Double blind, randomized, controlled, dose-escalation Phase 1 clinical trial in hookworm-exposed children aged 6 to 10 years living in the area of Lambaréné, Gabon. Children will receive three doses of the Na-GST-1/Alhydrogel hookworm vaccine co-administered with the Na-APR-1 (M74)/Alhydrogel hookworm vaccine or the hepatitis B vaccine co-administered with sterile saline. All injections will be delivered intramuscularly (deltoid) on approximately Days 0, 56, and 112 or 180.

Detailed description

Double blind, randomized, controlled, dose-escalation Phase 1 clinical trial in hookworm-exposed children aged 6 to 10 years living in the area of Lambaréné, Gabon. Children will receive three doses of the assigned vaccine(s) delivered intramuscularly (deltoid) on approximately Days 0, 56, and 112 or 180. Safety will be measured from the time of each study vaccination (Day 0) through 14 days after each study vaccination by the occurrence of solicited injection site and systemic reactogenicity events. Unsolicited non-serious adverse events (AEs) will be collected from the time of the first study vaccination through approximately 1 month after each study vaccination. New-onset chronic medical conditions and Serious Adverse Events (SAEs) will be collected from the time of the first study vaccination through approximately 9 months after the third study vaccination (final visit). Clinical laboratory evaluations for safety will be performed on venous blood collected approximately 14 days after each vaccination. Immunogenicity testing will include IgG antibody responses to each vaccine antigen, by a qualified indirect enzyme-linked immunosorbent assay (ELISA), on serum or plasma obtained prior to each study vaccination and at time points after each vaccination (see Appendix A); the functional activity of vaccine-induced antibodies will be assessed by in vitro enzyme neutralization assays; the induction of B cell memory will be measured by antigen-specific memory B cell responses. Recruitment and enrollment into the study will occur on an ongoing basis, with each group being recruited and vaccinated in sequence. 60 subjects will be enrolled into 3 groups of 20. The first 20 subjects will be assembled and enrolled into Group 1: 1. Group 1 double-blind IP allocation (n=20): * 16 subjects will receive 10 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 10 µg Na-GST-1 administered IM in the alternate arm. * 8 will be vaccinated according to a 0,2,4-month schedule * 8 will be vaccinated according to a 0,2,6-month schedule * 4 subjects will receive hepatitis B vaccine comparator: * 2 will be vaccinated according to a 0,2,4-month schedule * 2 will be vaccinated according to a 0,2,6-month schedule 2. Group 2 double-blind IP allocation (n=20): * 16 subjects will receive 30 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 30µg Na-GST-1 administered IM in the alternate arm. * 8 will be vaccinated according to a 0,2,4-month schedule * 8 will be vaccinated according to a 0,2,6-month schedule * 4 subjects will receive hepatitis B vaccine comparator: * 2 will be vaccinated according to a 0,2,4-month schedule * 2 will be vaccinated according to a 0,2,6-month schedule 3. Group 3 double-blind IP allocation (n=20): * 16 subjects will receive 100 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 100 µg Na-GST-1 administered IM in the alternate arm. * 8 will be vaccinated according to a 0,2,4-month schedule * 8 will be vaccinated according to a 0,2,6-month schedule * 4 subjects will receive hepatitis B vaccine comparator: * 2 will be vaccinated according to a 0,2,4-month schedule * 2 will be vaccinated according to a 0,2,6-month schedule

Interventions

BIOLOGICALHepatitis B Vaccine

Sponsors

Baylor College of Medicine
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
6 Years to 10 Years
Healthy volunteers
Yes

Inclusion criteria

1. Males or females between 6 and 10 years, inclusive, who are long-term residents of the study area. 2. Good general health as determined by means of the screening procedure. 3. Assumed availability for the duration of the trial (up to 15 months). 4. Willingness of parent or legal guardian for child to participate in the study as evidenced by signing the informed consent document in combination with the child assent form. 5. Negative for hookworm during screening, or if found to be infected with hookworm, has completed a course of three doses of albendazole.

Exclusion criteria

1. Inability of parent/legal guardian to correctly answer all questions on the informed consent comprehension questionnaire. 2. Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, diabetes, or renal disease by history, physical examination, and/or laboratory studies. 3. Known or suspected immunodeficiency. 4. Laboratory evidence of liver disease (alanine aminotransferase \[ALT\] greater than 1.25-times the upper reference limit). 5. Laboratory evidence of renal disease (serum creatinine greater than 1.25-times the upper reference limit, or more than 1+ protein, or more than trace blood on urine dipstick testing with the exception of greater than trace blood detected in females during menses). 6. Laboratory evidence of hematologic disease (absolute leukocyte count \<4500/mm3; absolute leukocyte count \>13.0 x 103/mm3; hemoglobin \<9.5 g/dl; or, platelet count \<140,000/mm3). 7. Other condition that in the opinion of the investigator could jeopardize the safety or rights of a child participating in the trial or would render the child unable to comply with the protocol. 8. Participation in another investigational vaccine or drug trial within 30 days of starting this study or for the duration of the study. 9. History of a severe allergic reaction or anaphylaxis. 10. Severe asthma as defined by the need for daily use of inhalers or emergency room/clinic visit or hospitalization within 6 months of the child's planned first vaccination in the study. 11. Positive for HCV. 12. Positive for HBsAg. 13. Positive for HIV infection. 14. Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of starting this study or expect to use for the duration of the study. 15. Receipt of a live vaccine within past 4 weeks or a killed vaccine within past 2 weeks prior to entry into the study. 16. History of a surgical splenectomy. 17. Receipt of blood products within the 6 months prior to entry into the study. 18. Previous receipt of a primary series (three doses according to a 0, 1, and 6 -12 month schedule) of the hepatitis B vaccine.

Design outcomes

Primary

MeasureTime frameDescription
Vaccine-Related Adverse EventsDay 380To evaluate the safety and reactogenicity of three different dose concentrations of Na-APR-1 (M74)/Alhydrogel® co-administered with Na-GST-1/Alhydrogel® in healthy Gabonese children.

Secondary

MeasureTime frameDescription
IgG Response to Na-GST-1 and Na-APR-1 (M74)14 days after the third vaccinationTo determine the doses of co-administered Na-APR-1 (M74) and Na-GST-1 that result in the highest levels of IgG antibody approximately 14 days after the third vaccination.

Other

MeasureTime frameDescription
Duration of Antibody Response to Na-GST-1 and Na-APR-1 (M74)Day 380To assess and compare the duration of the antibody responses of Na-GST-1 and Na-APR-1 (M74).
IgG Subclass Response to Na-GST-1 and Na-APR-1 (M74)Day 380To assess the distribution of IgG subclass responses to Na-GST-1 and Na-APR-1 (M74).

Countries

Gabon

Participant flow

Recruitment details

Recruitment and enrollment occurred on an ongoing basis, with each group being recruited and vaccinated in sequence.

Participants by arm

ArmCount
Low-dose (0,2,4 Months)
10 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 10 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 4 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
Low-dose (0,2,6 Months)
10 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 10 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 6 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
Medium-dose (0,2,4 Months)
30 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 30 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 4 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
Medium-dose (0,2,6 Months)
30 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 30 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 6 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
High-dose (0,2,4 Months)
100 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 100 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 4 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
High-dose (0,2,6 Months)
100 µg Na-APR-1 (M74) plus 5 µg GLA-AF delivered by IM injection in the deltoid muscle, with 100 µg Na-GST-1 administered IM in the alternate arm. Injections at 0, 2, and 6 months. Na-GST-1/Alhydrogel Na-APR-1 (M74)/Alhydrogel
8
Comparator (0,2,4 Months)
Hepatitis B vaccine delivered by IM injection in the deltoid muscle, with sterile saline solution administered IM in the alternate arm. Injections at 0, 2, and 4 months. Hepatitis B Vaccine
6
Comparator (0,2,6 Months)
Hepatitis B vaccine delivered by IM injection in the deltoid muscle, with sterile saline solution administered IM in the alternate arm. Injections at 0, 2, and 6 months. Hepatitis B Vaccine
6
Total60

Baseline characteristics

CharacteristicLow-dose (0,2,4 Months)TotalComparator (0,2,6 Months)Comparator (0,2,4 Months)High-dose (0,2,6 Months)High-dose (0,2,4 Months)Medium-dose (0,2,6 Months)Medium-dose (0,2,4 Months)Low-dose (0,2,6 Months)
Age, Continuous7 years7 years6.5 years7.5 years7 years7.5 years8 years6.5 years8 years
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
8 Participants60 Participants6 Participants6 Participants8 Participants8 Participants8 Participants8 Participants8 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Region of Enrollment
Gabon
8 participants60 participants6 participants6 participants8 participants8 participants8 participants8 participants8 participants
Sex: Female, Male
Female
1 Participants26 Participants2 Participants3 Participants7 Participants2 Participants5 Participants4 Participants2 Participants
Sex: Female, Male
Male
7 Participants34 Participants4 Participants3 Participants1 Participants6 Participants3 Participants4 Participants6 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
deaths
Total, all-cause mortality
0 / 80 / 80 / 80 / 80 / 80 / 80 / 60 / 6
other
Total, other adverse events
8 / 88 / 88 / 88 / 88 / 88 / 84 / 66 / 6
serious
Total, serious adverse events
0 / 80 / 81 / 80 / 80 / 80 / 80 / 60 / 6

Outcome results

Primary

Vaccine-Related Adverse Events

To evaluate the safety and reactogenicity of three different dose concentrations of Na-APR-1 (M74)/Alhydrogel® co-administered with Na-GST-1/Alhydrogel® in healthy Gabonese children.

Time frame: Day 380

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Low-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event2 Participants
Low-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)7 Participants
Low-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
Low-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
Low-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)8 Participants
Low-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event2 Participants
Medium-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
Medium-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)7 Participants
Medium-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event0 Participants
Medium-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)8 Participants
Medium-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event2 Participants
Medium-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
High-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
High-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)7 Participants
High-dose (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event0 Participants
High-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)8 Participants
High-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event3 Participants
High-dose (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)7 Participants
Comparator (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event0 Participants
Comparator (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)2 Participants
Comparator (0,2,4 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)4 Participants
Comparator (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 grade 3 (severe) event0 Participants
Comparator (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 AE (any grade)6 Participants
Comparator (0,2,6 Months)Vaccine-Related Adverse EventsNumber participants with at least 1 injection site AE (any grade)5 Participants
Secondary

IgG Response to Na-GST-1 and Na-APR-1 (M74)

To determine the doses of co-administered Na-APR-1 (M74) and Na-GST-1 that result in the highest levels of IgG antibody approximately 14 days after the third vaccination.

Time frame: 14 days after the third vaccination

Population: Overall Numbers of Participants Analyzed in each Arm/Group corresponded to participants who received all 3 study injections, did not have any significant protocol deviations, and who had serum collected and sent to the analyzing laboratory on the specified study day.

ArmMeasureValue (GEOMETRIC_MEAN)
Low-dose (0,2,4 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)9.52 Arbitrary Units
Low-dose (0,2,6 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)9.08 Arbitrary Units
Medium-dose (0,2,4 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)219.53 Arbitrary Units
Medium-dose (0,2,6 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)266.38 Arbitrary Units
High-dose (0,2,4 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)726.89 Arbitrary Units
High-dose (0,2,6 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)2295.97 Arbitrary Units
Comparator (0,2,4 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)2.36 Arbitrary Units
Comparator (0,2,6 Months)IgG Response to Na-GST-1 and Na-APR-1 (M74)2.36 Arbitrary Units
Other Pre-specified

Duration of Antibody Response to Na-GST-1 and Na-APR-1 (M74)

To assess and compare the duration of the antibody responses of Na-GST-1 and Na-APR-1 (M74).

Time frame: Day 380

Other Pre-specified

IgG Subclass Response to Na-GST-1 and Na-APR-1 (M74)

To assess the distribution of IgG subclass responses to Na-GST-1 and Na-APR-1 (M74).

Time frame: Day 380

Source: ClinicalTrials.gov · Data processed: Feb 8, 2026