Healthy
Conditions
Keywords
Vaccination, Geriatric, Immunology, Influenza
Brief summary
Researchers are evaluating the safety and effectiveness of a single administration of entolimod when administered at the same time as the influenza vaccine (flu vaccine).
Interventions
Intramuscular (IM) single dose administration. Entolimod is provided as a sterile, clear, colorless or slightly yellow liquid for IM injection.
Intramuscular (IM) single dose administration, no active ingredient. A matching placebo is provided as a sterile, clear, colorless to slightly yellow liquid for IM injection in prefilled vials that are identical in appearance to the vials containing active drug.
Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur
Sponsors
Study design
Eligibility
Inclusion criteria
Inclusion: * Men and women of age 65 years and older at the time of enrollment * Eligible to receive Fluzone High-Dose * Female subjects must be past menopause and not pregnant * No history of anaphylactic reaction to gelatin, neomycin, or other vaccine component * Must not have had the flu vaccine within the past 90 days * Medically stable with no exacerbations or changes in medication regimen for chronic diseases in the past 3 months and no hospitalizations in the past 6 months * Must be able to read/write English in order to provide informed consent and comply with study procedures * Expected to be available for the duration of the study Exclusion: * Receipt of any other vaccines within the past 30 days prior to enrollment * Acute illness within the last 7 days * History of hypersensitivity to the flu vaccine or its components (including gelatin, formaldehyde, octoxinol, thimerosal, and chicken protein). * History of Guillain Barré syndrome (GBS) * History of bleeding disorders * Medical contraindication to treatment with vaccine as indicated by a history of autoimmune disease, immune deficiency, or hypersensitivity to other vaccines. * Unstable major cardiovascular, renal, endocrine, immunological or hepatic disorder * Systolic blood pressure (SBP) \< 110 mmHg or orthostatic hypotension \[\>20 mmHg fall in SBP or \>10 mmHg fall in diastolic blood pressure (DBP) with standing\] at the time of screening. * Evidence of an ongoing systemic bacterial, fungal, or viral infection (including upper respiratory tract infections) (within 14 days prior to entolimod administration). Note: Subjects with localized fungal infections of skin or nails are eligible. * Clinical signs of febrile illness (temperature \>99.5oF) * Baseline vital signs with ≥Grade 2 abnormalities * Significant cardiovascular disease (e.g., myocardial infarction, arterial thromboembolism, cerebrovascular thromboembolism, venous thromboembolism) within 6 months prior to study drug administration; symptomatic dysrhythmias or unstable dysrhythmias requiring medical therapy; angina requiring therapy; symptomatic peripheral vascular disease; New York Heart Association Class 3 or 4 congestive heart failure; or uncontrolled Grade ≥3 hypertension (diastolic blood pressure ≥100 mmHg or systolic blood pressure ≥160 mmHg) despite antihypertensive therapy. o Significant screening ECG abnormalities, including unstable cardiac arrhythmia requiring medication, atrial fibrillation, 2nd-degree atrioventricular (AV) block type II, 3rd degree AV block, or Grade ≥2 bradycardia (within 14 days prior to entolimod administration). * Inadequate hepatic function (within 14 days prior to entolimod administration): * Serum alanine aminotransferase (ALT) ≥3 × upper limit of normal (ULN) (Grade ≥1). * Serum aspartate aminotransferase (AST) ≥3 × ULN (Grade ≥1) * Serum alkaline phosphatase (ALP) ≥5 × ULN (Grade ≥2) * Serum bilirubin ≥1.5 × ULN (Grade ≥1) * Positive antiviral serology: * Positive hepatitis C virus (HCV) antibody or positive HCV ribonucleic acid (RNA) by quantitative PCR. * Positive hepatitis B surface antigen (HBsAg) and negative hepatitis B core (HBc) antibody or undetectable hepatitis B (HBV) deoxyribonucleic acid (DNA) by quantitative polymerase chain reaction (PCR) testing. * Positive human immunodeficiency virus (HIV) antibody. * Use of medication that might interact with the flu vaccine including (but not limited to) specifically: aminopyrine, phenytoin sodium, theophylline, and warfarin sodium. * Any ongoing treatment with immunosuppressive or immune-stimulant therapy * Ongoing use of systemic corticosteroids. * Blood or blood products given within the three months prior to vaccination and two months after vaccination * Current and/or expected receipt of chemotherapy, radiation therapy or any other cytotoxic or immunosuppressive therapy \[i.e. more than 10 mg of prednisone given daily or on alternative days for 2 weeks or more in the past 3 months\] * Receipt of another investigational pharmaceutical product within 60 days of treatment * Diagnosis of Parkinson's Disease, previous stroke, or significant cognitive impairment (defined as MMSE \<20) * Other concerns that in the opinion of the PI would preclude a subject from participating in study procedures or from completing the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Anti- A/H1N1 Antibody Titer | Baseline, 1 month | Change of the anti- A/H1N1 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month. |
| Change in Anti-A/H3N2 Antibody Titer | Baseline, 1 month | Change of the anti-A/H3N2 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month. |
| Change in Anti-B Antibody Titer | Baseline, 1 month | Change of the anti-B influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month.. |
| Adverse Events | 1 year | The number of adverse events (AEs) related to dose limiting toxicities (DLTs); laboratory abnormalities; oxygen saturation and vital sign changes, and adverse electrocardiogram (ECG) findings for 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Grip Strength | baseline, 2 months | Measured by a grip dynamometer as reported in units of pounds. |
| Time of Onset for Upper-respiratory Infections | 1 year | Subject self-reporting of the number of days to develop an upper-respiratory infection |
| Change in Body Mass Index (BMI) | baseline, 2 months | Subject's BMI calculated as weight in kilograms divided by height in meters squared. Uses measurements of height and weight obtained during study (with appropriate metric conversions) |
| Upper Respiratory Infections | 1 year | The total number of subjects to self-report an upper-respiratory infection |
| Change in Frailty | baseline, 2 months | Change in self-reported 5 items frail scale. Frail scale scores range from 0-5, 1 point for each component, 0 = best 5 = worst (robust=0 points; pre-frail=0-1 points; frail 3-5 points) |
| Change in 6-minute Walk Test | baseline, 2 months | Distance a subject is able to walk over 6 minutes over a hard flat surface |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Entolimod 1 mcg Subjects received entolimod as a single dose administered intramuscularly (1mcg)
Entolimod: Intramuscular (IM) single dose administration. Entolimod was provided as a sterile, clear, colorless or slightly yellow liquid for IM injection.
Influenza vaccine: Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur | 20 |
| Entolimod 3 mcg Subjects received entolimod as a single dose administered intramuscularly (3mcg)
Entolimod: Intramuscular (IM) single dose administration. Entolimod was provided as a sterile, clear, colorless or slightly yellow liquid for IM injection.
Influenza vaccine: Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur | 19 |
| Entolimod 10 mcg Subjects received entolimod as a single dose administered intramuscularly (10mcg)
Entolimod: Intramuscular (IM) single dose administration. Entolimod was provided as a sterile, clear, colorless or slightly yellow liquid for IM injection.
Influenza vaccine: Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur | 6 |
| Placebo Subjects received a placebo as a single dose administered intramuscularly (no study drug); placebo that looks exactly like the study drug, but contains no active ingredient.
Placebo: Intramuscular (IM) single dose administration, no active ingredient. A matching placebo was provided as a sterile, clear, colorless to slightly yellow liquid for IM injection in prefilled vials that are identical in appearance to the vials containing active drug.
Influenza vaccine: Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur | 16 |
| Total | 61 |
Baseline characteristics
| Characteristic | Entolimod 1 mcg | Total | Placebo | Entolimod 10 mcg | Entolimod 3 mcg |
|---|---|---|---|---|---|
| Age, Continuous | 73.0 years STANDARD_DEVIATION 6.3 | 72.6 years STANDARD_DEVIATION 6.01 | 73.1 years STANDARD_DEVIATION 5.89 | 76.0 years STANDARD_DEVIATION 6.78 | 70.7 years STANDARD_DEVIATION 5.35 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 20 Participants | 61 Participants | 16 Participants | 6 Participants | 19 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 20 Participants | 61 Participants | 16 Participants | 6 Participants | 19 Participants |
| Region of Enrollment United States | 20 participants | 61 participants | 16 participants | 6 participants | 19 participants |
| Sex: Female, Male Female | 10 Participants | 29 Participants | 6 Participants | 3 Participants | 10 Participants |
| Sex: Female, Male Male | 10 Participants | 32 Participants | 10 Participants | 3 Participants | 9 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 20 | 0 / 19 | 0 / 6 | 0 / 16 |
| other Total, other adverse events | 20 / 20 | 19 / 19 | 6 / 6 | 16 / 16 |
| serious Total, serious adverse events | 0 / 20 | 0 / 19 | 0 / 6 | 1 / 16 |
Outcome results
Adverse Events
The number of adverse events (AEs) related to dose limiting toxicities (DLTs); laboratory abnormalities; oxygen saturation and vital sign changes, and adverse electrocardiogram (ECG) findings for 1 year
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Entolimod 1 mcg | Adverse Events | 39 adverse event |
| Entolimod 3 mcg | Adverse Events | 27 adverse event |
| Entolimod 10 mcg | Adverse Events | 23 adverse event |
| Placebo | Adverse Events | 26 adverse event |
Change in Anti- A/H1N1 Antibody Titer
Change of the anti- A/H1N1 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month.
Time frame: Baseline, 1 month
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Anti- A/H1N1 Antibody Titer | 65.0 titer | Standard Deviation 137.23 |
| Entolimod 3 mcg | Change in Anti- A/H1N1 Antibody Titer | 73.2 titer | Standard Deviation 111.43 |
| Entolimod 10 mcg | Change in Anti- A/H1N1 Antibody Titer | 88.4 titer | Standard Deviation 123.74 |
| Placebo | Change in Anti- A/H1N1 Antibody Titer | 20.3 titer | Standard Deviation 48.56 |
Change in Anti-A/H3N2 Antibody Titer
Change of the anti-A/H3N2 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month.
Time frame: Baseline, 1 month
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Anti-A/H3N2 Antibody Titer | 58.4 titer | Standard Deviation 90.57 |
| Entolimod 3 mcg | Change in Anti-A/H3N2 Antibody Titer | 81.6 titer | Standard Deviation 138.59 |
| Entolimod 10 mcg | Change in Anti-A/H3N2 Antibody Titer | 28.0 titer | Standard Deviation 30.98 |
| Placebo | Change in Anti-A/H3N2 Antibody Titer | 39.1 titer | Standard Deviation 79.84 |
Change in Anti-B Antibody Titer
Change of the anti-B influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month..
Time frame: Baseline, 1 month
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Anti-B Antibody Titer | 11.6 titer | Standard Deviation 18.93 |
| Entolimod 3 mcg | Change in Anti-B Antibody Titer | 28.3 titer | Standard Deviation 67.06 |
| Entolimod 10 mcg | Change in Anti-B Antibody Titer | 45.0 titer | Standard Deviation 56.48 |
| Placebo | Change in Anti-B Antibody Titer | 10.0 titer | Standard Deviation 18.26 |
Change in 6-minute Walk Test
Distance a subject is able to walk over 6 minutes over a hard flat surface
Time frame: baseline, 2 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in 6-minute Walk Test | 5.1 meters | Standard Deviation 25.64 |
| Entolimod 3 mcg | Change in 6-minute Walk Test | 11.0 meters | Standard Deviation 36.39 |
| Entolimod 10 mcg | Change in 6-minute Walk Test | 4.5 meters | Standard Deviation 9.83 |
| Placebo | Change in 6-minute Walk Test | -15.8 meters | Standard Deviation 66.73 |
Change in Body Mass Index (BMI)
Subject's BMI calculated as weight in kilograms divided by height in meters squared. Uses measurements of height and weight obtained during study (with appropriate metric conversions)
Time frame: baseline, 2 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Body Mass Index (BMI) | 0.3 kg/m^2 | Standard Deviation 0.58 |
| Entolimod 3 mcg | Change in Body Mass Index (BMI) | 0.1 kg/m^2 | Standard Deviation 0.67 |
| Entolimod 10 mcg | Change in Body Mass Index (BMI) | -0.2 kg/m^2 | Standard Deviation 0.97 |
| Placebo | Change in Body Mass Index (BMI) | 0.1 kg/m^2 | Standard Deviation 0.57 |
Change in Frailty
Change in self-reported 5 items frail scale. Frail scale scores range from 0-5, 1 point for each component, 0 = best 5 = worst (robust=0 points; pre-frail=0-1 points; frail 3-5 points)
Time frame: baseline, 2 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Frailty | -0.1 score on a scale | Standard Deviation 0.4 |
| Entolimod 3 mcg | Change in Frailty | -0.2 score on a scale | Standard Deviation 0.6 |
| Entolimod 10 mcg | Change in Frailty | -0.2 score on a scale | Standard Deviation 0.6 |
| Placebo | Change in Frailty | 0.1 score on a scale | Standard Deviation 0.5 |
Change in Grip Strength
Measured by a grip dynamometer as reported in units of pounds.
Time frame: baseline, 2 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Change in Grip Strength | 4.6 pounds | Standard Deviation 17.2 |
| Entolimod 3 mcg | Change in Grip Strength | 1.1 pounds | Standard Deviation 4.87 |
| Entolimod 10 mcg | Change in Grip Strength | 0.0 pounds | Standard Deviation 1.79 |
| Placebo | Change in Grip Strength | -0.7 pounds | Standard Deviation 2.68 |
Time of Onset for Upper-respiratory Infections
Subject self-reporting of the number of days to develop an upper-respiratory infection
Time frame: 1 year
Population: The number of subjects to develop upper-respiratory infections were analyzed for each arm
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Entolimod 1 mcg | Time of Onset for Upper-respiratory Infections | 152.5 days | Standard Deviation 127.4 |
| Entolimod 3 mcg | Time of Onset for Upper-respiratory Infections | 302.3 days | Standard Deviation 112.4 |
| Entolimod 10 mcg | Time of Onset for Upper-respiratory Infections | 339.0 days | Standard Deviation 0 |
| Placebo | Time of Onset for Upper-respiratory Infections | 157.0 days | Standard Deviation 114.3 |
Upper Respiratory Infections
The total number of subjects to self-report an upper-respiratory infection
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Entolimod 1 mcg | Upper Respiratory Infections | 10 Participants |
| Entolimod 3 mcg | Upper Respiratory Infections | 9 Participants |
| Entolimod 10 mcg | Upper Respiratory Infections | 2 Participants |
| Placebo | Upper Respiratory Infections | 3 Participants |