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Anti-malaria MAb in Malian Children

Safety and Efficacy of L9LS, a Human Monoclonal Antibody Against Plasmodium Falciparum, in a Dose-Escalation Trial in Adults and Children and a Randomized, Double-Blind Trial of Children in Mali

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05304611
Acronym
L9LS
Enrollment
365
Registered
2022-03-31
Start date
2022-03-18
Completion date
2024-04-20
Last updated
2025-07-10

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

Conditions

Malaria, Plasmodium Falciparum Infection

Brief summary

The purpose of this study is to evaluate the safety and tolerability of onetime subcutaneous (SC) or intravenous (IV) administration of monoclonal antibody (MAb) L9LS in healthy Malian adults and one-time SC administration of L9LS in healthy Malian children, as well as its protective efficacy against naturally occurring Plasmodium falciparum (Pf) infection over a 7-month malaria season in healthy Malian children 6-10 years of age.

Detailed description

A two-part, phase 2 trial evaluating the safety and tolerability of onetime subcutaneous (SC) or intravenous (IV) administration of monoclonal antibody (MAb) L9LS in healthy Malian adults and one-time SC administration of L9LS in healthy Malian children, as well as its protective efficacy against naturally occurring Plasmodium falciparum (Pf) infection over a 7-month malaria season in healthy Malian children 6-10 years of age. The first part of the study is an age de-escalation and dose-escalation study for safety and tolerability. Adult subjects in the dose-escalation study will be assigned in open-label fashion to 1 of 3 L9LS dose arms. Dosing will begin in the lowest dose arm. Once all subjects in that arm reach day 7 post-administration, if no safety concerns have arisen, dosing will begin at the next dose level. Once all subjects in that arm reach day 7 post-administration, if no safety concerns have arisen, dosing will begin at the highest dose level. Once all adult subjects reach day 7 post-administration, if no safety concerns have arisen, 18 subjects aged 6-10 years will be randomized 1:1 to L9LS or placebo in double-blind fashion. Once all 18 subjects reach day 7 post-administration, if no safety concerns have arisen, an additional 18 subjects aged 6-10 years will be randomized 1:1 to L9LS versus placebo. Randomization of subjects aged 6-10 years in each L9LS dose arm will be weight-stratified and enrollment will be weight de-escalated. Adult subjects will be followed for safety to assess adverse events (AEs) at study visits 1, 3, 7, 14, 21, and 28 days after administration, and once every month thereafter through 28 weeks. Subjects aged 6-10 years will be followed at study visits 1, 3, 7, 14, 21, and 28 days after administration, and once every 2 weeks thereafter through 36 weeks. Primary study assessments include physical examination and blood collection for identification of Pf infection and other research laboratory evaluations. After the last subject in the pediatric L9LS dose arm reaches day 7 safety follow-up, an interim safety evaluation will be performed before enrollment begins for the efficacy part of the study. Data from the 36 subjects aged 6-10 years enrolled in the dose-escalation study will be included in a secondary analysis to determine the relationship between L9LS concentration and the risk of Pf infection. The second part of the study is a weight-stratified, randomized, double-blind, placebo-controlled trial to assess safety and protective efficacy of L9LS versus placebo administered SC in children 6-10 years of age. In this part of the study, subjects will be randomized to L9LS or placebo. Randomization of subjects in each arm will be weight-stratified. Subjects in the efficacy study will receive the study agent prior to the malaria season and be followed at study visits 1, 3, 7, 14, 21, and 28 days later, and once every 2 weeks thereafter through 24 weeks. Primary study assessments include physical examination and blood collection for identification of Pf infection and other research laboratory evaluations. Prior to the last study visit of the original protocol described above (January 2023 - February 2023), study participants who remain enrolled in the dose-escalation and efficacy studies will be invited to participate in a 12-month extension study. After the safety and efficacy results are unblinded (approximately March/April 2023), participants who agree to continue with the extension will be grouped into one of 3 arms based on their original study arm assignment: Arm 1: Up to 84 subjects who received 150 mg of L9LS in year 1 (9 from the dose-escalation study, plus 75 from the efficacy study). Arm 2: Up to 84 subjects who received 300 mg of L9LS in year 1 (9 from the dose-escalation study, plus 75 from the efficacy study). Arm 3: Up to 93 subjects who received placebo in year 1 (18 from the dose-escalation study, plus 75 from the efficacy study). The protocol extension employs a pre-specified, adaptive design based on the time-to-event efficacy of 150 mg and 300 mg of L9LS against P. falciparum infection as detected by blood smear observed after the first malaria season in the original protocol. Specifically, if 150 mg and 300 mg of L9LS both show ≥60% efficacy during the first malaria season (based on the upper bound of the two-sided 95% confidence interval \[CI\]), participants will be re-randomized 1:1 in a double-blind fashion within each arm to receive a single dose of either L9LS (150 or 300 mg depending on study arm) or placebo administered SC before the 2023 malaria season. The same randomization scheme will be followed if in the first malaria season the 300-mg dose of L9LS shows ≥60% efficacy (based on the upper bound of the two-sided 95% CI) and the 150-mg dose of L9LS shows \<60% efficacy (based on the upper bound of the two-sided 95% CI) but the difference between their respective point estimates of efficacy is ≤10%, with the exception that children who received placebo in year 1 will receive 300 mg of L9LS (or placebo) in year 2. If 300 mg of L9LS shows ≥60% efficacy (based on the upper bound of the two-sided 95% CI) and 150 mg of L9LS shows \<60% efficacy (based on the upper bound of the two-sided 95% CI) but the difference between their respective point estimates of efficacy is \>10% during the first malaria season, participants will be re-randomized 1:1 in a double-blind fashion within each arm to receive a single dose of either 300 mg of L9LS or placebo administered SC before the 2023 malaria season. If 150 mg and 300 mg of L9LS both show \<60% efficacy (based on the upper bound of the two-sided 95% CI) after the first malaria season, the protocol extension will be abandoned. Before study agent administration, all subjects will be given artemether-lumefantrine to clear any preexisting Pf blood-stage infection. Subjects will be followed at study visits 1, 3, 7, 14, 21, and 28 days after administration, and once every 2 weeks thereafter through 28 weeks, with a final visit occurring on study day 252 (36 weeks) to collect a final PK sample. Primary study assessments include medical history, physical examination, and blood collection for pharmacokinetics (PK), anti-drug antibody (ADA) assessments, identification of Pf infection by microscopic examination of thick blood smears and RT-PCR, and other research laboratory evaluations.

Interventions

BIOLOGICALL9LS (VRC-MALMAB0114-00-AB) Subcutaneous injection

Administered one time via subcutaneous route.

BIOLOGICALL9LS (VRC-MALMAB0114-00-AB) intravenous injection

Administered one time via intravenous route.

OTHERPlacebo

Normal saline administered one time via subcutaneous route.

Sponsors

National Institutes of Health (NIH)
CollaboratorNIH
Malaria Research and Training Center, Bamako, Mali
CollaboratorOTHER
University of the Sciences, Techniques and Technologies of Bamako
CollaboratorOTHER
University of Washington
CollaboratorOTHER
Harvard School of Public Health (HSPH)
CollaboratorOTHER
Indiana University School of Medicine
CollaboratorOTHER
National Institute of Allergy and Infectious Diseases (NIAID)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
6 Years to 55 Years
Healthy volunteers
Yes

Inclusion criteria

* Is within the appropriate age range for the respective cohort: 1. Children: Aged ≥6 years and \<11 years. 2. Adults: Aged ≥18 years. * Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process. * In good general health and without clinically significant medical history. * Adult participants or parent and/or guardian of minor participants able to provide informed consent. * Willing to have blood samples and data stored for future research. * Resides in or near Kalifabougou or Torodo, Mali, and available for the duration of the study. * For the adult cohort, females of childbearing potential must be willing to use reliable contraception from 21 days prior to study day 0 through the final study visit as described below. * Reliable methods of birth control include 1 of the following: confirmed pharmacologic contraceptives via parenteral delivery or intrauterine or implantable device. * Nonchildbearing women will be required to report date of last menstrual period, history of surgical sterility (i.e., tubal ligation, hysterectomy) or premature ovarian insufficiency, and will have urine or serum pregnancy test performed per protocol. Year 2 Extension Inclusion Criteria: * Participated in the first year of the protocol. * Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process. * In good general health and without clinically significant medical history. * Parent and/or guardian able to provide informed consent. * Willing to have blood samples and data stored for future research. * Resides in or near Kalifabougou or Torodo, Mali, and available for the duration of the study.

Exclusion criteria

* Body weight \<15 kg or \>30 kg for children, or \>60 kg for adults. * Currently receiving or planning to receive seasonal malaria chemoprevention (SMC). * Any history of menses (for 6-10 year old cohort) or positive pregnancy test at screening (for adult cohort). * Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and comply with the study protocol. * Subject (for adult subjects) or parental (for minor subjects) study comprehension examination score of \<80% correct or per investigator discretion. * Hemoglobin, white blood cell, absolute neutrophil, or platelet count outside the local laboratory-defined limits of normal. (Subjects may be included at the investigator's discretion for not clinically significant values.) * Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal. (Subjects may be included at the investigator's discretion for not clinically significant values.) * Infected with HIV, hepatitis C virus (HCV), or hepatitis B virus (HBV). * Known or documented sickle cell disease by history. (Note: Known sickle cell trait is NOT exclusionary.) * Clinically significant abnormal electrocardiogram (ECG; Corrected QT Interval (QTc) \>460 or other significant abnormal findings, including unexplained tachycardia or bradycardia). * Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, oncologic, or renal disease by history, physical examination, and/or laboratory studies including urinalysis. * Receipt of any investigational product within the past 30 days. * Participation or planned participation in an interventional trial with an investigational product before the last required protocol visit. (Note: Past, current, or planned participation in observational studies is NOT exclusionary.) * Medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months. * History of a severe allergic reaction or anaphylaxis. * Severe asthma (defined as asthma that is unstable or required emergent care, urgent care, hospitalization, or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years). * Salivary gland disorder diagnosed by a doctor (e.g., parotitis, sialadenitis, sialolithiasis, salivary gland tumors). * Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, or autoimmune thrombocytopenia. * Known immunodeficiency syndrome. * Known asplenia or functional asplenia. * Use of chronic (≥14 days) oral or IV corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone \>10 mg/day) or immunosuppressive drugs within 30 days of day 0. * Receipt of a live vaccine within the past 4 weeks or a killed vaccine or COVID-19 vaccine within the past 2 weeks prior to study agent administration. * Receipt of immunoglobulins and/or blood products within the past 6 months. * Previous receipt of an investigational malaria vaccine or monoclonal antibody in the last 5 years. * Known allergies or contraindication against artemether-lumefantrine. * Clinical signs of malnutrition. * Other condition(s) that, in the opinion of the investigator, would jeopardize the safety or rights of a subject participating in the trial, interfere with the evaluation of the study objectives, or render the subject unable to comply with the protocol. Year 2 Extension

Design outcomes

Primary

MeasureTime frameDescription
Severity of Systemic Adverse Events (AEs) - Year OneWithin 7 days after the administration of L9LSThe severity of systemic AEs occurring after the administration of L9LS was assessed using the grading scale below: Grade 1: Fever = 37.5\^oC-37.9\^oC; Fatigue, Headache, Myalgia = No interference with activity; Nausea = no interference with activity or 1-2 episodes/hour Grade 2: Fever = 38\^oC-38.4\^oC; Fatigue, Myalgia = Some interference with activity; Headache = Repeated use of non-narcotic pain reliever \> 24 hours or some interference with activity; Nausea = Some interference with activity or \> 2 episodes/24 hours Grade 3: Fever = 38.5\^oC-39.5\^oC; Fatigue = Prevents daily activity; Headache =Significant; any use of narcotic pain reliever or prevents daily activity; Myalgia =Significant; prevents daily activity; Nausea = Prevents daily activity, requires outpatient intravenous hydration Grade 4: Fever = \> 39.5\^oC; Fatigue, Headache, Myalgia = Emergency room (ER) visit or hospitalization; Nausea = ER visit or hospitalization for hypotensive shock Grade 5: Death
Participants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination - Efficacy StudyDay 7 through week 28Number of participants with Plasmodium falciparum (Pf) blood stage infection defined as blood smear-positive for Pf was assessed by microscopic examination of thick blood smear collected from participants from day 14 through week 28 (196 days) after administration of L9LS or placebo. Analysis was done as number of participants who had at least one positive blood smear.
Participants With Detectable Anti-drug Antibody (ADA) in Sera - Extension StudyMeasured through week 36Number of participants with detectable anti-drug antibody (ADA) in sera after exposure to L9LS. Serum was collected from participants at specific timepoints throughout the study, on days 0, 7, 28, 84, 168, and 196. The tier 3 assay was used to directly measure ADA's ability to impair L9LS binding to Plasmodium falciparum circumsporozoite protein (PfCSP). Analysis was done to determine number of participants with positive or detectable ADA in sera.
Maximum Total Plasma Concentration (Cmax) for L9LS - Extension StudyMeasured through Week 36Maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 84, 140, 196, & 252 after the administration of L9LS. Cmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles post dose. Analysis was done to determine each participant's observed maximum concentration based on all available timepoints and cumulative output was calculated as the central tendency and dispersion metric based on the observed maximum concentrations.
Time to Maximum Plasma Concentration (TMax) for L9LS - Extension StudyMeasured through Week 36Time to maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 84, 140, 196, & 252 after the administration of L9LS. Tmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles. Analysis was done to determine the time (in days) at which the maximum observed concentration was achieved for each participant and cumulative output was calculated as the central tendency and dispersion metric based on the observed time of maximum concentration.
Participants With Local Adverse Events (AEs) - Extension StudyWithin 7 days after administration of L9LSNumber of participants with local adverse events occurring within 7 days after administration of L9LS. Local reactogenicity included pain/tenderness, swelling, redness, bruising, and pruritus at the site of infusion. Adverse events were captured by Investigator examination and history from participants.
Severity of Local Adverse Events (AEs) - Extension StudyWithin 7 days after administration of L9LSThe severity of local AEs was graded using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Clinical Trials. Grade 1: Pain = does not interfere with activity; Tenderness = mild discomfort to touch; Erythema/Redness = 2.5-5 cm; Induration/Swelling = 2.5-5 cm and does not interfere with activity. Grade 2: Pain = Repeated use of non-narcotic pain reliever \> 24 hours or interferes with daily activity; Tenderness= Discomfort with movement; Erythema/Redness = 5.1-10 cm; Induration/Swelling = 5.1-10 cm and interferes with activity. Grade 3: Pain = Any use of narcotic pain reliever or prevents daily activity; Tenderness = Significant discomfort at rest; Erythema/Redness = \> 10 cm; Induration/Swelling = \> 10 cm or prevents daily activity. Grade 4: Pain = Emergency room (ER) visit or hospitalization; Tenderness = ER visit or hospitalization; Erythema/Redness = Necrosis or exfoliative dermatitis; induration/Swelling = Necrosis Grade 5: Death
Participants With Systemic Adverse Events (AEs) - Extension StudyWithin 7 days after the administration of L9LSNumber of participants with local adverse events occurring within 7 days after administration of L9LS. Systemic reactogenicity events included fever, feeling unusually tired or unwell, muscle aches, headache, chills, nausea, and joint pain. Adverse events were captured by Investigator examination and history from participants.
Severity of Systemic Adverse Events (AEs) - Extension StudyWithin 7 days after the administration of L9LSThe severity of systemic AEs occurring after the administration of L9LS was assessed using the grading scale below: Grade 1: Fever = 37.5\^oC-37.9\^oC; Fatigue, Headache, Myalgia = No interference with activity; Nausea = no interference with activity or 1-2 episodes/hour Grade 2: Fever = 38\^oC-38.4\^oC; Fatigue, Myalgia = Some interference with activity; Headache = Repeated use of non-narcotic pain reliever \> 24 hours or some interference with activity; Nausea = Some interference with activity or \> 2 episodes/24 hours Grade 3: Fever = 38.5\^oC-39.5\^oC; Fatigue = Prevents daily activity; Headache =Significant; any use of narcotic pain reliever or prevents daily activity; Myalgia =Significant; prevents daily activity; Nausea = Prevents daily activity, requires outpatient intravenous hydration Grade 4: Fever = \> 39.5\^oC; Fatigue, Headache, Myalgia = Emergency room (ER) visit or hospitalization; Nausea = ER visit or hospitalization for hypotensive shock Grade 5: Death
Participants With Local Adverse Events (AEs) - Year OneWithin 7 days after administration of L9LSNumber of participants with local adverse events occurring within 7 days after administration of L9LS. Local reactogenicity included pain/tenderness, swelling, redness, bruising, and pruritus at the site of infusion. Adverse events were captured by Investigator examination and history from participants.
Severity of Local Adverse Events (AEs) - Year OneWithin 7 days after administration of L9LSThe severity of local AEs was graded using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Clinical Trials. Grade 1: Pain = does not interfere with activity; Tenderness = mild discomfort to touch; Erythema/Redness = 2.5-5 cm; Induration/Swelling = 2.5-5 cm and does not interfere with activity. Grade 2: Pain = Repeated use of non-narcotic pain reliever \> 24 hours or interferes with daily activity; Tenderness= Discomfort with movement; Erythema/Redness = 5.1-10 cm; Induration/Swelling = 5.1-10 cm and interferes with activity. Grade 3: Pain = Any use of narcotic pain reliever or prevents daily activity; Tenderness = Significant discomfort at rest; Erythema/Redness = \> 10 cm; Induration/Swelling = \> 10 cm or prevents daily activity. Grade 4: Pain = Emergency room (ER) visit or hospitalization; Tenderness = ER visit or hospitalization; Erythema/Redness = Necrosis or exfoliative dermatitis; induration/Swelling = Necrosis Grade 5: Death
Participants With Systemic Adverse Events (AEs) - Year OneWithin 7 days after the administration of L9LSNumber of participants with local adverse events occurring within 7 days after administration of L9LS. Systemic reactogenicity events included fever, feeling unusually tired or unwell, muscle aches, headache, chills, nausea, and joint pain. Adverse events were captured by Investigator examination and history from participants.

Secondary

MeasureTime frameDescription
Participants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Dose Escalation StudyMeasured through Week 28Number of participants with clinical malaria during a single malaria season, defined by an illness accompanied by any level of Plasmodium Falciparum (Pf) asexual parasitemia as detected from microscopic examination of thick blood smear that results in the administration of anti-malarial treatment.
Participants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Efficacy StudyMeasured through Week 24Number of participants with clinical malaria during a single malaria season, defined by an illness accompanied by any level of Plasmodium Falciparum (Pf) asexual parasitemia as detected from microscopic examination of thick blood smear that results in the administration of anti-malarial treatment.
Maximum Total Plasma Concentration (Cmax) for L9LS - Study Year OneMeasured through Week 36Maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 56, 84, 112, 140, 168, 196, 224, & 252 after the administration of L9LS. Cmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles post dose. Analysis was done to determine each participant's observed maximum concentration based on all available timepoints and cumulative output was calculated as the central tendency and dispersion metric based on the observed maximum concentrations.
Time to Maximum Plasma Concentration (TMax) for L9LS - Study Year OneMeasured through Week 36Time to maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum was collected on days 0, 7, 28, 56, 84, 112, 140, 168, 196, 224, & 252 after administration of L9LS. Tmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles. Analysis was done to determine the time (in days) at which the maximum observed concentration was achieved for each participant and cumulative output was calculated as the central tendency and dispersion metric based on the observed time of maximum concentration.
Participants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)Measured through week 24 (dose escalation study) and week 28 (efficacy study)Number of participants with Plasmodium falciparum (Pf) blood stage infection defined as blood sample positive for Pf was assessed by real-time polymerase chain reaction (RT-PCR) of blood sample collected from participants from day 0 through week 28 (196 days) after administration of L9LS or placebo. Analysis was done as number of participants who had at least one positive blood sample.
Participants With Clinical Malaria - Pediatric Dose Escalation StudyMeasured through Week 28Number of pediatric participants with clinical malaria during a single malaria season, defined by an illness accompanied by measured axillary fever ≥37.5°C, or history of fever (subjective or objective) in the previous 24 hours, and Plasmodium falciparum (Pf) asexual parasitemia \>5,000 parasites/μL as detected from microscopic examination of thick blood smear. Assessment was done from day 0 through week 28 (196 days) after administration of L9LS or placebo. Subjective data, objective data and blood sample were collected from administration of intervention through week 28. Analysis was done as number of participants who had at least one symptom and positive blood sample.
Participants With Clinical Malaria - Pediatric Efficacy StudyMeasured through Week 28Number of pediatric participants with clinical malaria during a single malaria season, defined by an illness accompanied by measured axillary fever ≥37.5°C, or history of fever (subjective or objective) in the previous 24 hours, and Plasmodium falciparum (Pf) asexual parasitemia \>5,000 parasites/μL as detected from microscopic examination of thick blood smear. Assessment was done from day 0 through week 28 (196 days) after administration of L9LS or placebo. Subjective data, objective data and blood sample were collected from administration of intervention through week 28. Analysis was done as number of participants who had at least one symptom and positive blood sample.

Countries

Mali

Participant flow

Pre-assignment details

365 participants were consented (341 pediatrics, 36 adults): * 62 participants were ineligible (57 pediatrics, five adults) * 23 participants served as backup (22 pediatrics, one adult) * One pediatric participant withdrew consent * 279 participants received intervention (261 pediatrics, 18 adults) in year one * 235 pediatric participants from year one participated in the extension study in year two

Participants by arm

ArmCount
Adult Dose-escalation Study: Arm 1: 300 mg of L9LS
Adult participants receive single dose of 300 mg of L9LS subcutaneously. Once subjects reach day 7 post-administration without safety concerns dosing begins for arm 2. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
6
Adult Dose-escalation Study: Arm 2: 600 mg of L9LS
Adult participants receive single dose of 600 mg of L9LS subcutaneously. Once subjects reach day 7 post-administration without safety concerns dosing begins for arm 3. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
6
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LS
Adult participants receive highest single dose of 20 mg/kg IV of L9LS intravenously. Once subjects reach day 7 post-administration without safety concerns dosing begins for pediatric subjects dose escalation arm 1. L9LS (VRC-MALMAB0114-00-AB): Administered one time via intravenous route.
6
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LS
Pediatric subjects ages 6-10 years receive 150 mg of L9LS subcutaneously. Once subjects reach day 7 post-administration without safety concerns, dosing begins for arm 2. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
9
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LS
Pediatric subjects ages 6-10 years receive 300 mg of L9LS subcutaneously. Once subjects reach day 7 post-administration without safety concerns, dosing begins for the pediatric efficacy study arms. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
9
Pediatric Dose-escalation Study: Arm 3: Placebo
Pediatric subjects ages 6-10 receive placebo of normal saline subcutaneously. Normal saline: Administered one time via subcutaneous administration.
18
Pediatric Efficacy Study: Arm 1: 150 mg of L9LS
Pediatric subjects ages 6-10 receive 150 mg of L9LS subcutaneously. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
75
Pediatric Efficacy Study: Arm 2: 300 mg of L9LS
Pediatric subjects ages 6-10 receive 300 mg of L9LS subcutaneously. L9LS (VRC-MALMAB0114-00-AB): Administered one time via subcutaneous route.
75
Pediatric Efficacy Study: Arm 3: Placebo
Pediatric subjects ages 6-10 receive placebo of normal saline subcutaneously. Normal saline: Administered one time via subcutaneous administration.
75
Total279

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006FG007FG008FG009FG010FG011
Pediatric Efficacy StudyLost to Follow-up000000101000
Pediatric Efficacy StudyWithdrew consent000000112000
Pediatric Extension StudyWithdrawal by Subject000000000012

Baseline characteristics

CharacteristicTotalPediatric Efficacy Study: Arm 3: PlaceboPediatric Efficacy Study: Arm 2: 300 mg of L9LSPediatric Efficacy Study: Arm 1: 150 mg of L9LSPediatric Dose-escalation Study: Arm 3: PlaceboPediatric Dose-escalation Study: Arm 2: 300 mg of L9LSPediatric Dose-escalation Study: Arm 1: 150 mg of L9LSAdult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSAdult Dose-escalation Study: Arm 2: 600 mg of L9LSAdult Dose-escalation Study: Arm 1: 300 mg of L9LS
Age, Customized
10
33 Participants8 Participants13 Participants6 Participants3 Participants1 Participants2 Participants0 Participants0 Participants0 Participants
Age, Customized
18-20
5 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants1 Participants1 Participants3 Participants
Age, Customized
21-30
5 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants2 Participants3 Participants0 Participants
Age, Customized
31-40
4 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants3 Participants1 Participants0 Participants
Age, Customized
41-50
4 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants1 Participants3 Participants
Age, Customized
51-55
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Customized
6
80 Participants31 Participants23 Participants20 Participants5 Participants1 Participants0 Participants0 Participants0 Participants0 Participants
Age, Customized
7
39 Participants8 Participants11 Participants11 Participants4 Participants2 Participants3 Participants0 Participants0 Participants0 Participants
Age, Customized
8
64 Participants19 Participants13 Participants23 Participants4 Participants2 Participants3 Participants0 Participants0 Participants0 Participants
Age, Customized
9
45 Participants9 Participants15 Participants15 Participants2 Participants3 Participants1 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
African
279 Participants75 Participants75 Participants75 Participants18 Participants9 Participants9 Participants6 Participants6 Participants6 Participants
Region of Enrollment
Mali
279 participants75 participants75 participants75 participants18 participants9 participants9 participants6 participants6 participants6 participants
Sex: Female, Male
Female
129 Participants36 Participants33 Participants31 Participants8 Participants3 Participants7 Participants4 Participants4 Participants3 Participants
Sex: Female, Male
Male
150 Participants39 Participants42 Participants44 Participants10 Participants6 Participants2 Participants2 Participants2 Participants3 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
EG008
affected / at risk
EG009
affected / at risk
EG010
affected / at risk
EG011
affected / at risk
deaths
Total, all-cause mortality
0 / 60 / 60 / 60 / 90 / 90 / 180 / 750 / 750 / 750 / 790 / 380 / 118
other
Total, other adverse events
5 / 66 / 66 / 69 / 98 / 918 / 1867 / 7571 / 7572 / 7574 / 7933 / 38111 / 118
serious
Total, serious adverse events
0 / 60 / 60 / 60 / 90 / 90 / 180 / 750 / 750 / 750 / 790 / 380 / 118

Outcome results

Primary

Maximum Total Plasma Concentration (Cmax) for L9LS - Extension Study

Maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 84, 140, 196, & 252 after the administration of L9LS. Cmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles post dose. Analysis was done to determine each participant's observed maximum concentration based on all available timepoints and cumulative output was calculated as the central tendency and dispersion metric based on the observed maximum concentrations.

Time frame: Measured through Week 36

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the L9LS intervention during the extension study.

ArmMeasureValue (MEAN)Dispersion
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Extension Study64.63 ug/mLStandard Deviation 17.36
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Extension Study116.93 ug/mLStandard Deviation 24.78
Primary

Participants With Detectable Anti-drug Antibody (ADA) in Sera - Extension Study

Number of participants with detectable anti-drug antibody (ADA) in sera after exposure to L9LS. Serum was collected from participants at specific timepoints throughout the study, on days 0, 7, 28, 84, 168, and 196. The tier 3 assay was used to directly measure ADA's ability to impair L9LS binding to Plasmodium falciparum circumsporozoite protein (PfCSP). Analysis was done to determine number of participants with positive or detectable ADA in sera.

Time frame: Measured through week 36

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention in the extension study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Detectable Anti-drug Antibody (ADA) in Sera - Extension Study0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Detectable Anti-drug Antibody (ADA) in Sera - Extension Study0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Detectable Anti-drug Antibody (ADA) in Sera - Extension Study0 Participants
Primary

Participants With Local Adverse Events (AEs) - Extension Study

Number of participants with local adverse events occurring within 7 days after administration of L9LS. Local reactogenicity included pain/tenderness, swelling, redness, bruising, and pruritus at the site of infusion. Adverse events were captured by Investigator examination and history from participants.

Time frame: Within 7 days after administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyInjection site swelling1 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyRedness at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPain at Injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPain at Injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyInjection site swelling2 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyRedness at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyInjection site swelling0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyPain at Injection site1 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Extension StudyRedness at injection site0 Participants
Primary

Participants With Local Adverse Events (AEs) - Year One

Number of participants with local adverse events occurring within 7 days after administration of L9LS. Local reactogenicity included pain/tenderness, swelling, redness, bruising, and pruritus at the site of infusion. Adverse events were captured by Investigator examination and history from participants.

Time frame: Within 7 days after administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling3 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling1 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site1 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling1 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling3 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OnePruritus at injection site1 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneBruising at injection site0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneInjection site swelling0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneRedness at injection site0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OneTenderness at injection site0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Local Adverse Events (AEs) - Year OnePain at Injection site1 Participants
Primary

Participants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination - Efficacy Study

Number of participants with Plasmodium falciparum (Pf) blood stage infection defined as blood smear-positive for Pf was assessed by microscopic examination of thick blood smear collected from participants from day 14 through week 28 (196 days) after administration of L9LS or placebo. Analysis was done as number of participants who had at least one positive blood smear.

Time frame: Day 7 through week 28

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention during the efficacy study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination - Efficacy Study36 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination - Efficacy Study30 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Microscopic Examination - Efficacy Study61 Participants
Primary

Participants With Systemic Adverse Events (AEs) - Extension Study

Number of participants with local adverse events occurring within 7 days after administration of L9LS. Systemic reactogenicity events included fever, feeling unusually tired or unwell, muscle aches, headache, chills, nausea, and joint pain. Adverse events were captured by Investigator examination and history from participants.

Time frame: Within 7 days after the administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyJoint pain0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyChills0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyMuscle aches0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFever0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyHeadache1 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyNausea0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyJoint pain0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyHeadache1 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFever0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyChills0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyNausea0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyMuscle aches0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyChills0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFever0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyJoint pain0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyNausea0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyHeadache4 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Extension StudyMuscle aches0 Participants
Primary

Participants With Systemic Adverse Events (AEs) - Year One

Number of participants with local adverse events occurring within 7 days after administration of L9LS. Systemic reactogenicity events included fever, feeling unusually tired or unwell, muscle aches, headache, chills, nausea, and joint pain. Adverse events were captured by Investigator examination and history from participants.

Time frame: Within 7 days after the administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneHeadache1 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache2 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever3 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneHeadache1 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneChills1 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSParticipants With Systemic Adverse Events (AEs) - Year OneFever0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneFever1 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneNausea0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneJoint pain0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneFeeling unusually tired or unwell0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneChills0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneMuscle aches0 Participants
Pediatric Efficacy Study: Arm 3: PlaceboParticipants With Systemic Adverse Events (AEs) - Year OneHeadache1 Participants
Primary

Severity of Local Adverse Events (AEs) - Extension Study

The severity of local AEs was graded using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Clinical Trials. Grade 1: Pain = does not interfere with activity; Tenderness = mild discomfort to touch; Erythema/Redness = 2.5-5 cm; Induration/Swelling = 2.5-5 cm and does not interfere with activity. Grade 2: Pain = Repeated use of non-narcotic pain reliever \> 24 hours or interferes with daily activity; Tenderness= Discomfort with movement; Erythema/Redness = 5.1-10 cm; Induration/Swelling = 5.1-10 cm and interferes with activity. Grade 3: Pain = Any use of narcotic pain reliever or prevents daily activity; Tenderness = Significant discomfort at rest; Erythema/Redness = \> 10 cm; Induration/Swelling = \> 10 cm or prevents daily activity. Grade 4: Pain = Emergency room (ER) visit or hospitalization; Tenderness = ER visit or hospitalization; Erythema/Redness = Necrosis or exfoliative dermatitis; induration/Swelling = Necrosis Grade 5: Death

Time frame: Within 7 days after administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 11 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 20 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 12 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 20 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 11 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Extension StudyGrade 20 Participants
Primary

Severity of Local Adverse Events (AEs) - Year One

The severity of local AEs was graded using the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Clinical Trials. Grade 1: Pain = does not interfere with activity; Tenderness = mild discomfort to touch; Erythema/Redness = 2.5-5 cm; Induration/Swelling = 2.5-5 cm and does not interfere with activity. Grade 2: Pain = Repeated use of non-narcotic pain reliever \> 24 hours or interferes with daily activity; Tenderness= Discomfort with movement; Erythema/Redness = 5.1-10 cm; Induration/Swelling = 5.1-10 cm and interferes with activity. Grade 3: Pain = Any use of narcotic pain reliever or prevents daily activity; Tenderness = Significant discomfort at rest; Erythema/Redness = \> 10 cm; Induration/Swelling = \> 10 cm or prevents daily activity. Grade 4: Pain = Emergency room (ER) visit or hospitalization; Tenderness = ER visit or hospitalization; Erythema/Redness = Necrosis or exfoliative dermatitis; induration/Swelling = Necrosis Grade 5: Death

Time frame: Within 7 days after administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 13 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 11 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 10 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 12 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Local Adverse Events (AEs) - Year OneGrade 13 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 12 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Local Adverse Events (AEs) - Year OneGrade 30 Participants
Primary

Severity of Systemic Adverse Events (AEs) - Extension Study

The severity of systemic AEs occurring after the administration of L9LS was assessed using the grading scale below: Grade 1: Fever = 37.5\^oC-37.9\^oC; Fatigue, Headache, Myalgia = No interference with activity; Nausea = no interference with activity or 1-2 episodes/hour Grade 2: Fever = 38\^oC-38.4\^oC; Fatigue, Myalgia = Some interference with activity; Headache = Repeated use of non-narcotic pain reliever \> 24 hours or some interference with activity; Nausea = Some interference with activity or \> 2 episodes/24 hours Grade 3: Fever = 38.5\^oC-39.5\^oC; Fatigue = Prevents daily activity; Headache =Significant; any use of narcotic pain reliever or prevents daily activity; Myalgia =Significant; prevents daily activity; Nausea = Prevents daily activity, requires outpatient intravenous hydration Grade 4: Fever = \> 39.5\^oC; Fatigue, Headache, Myalgia = Emergency room (ER) visit or hospitalization; Nausea = ER visit or hospitalization for hypotensive shock Grade 5: Death

Time frame: Within 7 days after the administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 10 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 21 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 10 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 21 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 11 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 30 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Extension StudyGrade 23 Participants
Primary

Severity of Systemic Adverse Events (AEs) - Year One

The severity of systemic AEs occurring after the administration of L9LS was assessed using the grading scale below: Grade 1: Fever = 37.5\^oC-37.9\^oC; Fatigue, Headache, Myalgia = No interference with activity; Nausea = no interference with activity or 1-2 episodes/hour Grade 2: Fever = 38\^oC-38.4\^oC; Fatigue, Myalgia = Some interference with activity; Headache = Repeated use of non-narcotic pain reliever \> 24 hours or some interference with activity; Nausea = Some interference with activity or \> 2 episodes/24 hours Grade 3: Fever = 38.5\^oC-39.5\^oC; Fatigue = Prevents daily activity; Headache =Significant; any use of narcotic pain reliever or prevents daily activity; Myalgia =Significant; prevents daily activity; Nausea = Prevents daily activity, requires outpatient intravenous hydration Grade 4: Fever = \> 39.5\^oC; Fatigue, Headache, Myalgia = Emergency room (ER) visit or hospitalization; Nausea = ER visit or hospitalization for hypotensive shock Grade 5: Death

Time frame: Within 7 days after the administration of L9LS

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 21 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 10 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 24 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 11 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 1: 150 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 21 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 2: 300 mg of L9LSSeverity of Systemic Adverse Events (AEs) - Year OneGrade 11 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 50 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 12 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 40 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 20 Participants
Pediatric Efficacy Study: Arm 3: PlaceboSeverity of Systemic Adverse Events (AEs) - Year OneGrade 30 Participants
Primary

Time to Maximum Plasma Concentration (TMax) for L9LS - Extension Study

Time to maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 84, 140, 196, & 252 after the administration of L9LS. Tmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles. Analysis was done to determine the time (in days) at which the maximum observed concentration was achieved for each participant and cumulative output was calculated as the central tendency and dispersion metric based on the observed time of maximum concentration.

Time frame: Measured through Week 36

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the L9LS intervention during the extension study.

ArmMeasureValue (MEAN)Dispersion
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Extension Study7.00 DaysStandard Deviation 0.16
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Extension Study7.58 DaysStandard Deviation 3.41
Secondary

Maximum Total Plasma Concentration (Cmax) for L9LS - Study Year One

Maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum collected on days 0, 7, 28, 56, 84, 112, 140, 168, 196, 224, & 252 after the administration of L9LS. Cmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles post dose. Analysis was done to determine each participant's observed maximum concentration based on all available timepoints and cumulative output was calculated as the central tendency and dispersion metric based on the observed maximum concentrations.

Time frame: Measured through Week 36

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received L9LS in year one study.

ArmMeasureValue (MEAN)Dispersion
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Study Year One76.97 ug/mLStandard Deviation 18.88
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Study Year One142.79 ug/mLStandard Deviation 30.36
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Study Year One76.19 ug/mLStandard Deviation 22.04
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSMaximum Total Plasma Concentration (Cmax) for L9LS - Study Year One142.70 ug/mLStandard Deviation 29.56
Secondary

Participants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Dose Escalation Study

Number of participants with clinical malaria during a single malaria season, defined by an illness accompanied by any level of Plasmodium Falciparum (Pf) asexual parasitemia as detected from microscopic examination of thick blood smear that results in the administration of anti-malarial treatment.

Time frame: Measured through Week 28

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the intervention during the pediatric dose escalation study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Dose Escalation Study7 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Dose Escalation Study7 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Dose Escalation Study13 Participants
Secondary

Participants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Efficacy Study

Number of participants with clinical malaria during a single malaria season, defined by an illness accompanied by any level of Plasmodium Falciparum (Pf) asexual parasitemia as detected from microscopic examination of thick blood smear that results in the administration of anti-malarial treatment.

Time frame: Measured through Week 24

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received intervention during the pediatric efficacy study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Efficacy Study33 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Efficacy Study25 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Clinical Malaria Detected by Microscopic Examination of Thick Blood Smear - Pediatric Efficacy Study57 Participants
Secondary

Participants With Clinical Malaria - Pediatric Dose Escalation Study

Number of pediatric participants with clinical malaria during a single malaria season, defined by an illness accompanied by measured axillary fever ≥37.5°C, or history of fever (subjective or objective) in the previous 24 hours, and Plasmodium falciparum (Pf) asexual parasitemia \>5,000 parasites/μL as detected from microscopic examination of thick blood smear. Assessment was done from day 0 through week 28 (196 days) after administration of L9LS or placebo. Subjective data, objective data and blood sample were collected from administration of intervention through week 28. Analysis was done as number of participants who had at least one symptom and positive blood sample.

Time frame: Measured through Week 28

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received intervention during the pediatric dose escalation study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Clinical Malaria - Pediatric Dose Escalation Study6 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Clinical Malaria - Pediatric Dose Escalation Study4 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Clinical Malaria - Pediatric Dose Escalation Study11 Participants
Secondary

Participants With Clinical Malaria - Pediatric Efficacy Study

Number of pediatric participants with clinical malaria during a single malaria season, defined by an illness accompanied by measured axillary fever ≥37.5°C, or history of fever (subjective or objective) in the previous 24 hours, and Plasmodium falciparum (Pf) asexual parasitemia \>5,000 parasites/μL as detected from microscopic examination of thick blood smear. Assessment was done from day 0 through week 28 (196 days) after administration of L9LS or placebo. Subjective data, objective data and blood sample were collected from administration of intervention through week 28. Analysis was done as number of participants who had at least one symptom and positive blood sample.

Time frame: Measured through Week 28

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received the study intervention.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Clinical Malaria - Pediatric Efficacy Study21 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Clinical Malaria - Pediatric Efficacy Study14 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Clinical Malaria - Pediatric Efficacy Study44 Participants
Secondary

Participants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)

Number of participants with Plasmodium falciparum (Pf) blood stage infection defined as blood sample positive for Pf was assessed by real-time polymerase chain reaction (RT-PCR) of blood sample collected from participants from day 0 through week 28 (196 days) after administration of L9LS or placebo. Analysis was done as number of participants who had at least one positive blood sample.

Time frame: Measured through week 24 (dose escalation study) and week 28 (efficacy study)

Population: Modified intention-to-treat (MITT) - Analysis include all randomized pediatric subjects that received intervention during year one of the study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)7 Participants
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)8 Participants
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)13 Participants
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)33 Participants
Pediatric Dose-escalation Study: Arm 2: 300 mg of L9LSParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)32 Participants
Pediatric Dose-escalation Study: Arm 3: PlaceboParticipants With Plasmodium Falciparum (Pf) Infection Detected by Real-Time Polymerase Chain Reaction (RT-PCR)62 Participants
Secondary

Time to Maximum Plasma Concentration (TMax) for L9LS - Study Year One

Time to maximum total plasma concentration (Cmax) following a dose of 150 mg or 300 mg L9LS. Serum was collected on days 0, 7, 28, 56, 84, 112, 140, 168, 196, 224, & 252 after administration of L9LS. Tmax for L9LS was obtained directly by visual inspection of the plasma concentration versus time profiles. Analysis was done to determine the time (in days) at which the maximum observed concentration was achieved for each participant and cumulative output was calculated as the central tendency and dispersion metric based on the observed time of maximum concentration.

Time frame: Measured through Week 36

Population: Modified intention-to-treat (MITT) - Analysis include all randomized subjects that received L9LS in year one study.

ArmMeasureValue (MEAN)Dispersion
Adult Dose-escalation Study: Arm 1: 300 mg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Study Year One7.00 DaysStandard Deviation 0
Adult Dose-escalation Study: Arm 2: 600 mg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Study Year One7.00 DaysStandard Deviation 0
Adult Dose-escalation Study: Arm 3: 20 mg/kg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Study Year One7.17 DaysStandard Deviation 2.46
Pediatric Dose-escalation Study: Arm 1: 150 mg of L9LSTime to Maximum Plasma Concentration (TMax) for L9LS - Study Year One7.36 DaysStandard Deviation 2.45

Source: ClinicalTrials.gov · Data processed: Feb 6, 2026