Immunogenicity and Safety of a Purified Vero Rabies Vaccine

Immunogenicity and Safety of a Purified Vero Rabies Vaccine - Serum Free When Administered According to a Simulated Rabies Post-exposure Regimen in Healthy Adults

This multicenter, observer-blind, controlled, randomized, Phase II study was designed to evaluate different formulations of the Purified Vero Rabies Cell vaccine VRVg.

Study Overview

• Status: Completed
• Conditions: Rabies Virus
• Intervention / Treatment: Biological: VRVg 2; Biological: VRVg 2; Biological: VRVg 2; Biological: Human Rabies Immunoglobulins (HRIG); Biological: VRVg 1; Biological: Imovax Rabies

Detailed Description

This study assessed different formulations of the modified formulation of VRVg (VRVg 2- formulations 1 [low], 2 [medium] and 3 [high]) tested in parallel to the initial VRVg formulation (VRVg-1) and Imovax Rabies. Immune responses were assessed at Day 14, Day 28, Day 42, and at Month 7. Safety events were also reported.

• Study Type: Interventional
• Enrollment (Actual): 320
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • California
    • Redding, California, United States, 96001
      • Investigational Site
    • San Diego, California, United States, 92117
      • Investigational Site
  • Florida
    • South Miami, Florida, United States, 33143
      • Investigational Site
  • Nebraska
    • Omaha, Nebraska, United States, 68134
      • Investigational Site
  • Nevada
    • Las Vegas, Nevada, United States, 89104
      • Investigational Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 63 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

An individual must fulfill all of the following criteria in order to be eligible for trial enrollment:

1. Aged 18 to less than 65 years on the day of inclusion.
2. Informed consent form had been signed and dated.
3. Able to attend all scheduled visits and to complied with all trial procedures.
4. Body Mass Index (BMI): 18.5 kilograms per meter square (Kg/m^2) less than or equal to (<=) BMI <= 30 Kg/m^2.

Exclusion Criteria:

An individual fulfilling any of the following criteria was to be excluded from trial enrollment:

1. Participant was pregnant, or lactating, or of childbearing potential and not using an effective method of contraception or abstinence from at least 4 weeks prior to the first vaccination until at least 4 weeks after the last vaccination. To be considered of non-childbearing potential, a female must be post-menopausal for at least 1 year, or surgically sterile.
2. Participation at the time of study enrollment or, planned participation during the present trial period in another clinical trial investigating a vaccine, drug, medical device, or medical procedure.
3. Receipt of any vaccine in the 4 weeks (28 days) preceding the first trial vaccination or planned receipt of any vaccine prior to Visit 6.
4. Previous vaccination against rabies (in pre- or post-exposure regimen) with either the trial vaccine or another vaccine.
5. Receipt of immune globulins, blood or blood-derived products in the past 3 months.
6. Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy, such as anti-cancer chemotherapy or radiation therapy, within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months).
7. At high risk for rabies infection during the trial (e.g., veterinarians and staff, animal handlers, rabies researchers, or any others whose activities may bring them into frequent contact with rabies virus or animals who had the rabies virus).
8. Known systemic hypersensitivity to any of the vaccine or human rabies immunoglobulins (HRIG) components, or history of a life-threatening reaction to the vaccines used in the trial or to a vaccine containing any of the same substances.
9. Self-reported thrombocytopenia, contraindicating IM vaccination.
10. Bleeding disorder, or receipt of anticoagulants in the 3 weeks preceding inclusion, contraindicating IM vaccination.
11. Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily.
12. Current alcohol abuse or drug addiction.
13. Chronic illness that, in the opinion of the investigator, was at a stage where it might interfere with trial conduct or completion (e.g., cardiac disorders, renal disorders, auto immune disorders, diabetes, psychiatric disorders or chronic infection).
14. Moderate or severe acute illness/infection (according to investigator judgment) on the day of vaccination or febrile illness (temperature greater than or equal to [>=] 100.4 Fahrenheit >=38.0 Celsius). A prospective participant should not be included in the study until the condition had resolved or the febrile event had subsided.
15. Identified as an Investigator or employee of the Investigator or study center with direct involvement in the proposed study, or identified as an immediate family member (i.e., parent, spouse, natural or adopted child) of the Investigator or employee with direct involvement in the proposed study.
16. History of Guillain-Barré syndrome.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

5

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1: VRVg-2 Formulation 1; VRVg-2 formulation 1, intramuscular (IM) injection on Days 0, 3, 7, 14 and 28. Concomitant administration of human rabies immunoglobulins (HRIG) on Day 0.	Biological: VRVg 2; Modified formulation 1 (Low) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 2 (Medium) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 3 (High) of Purified Vero Rabies Vaccine Serum Free; Biological: Human Rabies Immunoglobulins (HRIG); Commercialized formulation of HRIG
Experimental: Group 2: VRVg-2 Formulation 2; VRVg-2 formulation 2, IM injection on Days 0, 3, 7, 14 and 28. Concomitant administration of HRIG on Day 0.	Biological: VRVg 2; Modified formulation 1 (Low) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 2 (Medium) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 3 (High) of Purified Vero Rabies Vaccine Serum Free; Biological: Human Rabies Immunoglobulins (HRIG); Commercialized formulation of HRIG
Experimental: Group 3: VRVg-2 Formulation 3; VRVg-2 formulation 3, IM injection on Days 0, 3, 7, 14 and 28. Concomitant administration of HRIG on Day 0.	Biological: VRVg 2; Modified formulation 1 (Low) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 2 (Medium) of Purified Vero Rabies Vaccine Serum Free; Biological: VRVg 2; Modified formulation 3 (High) of Purified Vero Rabies Vaccine Serum Free; Biological: Human Rabies Immunoglobulins (HRIG); Commercialized formulation of HRIG
Experimental: Group 4: VRVg-1; VRVg-1 initial formulation, IM injection on Days 0, 3, 7, 14 and 28. Concomitant administration of HRIG on Day 0.	Biological: Human Rabies Immunoglobulins (HRIG); Commercialized formulation of HRIG; Biological: VRVg 1; Initial formulation of Purified Vero Rabies Vaccine Serum Free
Active Comparator: Group 5: Imovax Rabies; Imovax Rabies, IM injection on Days 0, 3, 7, 14 and 28. Concomitant administration of HRIG on Day 0.	Biological: Human Rabies Immunoglobulins (HRIG); Commercialized formulation of HRIG; Biological: Imovax Rabies; Purified inactivated rabies vaccine prepared on human diploid cell cultures

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rabies Virus Neutralizing Antibody (RVNA) Geometric Mean Titers (GMTs) Against Rabies Virus at Day 0	RVNA GMT against rabies virus was assessed using the rapid fluorescent focus inhibition test (RFFIT) assay method.	Day 0
Rabies Virus Neutralizing Antibody Geometric Mean Titers Against Rabies Virus at Day 14	RVNA GMT against rabies virus was assessed using the RFFIT assay method.	Day 14
Rabies Virus Neutralizing Antibody Geometric Mean Titers Against Rabies Virus at Day 28	RVNA GMT against rabies virus was assessed using the RFFIT assay method.	Day 28
Rabies Virus Neutralizing Antibody Geometric Mean Titers Against Rabies Virus at Day 42	RVNA GMT against rabies virus was assessed using the RFFIT assay method.	Day 42
Rabies Virus Neutralizing Antibody Geometric Mean Titers Against Rabies Virus at Month 7	RVNA GMT against rabies virus was assessed using the RFFIT assay method.	Month 7
Percentage of Participants With Rabies Virus Neutralizing Antibody Titer Greater Than or Equal to (>=) 0.2 IU/mL and >=0.5 IU/mL at Day 0	RVNA titer against rabies virus was assessed using the RFFIT assay method. Participants with RVNA titer >=0.2 IU/mL were considered as seropositive.	Day 0
Percentage of Participants With Rabies Virus Neutralizing Antibody Titers >=0.2 IU/mL and >=0.5 IU/mL at Day 14	RVNA titer against rabies virus was assessed using the RFFIT assay method. Participants with RVNA titer >=0.2 IU/mL were considered as seropositive.	Day 14
Percentage of Participants With RVNA Titers >=0.2 IU/mL and >=0.5 IU/mL at Day 28	RVNA titer against rabies virus was assessed using the RFFIT assay method. Participants with RVNA titer >=0.2 IU/mL were considered as seropositive.	Day 28
Percentage of Participants With RVNA Titers >=0.2 IU/mL and >=0.5 IU/mL at Day 42	RVNA titer against rabies virus was assessed using the RFFIT assay method. Participants with RVNA titer >=0.2 IU/mL were considered as seropositive.	Day 42
Percentage of Participants With RVNA Titers >=0.2 IU/mL and >=0.5 IU/mL at Month 7	RVNA titer against rabies virus was assessed using the RFFIT assay method. Participants with RVNA titer >= 0.2 IU/mL were considered as seropositive.	Month 7
Geometric Mean Titer Ratio (GMTR) of Rabies Virus Neutralizing Antibody 7 Days Following Vaccination 3 (Day 14/Day 0)	RVNA titer against rabies virus was assessed using the RFFIT assay method. GMTRs were calculated as the ratio of GMTs 7 days post 3rd vaccination (i.e., on Day 14) and pre-vaccination on Day 0.	Day 0 (pre-dose) and Day 14 (7 days post-dose 3)
Geometric Mean Titer Ratio of Rabies Virus Neutralizing Antibody 14 Days Following Vaccination 4 (Day 28/Day 0)	RVNA titer against rabies virus was assessed using the RFFIT assay method. GMTRs were calculated as the ratio of GMTs 14 days post 4th vaccination (i.e., on Day 28) and pre-vaccination on Day 0.	Day 0 (pre-dose) and Day 28 (14 days post-dose 4)
Geometric Mean Titer Ratio of Rabies Virus Neutralizing Antibody 14 Days Following Vaccination 5 (Day 42/Day 0)	RVNA titer against rabies virus was assessed using the RFFIT assay method. GMTRs were calculated as the ratio of GMTs 14 days post 5th vaccination (i.e., on Day 42) and pre-vaccination on Day 0.	Day 0 (Pre-dose) and Day 42 (14 days Post-dose 5)
Geometric Mean Titer Ratio of Rabies Virus Neutralizing Antibody 6 Months Following Last Vaccination (Month 7/Day 0)	RVNA titer against rabies virus was assessed using the RFFIT assay method. GMTRs were calculated as the ratio of GMTs 6 month post last vaccination on Month 7 and pre-vaccination on Day 0.	Day 0 (Pre-dose) and Month 7 (6 Months Post Last Vaccination)
Percentage of Participants With Complete Virus Neutralization at Starting Dilution (1/5) of Rapid Fluorescent Focus Inhibition Test Assay at Day 0	Complete virus neutralization was defined as absence of fluorescent cells at the participant/time point level at the starting dilution (1/5) of the RFFIT assay. Percentage of participants with complete virus neutralization were reported.	Day 0
Percentage of Participants With Complete Virus Neutralization at Starting Dilution (1/5) of Rapid Fluorescent Focus Inhibition Test Assay at Day 14	Complete virus neutralization was defined as absence of fluorescent cells at the participant/time point level at the starting dilution (1/5) of the RFFIT assay. Percentage of participants with complete virus neutralization were reported.	Day 14
Percentage of Participants With Complete Virus Neutralization at Starting Dilution (1/5) of Rapid Fluorescent Focus Inhibition Test Assay at Day 28	Complete virus neutralization was defined as absence of fluorescent cells at the participant/time point level at the starting dilution (1/5) of the RFFIT assay. Percentage of participants with complete virus neutralization were reported.	Day 28
Percentage of Participants With Complete Virus Neutralization at Starting Dilution (1/5) of Rapid Fluorescent Focus Inhibition Test Assay at Day 42	Complete virus neutralization was defined as absence of fluorescent cells at the participant/time point level at the starting dilution (1/5) of the RFFIT assay. Percentage of participants with complete virus neutralization were reported.	Day 42
Percentage of Participants With Complete Virus Neutralization at Starting Dilution (1/5) of Rapid Fluorescent Focus Inhibition Test Assay at Month 7	Complete virus neutralization was defined as absence of fluorescent cells at the participant/time point level at the starting dilution (1/5) of the RFFIT assay. Percentage of participants with complete virus neutralization were reported.	Month 7
Number of Participants With Immediate Unsolicited Adverse Events	An adverse event was defined as any untoward medical occurrence in a participant who received study drug and does not necessary have to have a causal relationship with treatment. An unsolicited AE was an observed AE that did not fulfill the conditions prelisted in the case report form (CRF) in terms of diagnosis and/or onset post-vaccination. All participants were observed for 30 minutes after any vaccination, and any unsolicited AEs occurred during that time were recorded as immediate unsolicited AEs in the CRF. Immediate AEs considered as related to vaccination were recorded as immediate unsolicited adverse reactions (ARs).	Within 30 Minutes After any Vaccination
Number of Participants With at Least One Solicited Injection Site Reactions	A solicited reaction (SR) was an AR observed and reported under conditions (symptoms and onset) prelisted (i.e., solicited) in the CRF and considered as related to vaccination. An AR was all noxious and unintended responses to a medicinal product related to any dose. Solicited injection site reactions included pain, erythema and swelling at and around the injection site.	Within 7 Days After any and each vaccination (Vaccination 1, 2, 3, 4 and 5)
Number of Participants With at Least One Solicited Systemic Reactions	A solicited reaction was an AR observed and reported under the conditions (symptom and onset) prelisted (i.e., solicited) in the CRF and considered as related to vaccination. An AR was all noxious and unintended responses to a medicinal product related to any dose. Solicited systemic reactions included fever, headache, malaise and myalgia.	Within 7 Days After any and each vaccination (Vaccination 1, 2, 3, 4 and 5)
Number of Participants With at Least One Unsolicited Adverse Events	An AE was defined as any untoward medical occurrence in a participant who received study drug and does not necessary have to have a causal relationship with treatment. An unsolicited AE was an observed AE that did not fulfill the conditions prelisted in the CRF in terms of diagnosis and/or onset post-vaccination.	Within 28 Days After any vaccination
Number of Participants With Serious Adverse Events (SAEs)	An AE was defined as any untoward medical occurrence in a participant who received study drug and does not necessary have to have a causal relationship with treatment. An SAE was any untoward medical occurrence that at any dose resulted in death; life-threatening; initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect or a medically important event.	From Day 0 up to Month 7

Collaborators and Investigators

• Sponsor: Sanofi Pasteur, a Sanofi Company

Study record dates

Study Major Dates

• Study Start (Actual): April 17, 2017
• Primary Completion (Actual): January 8, 2018
• Study Completion (Actual): January 8, 2018

Study Registration Dates

• First Submitted: May 3, 2017
• First Submitted That Met QC Criteria: May 5, 2017
• First Posted (Actual): May 9, 2017

Study Record Updates

• Last Update Posted (Actual): April 19, 2022
• Last Update Submitted That Met QC Criteria: March 30, 2022
• Last Verified: March 1, 2022

More Information

Terms related to this study

• Keywords: Rabies virus
• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Mononegavirales Infections; Rhabdoviridae Infections; Rabies; Physiological Effects of Drugs; Immunologic Factors; Antibodies; Immunoglobulins; Immunoglobulins, Intravenous
• Other Study ID Numbers: VRV11; U1111-1174-4976 (Other Identifier: UTN)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No