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The Safety and Immunogenicity of the DNA-GTU Vaccine Administered to HIV-infected Patients on ART vs Placebo (CUTHIVTHER001)

2016年11月9日 更新者:Imperial College London

A Randomized Phase I/II Study to Assess the Safety and Immunogenicity of the DNA-GTU Vaccine Administered by Two Novel Routes Compared to Placebo in HIV-infected Patients on Antiretroviral Therapy

CUT*HIVTHER 001 is a randomised placebo-controlled Phase I/II study aimed at exploring the safety and immunogenicity of two different modes of delivery of a GTU® DNA plasmid vaccine (GTU®-multiHIV B clade) in HIV infected volunteers on antiretroviral therapy (ART):

  • Transcutaneous (TC) delivery to enhance intramuscular delivery and
  • Electroporation (EP) enhanced intramuscular delivery Participants will be randomised 1:1:1 to TC:EP:saline for the purposes of analysis. Half the saline group will receive TC saline and half will receive EP saline.

    30 HIV infected male and female volunteers aged 18-45 years, who have been on ART for at least 6 months with 2 or more HIV plasma viral load measurements < 50 copies HIV RNA/ml prior to enrolment.

The investigational HIV-1 vaccine GTU®-MultiHIV B clade encodes for a MultiHIV antigen which is a synthetic fusion protein consisting of full-length polypeptides of Rev, Nef, Tat, p17 and p24 and containing more than 20 Th and CTL epitopes of protease, reverse transcriptase (RT) and gp160 regions of the HAN2 HIV-1 B clade.

Vaccine is provided in sealed vials at 2mg/ml, and a single 1ml IM injection of 2mg GTU®-MultiHIV DNA IM (into the thigh) is required to deliver a 2mg dose. Individuals in Group 2 will receive a further 0.4mg GTU®-MultiHIV DNA in 0.2ml administered by TC, a novel needle-free method of vaccine delivery.

調査の概要

詳細な説明

The investigators are exploring combination regimens with the overall aims of (i) optimising immune responses and (ii) developing safe and well tolerated strategies which will favour the development of T-cell responses that may enhance anti-HIV HIV therapy with the forward looking goal of working towards functional eradication of infection. The investigator proposes to combine the previously used IM and TC methods because preclinical data suggest that the combination of methods will favour the development of CD8 T cell responses. All groups will receive 6.0mg of the vaccine IM given in 3 doses over 12 weeks. Group 1 will receive the 6.0mg IM with electroporation (EP) and Group 2 will receive the 6.0mg IM without EP but together with an additional 1.2mg vaccine TC. The primary immunogenicity endpoint will be to determine whether either intervention group augments the cellular responses to vaccine specific peptides in relation to baseline. It is anticipated that none of subjects receiving saline placebo would have an increase in vaccine specific responses relative to those at baseline. Therefore if the differences between the active groups and saline placebo are sufficiently large, for example 80% responders in a GTU®-MultiHIV DNA active group, <10% in the control group, this would be significant.

Should the regimes prove safe, acceptable and induce significant immunogenicity then the intention is to move one or both regimes into a larger study powered to determine their potential long-term impact on therapy when used in combination with conventional ARV regimens. Proof of concept that DNA vaccination can induce de novo HIV specific responses that are associated with control of viral replication, would justify further investigation of their use in immunotherapies combined with ART intensification and/or anti-latency drugs.

研究の種類

介入

入学 (実際)

30

段階

  • フェーズ2
  • フェーズ 1

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

      • Greater London、イギリス、W2 1PG
        • Imperial College London

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~45年 (大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  1. Male or female
  2. Aged between 18 and 45 years on the day of screening
  3. BMI between 19-30
  4. Available for follow-up for the duration of the study
  5. Willing and able to give written informed consent
  6. HIV-1 Clade B infection documented by confirmed antibody test
  7. Confirmed on 2 separate occasions in the 6 month period prior to enrolment to have viral load < 200 copies HIV RNA/ml whilst on ART
  8. Nadir CD4+ > 250 CD4 lymphocytes AND screening CD4 >200 CD4 lymphocytes
  9. Willing to avoid UV tanning or strong sun exposure during the immunisation period of the study
  10. Willing to avoid all other vaccines within four weeks of scheduled study vaccinations
  11. If heterosexually active female, using an effective method of contraception with partner (combined oral contraceptive pill; injectable or implanted contraceptive; consistent record with condoms if using these; physiological or anatomical sterility (in self or partner) from 14 days prior to the first vaccination until 4 months after the last, and willing to undergo urine pregnancy tests prior to each vaccination
  12. If heterosexually active male, using an effective method of contraception with their partner from the first day of vaccination until 4 months after the last vaccination

Exclusion Criteria:

  1. Pregnant or lactating
  2. Use of regular topical treatment on the injection or application site within the last four weeks
  3. UV tanning sessions or strong sun exposure within four weeks prior to enrolment
  4. Excessive terminal hair growth on the investigational skin areas (to be assessed by reference to a photograph which will be available during screening visit)
  5. Individuals in which a skin-fold measurement (cutaneous and subcutaneous tissue) of the upper right or left thigh exceeds 40 mm
  6. Clinically relevant abnormality on history or examination including

    • history of grand-mal epilepsy, seizure disorder or any history of prior seizure
    • history of syncope or fainting episodes within 1 year of study entry
    • liver disease including active hepatitis B (surface antigen positive) or C (PCR positive)
    • any skin condition which may interfere with the trial assessment of the injection site
    • haematological, metabolic, gastrointestinal (excluding gastritis) or cardio-pulmonary disorders (excluding mild asthma)
    • a clinically significant abnormality on the ECG
    • autoimmune disease, or use of regular, systemic immunosuppressives in preceding 3 months
  7. Known hypersensitivity to any component of the vaccine formulations used in this trial, or have severe or multiple allergies to drugs or pharmaceutical agents
  8. History of severe local or general reaction to vaccination defined as

    1. local: extensive, indurated redness and swelling involving most of the antero-lateral thigh or the major circumference of the arm, not resolving within 72 hours
    2. general: fever >= 39.5oC within 48 hours; anaphylaxis; bronchospasm; laryngeal oedema; collapse; convulsions or encephalopathy within 72 hours
  9. Receipt of live attenuated vaccine within 60 days of enrolment and any vaccine within 30 days of enrolment.
  10. Receipt of an experimental vaccine containing HIV antigens at any time in the past
  11. Receipt of immunoglobin within 4 months of screening
  12. Participation in another trial of a medicinal product, completed less than 30 days prior to enrolment
  13. Grade 2 or above routine laboratory parameters. Hyperbilirubinaemia to be considered an exclusion criterion only when confirmed to be conjugated bilirubinaemia
  14. Current use of any electronic stimulation device, such as cardiac demand pacemakers, automatic implantable cardiac defibrillator, nerve stimulators, or deep brain stimulators.
  15. Presence of any surgical or traumatic metal implants at the sites of administration
  16. Unable to read and speak English to a fluency level adequate for the full comprehension of procedures required in participation and consent.
  17. Unlikely to comply with protocol.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:防止
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
プラセボコンパレーター:Group 1 (Transcutaneous and Placebo)
Group 1 (Transcutaneous and Placebo) Participants will receive 1.0ml intramuscular injections of the vaccine Sodium Chloride BP into the upper thigh. Participants will also have a further 0.2ml of Sodium Chloride BP delivered transcutaneously. An area of skin of approximately 4 x 4cm will be photographed and prepared first. During this preparation, the area is shaved to remove the hair, and then superglue is applied to remove the top layer of skin (like waxing). The vaccine is spread onto the skin surface. Once applied, the area is covered with a comfeel bandage, the investigator will ask volunteers to not engage in strenuous exercise, shower, or bathe for 24 hours afterwards.
For use in prophylactic and replacement therapy, requiring the use of isotonic saline solution.
アクティブコンパレータ:Group 2 (Transcutaneous and Active)
Group 2 (Transcutaneous and Active) Participants will receive 1.0ml intramuscular injections of the GTU®-MultiHIV B Clade Vaccine (2 mg/ml) into the upper thigh. Participants will also have a further 0.2ml of the vaccine (2mg/ml) delivered transcutaneously. An area of skin of approximately 4 x 4cm will be photographed and prepared first. During this preparation, the area is shaved to remove the hair, and then superglue is applied to remove the top layer of skin (like waxing). The vaccine is spread onto the skin surface. Once applied, the area is covered with a comfeel bandage, the investigator will ask volunteers to not engage in strenuous exercise, shower, or bathe for 24 hours afterwards.
The investigational HIV-1 vaccine GTU®-MultiHIV B clade encodes for a MultiHIV antigen (synthetic fusion protein) built up by full-length polypeptides of Rev, Nef, Tat, p17 and p24 with more than 20 Th and CTL epitopes of protease, reverse transcriptase (RT) and gp160 regions of an HAN2 HIV-1 B clade isolate.
プラセボコンパレーター:Group 3 (Electroporation and Placebo)
Group 3 (Electroporation and Placebo) Participants will receive 1.0ml intramuscular injections of Sodium Chloride BP into the upper thigh using the ICHOR TriGridTM delivery system for intramuscular (TDS-IM) delivery with electroporation. Electroporation (EP) improves the delivery of the product into muscle cells, by delivering an electrical pulse with the injection using a hand held device that is pressed against your thigh. This will cause a muscle twitch with a sharp cramp-like feeling in the thigh lasting a few seconds. Once the procedure is carried out, the muscle will feel sore for up to 72 hours. The investigator will ask volunteers not to engage in any strenuous exercise for at least 24 hours after the procedure.
For use in prophylactic and replacement therapy, requiring the use of isotonic saline solution.
アクティブコンパレータ:Group 4 (Electroporation and Active)
Group 4 (Electroporation and Active) Participants will receive 1.0ml intramuscular injections of the GTU®-MultiHIV B Clade Vaccine (2mg/ml) into the upper thigh using the ICHOR TriGridTM delivery system for intramuscular (TDS-IM) delivery with electroporation. Electroporation (EP) improves the delivery of the product into muscle cells, by delivering an electrical pulse with the injection using a hand held device that is pressed against your thigh. This will cause a muscle twitch with a sharp cramp-like feeling in the thigh lasting a few seconds. Once the procedure is carried out, the muscle will feel sore for up to 72 hours. The investigator will ask volunteers not to engage in any strenuous exercise for at least 24 hours after the procedure.
The investigational HIV-1 vaccine GTU®-MultiHIV B clade encodes for a MultiHIV antigen (synthetic fusion protein) built up by full-length polypeptides of Rev, Nef, Tat, p17 and p24 with more than 20 Th and CTL epitopes of protease, reverse transcriptase (RT) and gp160 regions of an HAN2 HIV-1 B clade isolate.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Grade 3 or above local solicited adverse event
時間枠:Two weeks after final vaccination
Two weeks after final vaccination
Grade 3 or above systemic clinical and laboratory solicited adverse event
時間枠:Four weeks after final vaccination
Four weeks after final vaccination
Any grade of adverse event that results in a clinical decision to discontinue further immunisations
時間枠:Four weeks after final vaccination
Four weeks after final vaccination
Immunogenicity
時間枠:Two weeks after final vaccination
Change in IFN-γ ELISpot response to any of the pools of HIV-peptides encoded by the vaccine 2 weeks after the last immunisation relative to baseline, defined as a doubling in frequency from baseline or the presence of a response that was absent at baseline
Two weeks after final vaccination

二次結果の測定

結果測定
メジャーの説明
時間枠
Any grade of adverse event that occurs in a participant that has received at least one immunisation
時間枠:Two weeks after final vaccination
Two weeks after final vaccination
Immunogenicity
時間枠:Two weeks after final vaccination
Change in CD4+ and CD8+ T-cell cytokine responses (frequency and poly-functionality) to any of the pools of HIV peptides encoded by the vaccine, assessed by poly-chromatic ICS 2 weeks after the last immunisation
Two weeks after final vaccination

その他の成果指標

結果測定
メジャーの説明
時間枠
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in epitope recognition (frequency and magnitude) as determined by ELISpot analysis using overlapping 15mer peptides
Four weeks after final vaccination
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in the magnitude of antigen-specific IgG Ab response
Four weeks after final vaccination
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in HIV proviral DNA within PBMC
Four weeks after final vaccination
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in HIV plasma viral load (number of copies of HIV RNA per millilitre), measured by quantitative PCR
Four weeks after final vaccination
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in the immune activation and surface expression markers on T cells from baseline measured by poly-chromatic flow cytometry
Four weeks after final vaccination
Exploratory Immunogenicity
時間枠:Four weeks after final vaccination
Change from baseline in CD4+ lymphocyte count
Four weeks after final vaccination

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:Sheena McCormack, Phd, MD、Medical Research Council University College London

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2015年7月1日

一次修了 (実際)

2016年7月1日

研究の完了 (実際)

2016年7月1日

試験登録日

最初に提出

2015年5月27日

QC基準を満たした最初の提出物

2015年5月28日

最初の投稿 (見積もり)

2015年5月29日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年11月10日

QC基準を満たした最後の更新が送信されました

2016年11月9日

最終確認日

2016年10月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 14SM2037

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

HIVの臨床試験

Sodium chloride BPの臨床試験

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