- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT06325657
Um estudo para aprender sobre a vacina RSVpreF em participantes grávidas com HIV e seus bebês (MORISOT)
Um ensaio de fase 3, randomizado, duplo-cego e controlado por placebo para avaliar a segurança, tolerabilidade e imunogenicidade da vacina de subunidade F de pré-fusão do vírus sincicial respiratório (RSV) em participantes grávidas que vivem com HIV e seus bebês
O objetivo do estudo é aprender sobre a segurança e atividade imunológica da vacina RSVpreF. Será estudado em bebês nascidos de mães que vivem com HIV. Essas crianças podem ter maiores chances de adoecer ou morrer devido à infecção pelo VSR. O vírus sincicial respiratório (RSV) é um tipo comum de vírus (germe) que pode causar doenças graves (doenças das vias aéreas), onde é necessária ajuda médica. As vacinas ajudam seu corpo a produzir anticorpos que ajudam a combater doenças. Os anticorpos são substâncias que seu corpo usa para combater uma infecção. Os anticorpos podem ser transmitidos ao bebê através da placenta da mãe.
O estudo analisará a segurança, tolerabilidade e atividade imunológica em mães e seus bebês.
Este estudo está buscando mulheres grávidas que são:
- Menor ou igual a 49 anos e ter HIV (Vírus da Imunodeficiência Humana -
- Recebendo cuidados médicos padrão durante a gravidez
- Não ter sífilis (doença bacteriana sexualmente transmissível), vírus da hepatite B ((HBV) infecção hepática), tuberculose ((TB) infecção pulmonar bacteriana).
- Estar em tratamento estável (antirretroviral) para HIV há mais ou igual a 90 dias.
- concordar em estar presente em todas as visitas do estudo, procedimentos e coletas de sangue.
Os participantes receberão:
- Vacina RSVpreF
- Um placebo. Um placebo não contém nenhum medicamento, mas se parece com a vacina do estudo.
As participantes grávidas estarão envolvidas no estudo a partir de:
- consentimento durante a gravidez atual, e
- durante 6 meses após o parto do bebé (cerca de 10 meses no total). As participantes grávidas terão pelo menos 5 visitas planejadas neste estudo. Participantes infantis: Todos os bebês elegíveis nascidos de mães inscritas serão acompanhados desde o nascimento por até 6 meses. Os participantes infantis terão pelo menos 3 visitas de estudo, com algumas visitas ao local permitidas por meio de visitas domiciliares ou por telefone.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 3
Contactos e Locais
Locais de estudo
-
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Eastern Cape
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East London, Eastern Cape, África do Sul, 5241
- Synergy Biomed Research Institute
-
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Free State
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Bloemfontein, Free State, África do Sul, 9301
- Josha Research
-
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Gauteng
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Benoni, Gauteng, África do Sul, 1500
- Worthwhile Clinical Trials
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Boksburg, Gauteng, África do Sul, 1459
- REIMED Reiger Park
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Johannesburg, Gauteng, África do Sul, 2001
- Wits RHI
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Johannesburg, Gauteng, África do Sul, 2013
- University of Witwatersrand (WITS) - Vaccines and Infectious Diseases Analytics (VIDA)
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Johannesburg, Gauteng, África do Sul, 2093
- Wits VIDA Nkanyezi Research Unit
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Pretoria, Gauteng, África do Sul, 0184
- Botho ke Bontle Health Services
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Pretoria, Gauteng, África do Sul, 0152
- Setshaba Research Centre
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KwaZulu-Natal
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Ladysmith, KwaZulu-Natal, África do Sul, 3370
- Qhakaza Mbokodo Research Clinic
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Limpopo
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Polokwane, Limpopo, África do Sul, 0699
- Gole Biomed Research Centre
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Western Cape
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Cape Town, Western Cape, África do Sul, 7700
- MRC Unit on Child And Adolescent Health
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Cape Town, Western Cape, África do Sul, 7750
- Gugulethu Green Clinic
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Worcester, Western Cape, África do Sul, 6850
- FAMCRU - Worcester
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Filho
- Adulto
Aceita Voluntários Saudáveis
Descrição
Critérios Chave de Inclusão - Participantes Maternas
- Mulheres ≤49 anos de idade com idade entre 24 0/7 e 36 0/7 semanas de gestação no dia da vacinação planejada, com gravidez única não complicada e sem risco aumentado conhecido de complicações.
- Doença por HIV estável confirmada.
- Uso atual e estável de terapia antirretroviral (TARV) por pelo menos 90 dias antes da inscrição.
- Teve um exame de ultrassom de anomalia fetal realizado em ≥18 semanas de gravidez sem anormalidades fetais significativas observadas.
- Intenção de parto em um hospital ou centro de parto onde os procedimentos do estudo possam ser obtidos.
- O participante está disposto a dar consentimento informado para que o bebê do participante participe do estudo.
- Capaz de dar consentimento informado assinado, que inclui o cumprimento dos requisitos e restrições listados no documento de consentimento informado (CID) e neste protocolo.
Critérios Chave de Inclusão - Participantes Infantis
- Comprovante de CID assinado e datado, assinado pelos pais/responsáveis legais.
- Os pais/responsáveis legais desejam e são capazes de cumprir as visitas agendadas, o plano de investigação, os testes laboratoriais e outros procedimentos do estudo
Critérios Chave de Exclusão - Participantes Maternas
- Índice de massa corporal (IMC) pré-gravidez >40 kg/m2. Se o IMC pré-gestacional não estiver disponível, o IMC no momento da primeira consulta obstétrica durante a gravidez atual pode ser utilizado.
- Participante com infecções oportunistas ou malignidade.
- História de hepatite viral crônica ativa com evidência bioquímica de valores de aspartato aminotransferase (AST) ou alanina aminotransferase (ALT)> 5 vezes o limite superior do normal dentro de 6 meses antes da inscrição.
- História de reação adversa grave associada a uma vacina e/ou reação alérgica grave (por exemplo, anafilaxia) a qualquer componente da intervenção do estudo ou qualquer vacina relacionada.
- Gravidez atual resultante de fertilização in vitro. Participantes conhecidos por terem usado citrato de clomifeno e/ou letrozol com ou sem inseminação intrauterina (IUI) são permitidos.
- Complicações ou anormalidades atuais na gravidez no momento do consentimento que aumentarão o risco associado à participação e conclusão do estudo, incluindo, mas não se limitando ao seguinte:
- Pré-eclâmpsia, eclâmpsia ou hipertensão gestacional não controlada.
- Anormalidade placentária.
- Polidrâmnio ou oligodrâmnio.
- Sangramento significativo ou distúrbio de coagulação sanguínea.
- Distúrbios endócrinos, incluindo hipertireoidismo não tratado ou hipotireoidismo não tratado. Isto também inclui distúrbios de intolerância à glicose (por exemplo, diabetes mellitus tipo 1 ou 2) anteriores à gravidez ou que ocorrem durante a gravidez se não forem controlados no momento do consentimento.
- Quaisquer sinais de trabalho de parto prematuro com a gravidez atual ou intervenção contínua (médica/cirúrgica) na gravidez atual para prevenir o parto prematuro.
- Complicações ou anormalidades anteriores na gravidez no momento do consentimento, com base no julgamento do investigador, que aumentarão o risco associado à participação e conclusão do estudo, incluindo, mas não se limitando ao seguinte:
- Parto prematuro anterior com ≤34 semanas de gestação
- Natimorto anterior ou morte neonatal
- Bebê anterior com doença genética conhecida ou anomalia congênita significativa
- Distúrbio de imunodeficiência congênita ou adquirida não associada ao HIV, ou distúrbio reumatológico ou outra doença que requer tratamento crônico com medicamentos imunossupressores conhecidos.
- Tratamento antituberculose usado atualmente ou em qualquer momento durante a gravidez atual.
Critérios Chave de Exclusão - Participantes Infantis
• Bebê que é descendente direto (por exemplo, filho ou neto) da equipe do centro investigador ou dos funcionários do patrocinador e delegado do patrocinador diretamente envolvidos na condução do estudo.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Prevenção
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Quadruplicar
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador de Placebo: Placebo
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Placebo
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Experimental: Vacina RSVpreF
Vacina contra VSR (RSVpreF)
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Vacina RSVpreF
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Percentage of Maternal Participants With Prespecified Local Reactions Within 7 Days After Vaccination
Prazo: From Day 1 to Day 7 after vaccination
|
Local reactions included redness, swelling, and pain at injection site and were recorded in electronic diary (e-diary).
Redness and swelling were measured by the maternal participant and recorded in measuring device units (mdu) in the e-diary (range: 1 to 21). 1 mdu = 0.5 centimetre (cm).
Redness and swelling were graded as mild (>2.0 to 5.0 cm), moderate (>5.0 to 10.0 cm), severe (>10.0 cm) and grade 4 (necrosis or exfoliative dermatitis for redness and necrosis for swelling).
Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), severe (prevented daily activity) and grade 4 (emergency room visit or hospitalization for severe pain at the injection site).
Grade 4 reactions were classified by the investigator or medically qualified designee.
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From Day 1 to Day 7 after vaccination
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Percentage of Maternal Participants With Prespecified Systemic Events Within 7 Days After Vaccination
Prazo: From Day 1 to Day 7 after vaccination
|
Systemic events included fever, fatigue, headache, nausea, muscle pain, joint pain, vomiting and diarrhea and were recorded by participants in the e-diary.
Fever was defined as an oral temperature greater than or equal to (>=) 38.0 degree Celsius (C) and classified as mild (38.0 to 38.4 degree C), moderate (38.5 to 38.9 degree C), severe (39.0 to 40.0 degree C) and grade 4 (>40.0
degree C).
Headache, nausea, fatigue, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity), severe (prevented daily activity).
Vomiting: mild (1-2 times in 24 hours [H]), moderate (>2 times in 24 H), severe (required intravenous [IV] hydration).
Diarrhea: mild (2-3 loose stools in 24 H), moderate (4-5 loose stools in 24 H), severe (>=6 loose stools in 24 H).
For all systemic events except fever, Grade 4= emergency room visit or hospitalization.
Grade 4 events were classified by investigator or medically qualified designee.
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From Day 1 to Day 7 after vaccination
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Percentage of Maternal Participants With Adverse Events (AEs) From the Time of Vaccination Through 1 Month After Vaccination
Prazo: From vaccination on Day 1 up to 1 month after vaccination
|
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
Only AEs collected by non-systematic assessment (i.e.
excluding local reactions and systemic events) were included in this outcome measure.
|
From vaccination on Day 1 up to 1 month after vaccination
|
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Percentage of Maternal Participants With Adverse Event of Special Interest (AESIs)
Prazo: From vaccination on Day 1 up to 6 months after delivery (up to maximum of 10 months)
|
AESIs are a subset of targeted medical events based on review of known pharmacology, toxicology findings, possible class effects, published literature, and signals arising from safety data assessments, and on population under study.
AESIs were based on targeted medical events associated with pregnant maternal participants prior to/during delivery and post delivery.
For maternal participants, the following were considered as protocol defined AESIs: diagnosis of Guillain-Barré syndrome; diagnosis of acute polyneuropathy without an underlying etiology; hypertensive disorders of pregnancy; preterm delivery (delivery at <37 0/7 weeks' gestation) and atrial fibrillation.
AESIs was to be recorded as an AE or serious adverse event (SAE) on the case report form (CRF).
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From vaccination on Day 1 up to 6 months after delivery (up to maximum of 10 months)
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Percentage of Maternal Participants With SAEs From Vaccination Throughout the Study
Prazo: From vaccination on Day 1 up to 6 months after delivery (up to maximum of 10 months)
|
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event.
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From vaccination on Day 1 up to 6 months after delivery (up to maximum of 10 months)
|
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Percentage of Infant Participants With AESIs From Birth Through 6 Months of Age
Prazo: From birth up to 6 months of age
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AESIs are a subset of targeted medical events based on review of known pharmacology, toxicology findings, possible class effects, published literature, and signals arising from safety data assessments, and on population under study.
AESIs were based on targeted medical events associated with infants at birth.
For infant participants the following were considered as protocol defined AESIs: preterm birth (born at <37 0/7 week's gestation); birth weight 1001-2500 grams (g); developmental delay.
Extremely preterm birth (born at <28 0/7 week's gestation) and extremely low birth weight (less than or equal to [<=] 1000 g) were reported as serious AESIs.
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From birth up to 6 months of age
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Number of Infant Participants With Reported Neonatal Deaths From Birth Through 1 Months of Age
Prazo: Within 1 Month after birth
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Neonatal death was defined as the death of a live-born infant that occurred within a month after birth.
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Within 1 Month after birth
|
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Number of Infant Participants With Congenital Malformations/Anomalies at Birth
Prazo: At birth
|
Congenital malformations/anomalies were defined as structural or functional anomalies that occurred during intrauterine life and could be identified prenatally, at birth or later in life.
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At birth
|
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Number of Infant Participants With Other Neonatal Problems at Birth
Prazo: At birth
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Other neonatal problem included dysmaturity, neonatal illness, hospitalization, and drug therapies.
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At birth
|
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Number of Infant Participants According to Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) Score at 1 Minute After Birth
Prazo: 1 minute after birth
|
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health.
APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing).
Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health.
A score of 7 to 10 was good, 4 to <7 was moderate, and <4 was poor.
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1 minute after birth
|
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Number of Infant Participants According to APGAR Score at 5 Minutes After Birth
Prazo: 5 minutes after birth
|
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health.
APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing).
Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health.
A score of 7 to 10 was good, 4 to <7 was moderate, and <4 was poor.
|
5 minutes after birth
|
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Number of Infant Participants According to APGAR Score at 10 Minutes After Birth
Prazo: 10 minutes after birth
|
APGAR was a fast evaluation technique used to evaluate a newborn baby's overall health.
APGAR stands for (A) Appearance (skin coloration), (P) Pulse (heart rate), (G) Grimace (reflex response), (A) Activity (muscle tone) and (R) Respiration (breathing).
Each component was given a score of 0, 1, or 2; after summing up scores for each component a total possible score was of 0 (worst condition) to 10 (best condition), where higher scores indicate better health.
A score of 7 to 10 was good, 4 to <7 was moderate, and <4 was poor.
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10 minutes after birth
|
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Number of Infant Participants According to Gestational Age (GA) at Birth
Prazo: At birth
|
GA at birth was collected as:>=24 to <28 weeks, >=28 to <34 weeks, >=34 to <37 weeks, >=37 to <42 weeks, and >=42 weeks.
|
At birth
|
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Number of Infant Participants Requiring Hospitalization at Birth
Prazo: From birth until discharge from hospitalization (up to a maximum of 72 hours)
|
Length of hospitalization at birth refers to the amount of time the infant remains admitted to the healthcare facility immediately following delivery and if that length of time is greater than or less than 72 hours.
Postnatal standard of care procedures in South Africa were as follows: healthy newborns and their mothers were typically discharged within 24 hours after an uncomplicated vaginal delivery, or within 72 hours following an uncomplicated Caesarean section.
These practices were supported by the Guidelines for Maternity Care in South Africa.
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From birth until discharge from hospitalization (up to a maximum of 72 hours)
|
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Percentage of Infant Participants With AEs From Birth to 1 Month of Age
Prazo: From birth to 1 month of age
|
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
|
From birth to 1 month of age
|
|
Percentage of Infant Participants With SAEs From Birth Through 6 Months of Age
Prazo: From birth to 6 months of age
|
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.
An SAE was any untoward medical occurrence that at any dose: resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect or that was considered an important medical event.
|
From birth to 6 months of age
|
|
Percentage of Infant Participants With Newly Diagnosed Chronic Medical Conditions (NDCMCs) From Birth Through 6 Months of Age
Prazo: From birth to 6 months of age
|
An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or otherwise long-lasting in its effects.
NDCMCs were reported as both AEs and SAEs.
|
From birth to 6 months of age
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Geometric Mean Titer (GMT) of Neutralizing Titer (NTs) for Respiratory Syncytial Virus Subgroup A (RSV A) and Respiratory Syncytial Virus Subgroup B (RSV B) Before Vaccination and at Delivery: Maternal Participants
Prazo: Before vaccination on Day 1 and at delivery
|
GMTs and the corresponding 2-sided 95% confidence intervals (CIs) were calculated by exponentiating the mean logarithm of the neutralizing titers and the corresponding CIs based on the Student t distribution.
|
Before vaccination on Day 1 and at delivery
|
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Geometric Mean Fold Rise (GMFR) of NTs for RSV A and RSV B From Before Vaccination to Delivery: Maternal Participants
Prazo: Before vaccination on Day 1 to delivery
|
GMFRs and the corresponding 2-sided 95% CIs were calculated by exponentiating the mean logarithm of the fold rises and the corresponding CIs based on the Student t distribution.
The GMFR for each vaccine group was defined as the geometric mean of the fold rises in the assay results from the specified time points.
|
Before vaccination on Day 1 to delivery
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Diretor de estudo: Pfizer CT.gov Call Center, Pfizer
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- C3671032
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Descrição do plano IPD
Informações sobre medicamentos e dispositivos, documentos de estudo
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