Pan African Clinical Trials Registry

South African Medical Research Council, South African Cochrane Centre
PO Box 19070, Tygerberg, 7505, South Africa
Telephone: +27 21 938 0506 / +27 21 938 0834 Fax: +27 21 938 0836
Email: pactradmin@mrc.ac.za Website: pactr.samrc.ac.za
Trial no.: PACTR202311679101744 Date of Registration: 01/11/2023
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title RV 591 RAPIDVAX
Official scientific title RV 591: A Phase I, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety, Tolerability, and Immunogenicity of an Ad26.Mos4.HIV and CH505 TF chTrimer (Env) Combination to Mimic Acute HIV Viral Replication Kinetics in Healthy Adults
Brief summary describing the background and objectives of the trial To date, several efficacy trials of candidate HIV vaccines have been completed, including VAX003 (Pitisuttithum, 2006), VAX004 (Flynn, 2005), RV144 (Rerks-Ngarm, 2009), STEP (Buchbinder, 2008), HVTN503 (Gray, 2011), HVTN505 (Hammer, 2013), and HVTN702 (Gray, 2021). Multiple early phase trials are active in Africa, though only a few are HIV vaccine efficacy trials, including HVTN503, HVTN702, and HVTN705/HPX2008. Of all listed trials, only RV144, a Phase III HIV vaccine prime/boost trial conducted in Thailand from 2003-2009, showed modest efficacy, with HIV Env antibody being the sole correlate for reduced risk of HIV acquisition (Haynes, 2012). Healthy participants in RV144 who received the 6-month vaccination regimen containing ALVAC-HIV and AIDSVAX® B/E, formulated in aluminum hydroxide, were 31% less likely than placebo recipients to become HIV infected over 3.5 years of follow-up. In post-hoc analysis, efficacy was 60% at 12 months, indicating that protective immunity waned rapidly (Robb, 2012). A subsequent trial, HVTN702, failed to show protection despite using a similar vaccine schedule and immunogens (Gray, 2021), but a different adjuvant. An acute HIV study, RV217, showed that viral replication peaks about 13 days after HIV acquisition with a median of 6.7 log10 HIV RNA copies/mL, suggesting the immune system is unable to produce antibodies at a rate that provides protection, even with bolus vaccine injections. Despite some progress, an effective HIV vaccine does not yet exist, nor has an optimal vaccination schedule been identified to maximize the magnitude and quality of the induced immune response. Objectives:Primary objective is to assess the safety, reactogenicity and tolerability of two vaccination regimens: rapid dose-escalation of CH505 TF chTrimer+ALFQ and Ad26.Mos4.HIV or co-administration of CH505 TF chTrimer+ALFQ and Ad26.Mos4.HIV. Secondary objective is to evaluate HIV-specific antibody responses induced by the two vaccination regimens
Type of trial RCT
Acronym (If the trial has an acronym then please provide) RV 591 RAPIDVAX
Disease(s) or condition(s) being studied Infections and Infestations
Sub-Disease(s) or condition(s) being studied HIV/AIDS
Purpose of the trial Prevention: Vaccines
Anticipated trial start date 19/12/2023
Actual trial start date
Anticipated date of last follow up 07/05/2025
Actual Last follow-up date
Anticipated target sample size (number of participants) 50
Actual target sample size (number of participants)
Recruitment status Not yet recruiting
Publication URL
Secondary Ids Issuing authority/Trial register
HS 2891ES Uganda National Council for Science and Technology
3024 Human Subject Protection Branch, Walter Reed Army Institute of Research
CTA 0254 Uganda National Drug Authority
SPH2022356 Makerere University School of Public Health REC
STUDY DESIGN
Intervention assignment Allocation to intervention If randomised, describe how the allocation sequence was generated Describe how the allocation sequence/code was concealed from the person allocating the participants to the intervention arms Masking If masking / blinding was used
Parallel: different groups receive different interventions at same time during study Randomised Simple randomization using a randomization table created by a computer software program Allocation was determined by the holder of the sequence who is situated off site Masking/blinding used Participants
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Experimental Group Coadministration Dose consistent injections (5x1010 vp/0.5 mL) of Ad26.Mos4.HIV in a 0.5 mL injection volume and dose consistent injections of CH505 TF chTrimer (300 µg)+ALFQ (200 µg MPLA/100 µg QS-21) in a 1.1 mL injection volume (20 participants) OR a 0.5 mL injection 3 injections Ad26.Mos4.HIV is a tetravalent vaccine composed of 4 recombinant, replication-incompetent Ad26 vectors encoding group-specific antigen (Gag) and polymerase (Pol) or envelope (Env) proteins of HIV-1. CH505 transmitted-founder (TF) chimeric (ch) Trimer is a stabilized chimeric SOSIP Env trimer protein with the N-terminal sequence of CH505 TF gp120 Env transplanted into the BG505 SOSIP sequence. ALFQ is a liposome adjuvant containing a synthetic monophosphoryl lipid A (MPLA) with the addition of QS 21. 20
Experimental Group Rapidvax A lower dose of Ad26.Mos4.HIV (2.5x1010 vp/0.25 mL) in a 0.25 mL injection volume and a lower dose of CH505 TF chTrimer (30 µg)+ALFQ (50 µg MPLA/25 µg QS-21) in a 0.5 mL injection volume on Study Day 1; followed by rapid, dose escalating injections of CH505 TF chTrimer (100 µg, 150 µg, and 300 µg)+ALFQ (50 µg MPLA/ 25 µg QS-21) on Study Days 4 (0.5 mL injection volume), 8 (0.5 mL injection volume), and 15 (0.9 mL injection volume); followed by dose consistent injections of Ad26.Mos4.HIV (5x1010 vp/0.5 mL) in a 0.5 mL injection volume and CH505 TF chTrimer (300 µg)+ALFQ (200 µg MPLA/100 µg QS 21) in a 1.1 mL injection volume on Study Days 57 and 169 (20 participants); 3 injections Ad26.Mos4.HIV is a tetravalent vaccine composed of 4 recombinant, replication-incompetent Ad26 vectors encoding group-specific antigen (Gag) and polymerase (Pol) or envelope (Env) proteins of HIV-1. CH505 transmitted-founder (TF) chimeric (ch) Trimer is a stabilized chimeric SOSIP Env trimer protein with the N-terminal sequence of CH505 TF gp120 Env transplanted into the BG505 SOSIP sequence. ALFQ is a liposome adjuvant containing a synthetic monophosphoryl lipid A (MPLA) with the addition of QS 21. 20
Control Group Placebo A 1.1 mL injection of Placebo on Study Days 1, 57, and 169 (5 participants) in the coadministration arm and 0.9 mL injections of Placebo on Study Days 4, 8, and 15, respectively; followed by a 0.5 mL injection and a 1.1 mL injection of Placebo on Study Days 57 and 169 (5 participants) for participants in the rapidvax arm 3 injections Placebo 10 Placebo
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
Volunteers must meet all of the following criteria to be eligible for participation: 1. Male or female, aged 18 to 50 years, inclusive, at the time of enrollment 2. Willing and able to read, sign, and date the informed consent form 3. Demonstrates an understanding of the study with a passing score (90% or greater) on the TOU by the third attempt, before study-related procedures are performed 4. Willing and able to comply with study requirements and be available to attend visits for the duration of study participation 5. Must have the means to be contacted by telephone for the duration of study participation 6. Willing to have photo or fingerprint taken for identification purposes 7. At low risk for HIV acquisition per investigator assessment 8. Agrees to refrain from donating blood or plasma outside of this study for at least the duration of study participation 9. Healthy based on the physician investigator’s clinical judgment after review of past medical history, medication use, vital signs, and an abbreviated physical examination Note: Good health is defined by the absence of any medical condition described in the exclusion criteria in a participant with a normal abbreviated physical exam and vital signs. If the participant has a pre existing chronic condition not listed in the exclusion criteria, the condition cannot meet any of the following criteria: a. first diagnosed within the 12 weeks prior to screening; or b. worsening in terms of clinical outcome in the 24 weeks prior to screening; or c. involves the need for medication that may pose a risk to the participant’s safety or impede assessment of adverse events or immunogenicity if they participate in the study. Note: Vital signs must be normal by Appendix A Adverse Event Grading Scales, local normal ranges, or determined to be a normal variant by the physician investigator. Note: An abbreviated physical exam differs from a complete exam in that it does not include a genitourinary and rectal exam. 10. Laboratory criteria within 45 days prior to enrollment: a. Hemoglobin ≥11.0 g/dL for females; ≥12.5 g/dL for males b. White blood cells (WBC) range: 3,500-9,000 cells/mm3 c. Platelets between 150,000 – 450,000 cells/µL d. Normal liver function: Alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤1.25x upper limit of normal e. Serum creatinine ≤1.25x upper limit of normal f. Urinalysis: blood and protein less than 1+ and negative glucose g. Negative HIV serology h. Negative hepatitis B surface antigen (HbsAg) i. Negative hepatitis C serology or negative hepatitis C RNA (viral load) if antibodies are detected Note: Each laboratory screening test that is out of acceptable range can be repeated one time during the screening window if there is a possible alternative explanation for the out of range value or if the out of range value is due to a temporary condition that resolves within the screening visit window. 11. Biological Male-Specific Criteria: a. Must agree to refrain from donating sperm from screening until at least 12 weeks after the last study injection b. Must agree to consistently use a method of contraception (see Section 5.4.1.2) from screening until at least 12 weeks after the last study injection 12. Biological Female-Specific Criteria: a. Not pregnant within 12 weeks prior to screening, not pregnant or breastfeeding at screening, and not planning to become pregnant or breastfeed at any time from screening until 12 weeks after the last study injection b. Must have a negative human chorionic gonadotropin (β-HCG) pregnancy test (urine) at screening and at timepoints throughout the study (see Table 2), if of childbearing potential (see Section 5.4.1.1) c. Must agree to consistently practice a highly effective method of contraception (see Section 5.4.1.4) at least 45 days prior to enrollment and for 12 weeks after the final injection, if of childbearing potential (see Section 5.4.1.1) Volunteers will be excluded if any of the following apply: 1. Body mass index (BMI) <18.0 kg/m2 and >35.1 kg/m2 2. Has a condition which affects immune function, including but not limited to: a. Known or suspected congenital or acquired immunodeficiency b. Diabetes mellitus type 1 or type 2 (including cases controlled with diet alone) Note: A history of isolated gestational diabetes is not an exclusion criterion. c. Thyroid disease d. Asplenia, defined as any condition resulting in the absence of a functional spleen e. Conditions and diagnoses defined as potential immune-mediated medical conditions (see Appendix C) 3. Has a history of other chronic or clinically significant diseases or medical conditions that in the opinion of the investigator would jeopardize the safety or rights of the participant Note: Includes but is not limited to sickle cell anemia, chronic hepatitis or cirrhosis, chronic urticaria, chronic cardiac disease, hypertension not controlled by medication, severe asthma, chronic pulmonary disease, renal failure, and lymphatic filariasis. 4. Has a history of malignancy other than squamous cell or basal cell skin cancer, unless there has been definitive surgical and/or medical treatment that is considered to have achieved a cure 5. Had major surgery (per the physician investigator’s judgment) within the 28 days prior to screening or has plans to have major surgery during the study 6. Has a personal or family history of a bleeding disorder, such as factor deficiency, coagulopathy, or platelet disorder requiring special precautions 7. Has a personal or family history of a blood clotting disorder, such as thrombosis with thrombocytopenia syndrome (TTS), heparin-induced thrombocytopenia and thrombosis (HITT), deep vein thrombosis, pulmonary embolism, acute myocardial infarction, and stroke 8. Has a condition known to increase risk of blood clotting, including but not limited to autoimmune disease, connective tissue and other inflammatory conditions, immobility, recent infection, and recent head trauma including cerebrovascular accidents (stroke) 9. Hepatitis B surface antigen positive at any time in the past 10. Untreated syphilis infection as confirmed by RPR or a similar quantitative nontreponemal test such as VDRL 11. Prior receipt or plans to receive any of the following: a. Chronic use of therapies that may modify immune response, such as high dose inhaled and sprayed corticosteroids (>440 µg/twice daily doses of inhaled fluticasone equivalent) and systemic corticosteroids (>20 mg/day doses of prednisone equivalent for periods exceeding 10 days) within 14 days prior to enrollment or at any time during participation in this study Note: The following exceptions are permitted and will not exclude study participation: use of stable low/medium doses (<440 µg/twice daily doses of inhaled fluticasone equivalent) of inhaled and sprayed corticosteroids, topical corticosteroids for an acute uncomplicated dermatitis; or a short course (duration of 10 days or less, or a single injection) of corticosteroid for a non-chronic condition (based on the physician investigator’s clinical judgment) at least 14 days prior to enrollment in this study. Includes other medications, which, in the opinion of the physician investigator(s), will impact the participant’s immune response. b. Blood products within 120 days prior to enrollment or at any time during participation in this study c. Immunoglobulins within 90 days prior to enrollment or at any time during participation in this study d. Therapy for active tuberculosis within 90 days prior to enrollment, unless the therapy is considered to have achieved a cure, or at any time during participation in this study e. Licensed or authorized vaccine from 30 days prior to enrollment until 42 days (6 weeks) after the last study injection Note: Participants may receive inactivated seasonal influenza vaccine or COVID-19 vaccine during their participation in this study but not within 14 days prior or 6 weeks after each study injection f. Any investigational study products for conditions other than HIV within 90 days prior to enrollment or at any time during participation in this study g. An investigational HIV vaccine or HIV antibody at any time prior to or during participation in this study h. Medications that increase the risk of bleeding (warfarin, clopidogrel, ticagrelor, dabigatran, rivaroxaban, apixaban, heparin and other heparinoids) or blood clots (heparin in participants who have a prior history of heparin-induced coagulopathy) within 30 days prior to enrollment or at any time during participation in this study 12. Has a known allergy or history of anaphylaxis or other serious reaction to a vaccine, vaccine component, or latex 13. Current or planned participation in another study requiring blood draws or exposure to investigational or non-investigational vaccine/product (pharmaceutical or device) throughout the study period 14. Has tattoos, scars, or other marks that would, in the opinion of the physician investigator, interfere with the assessment of the injection sites 15. Current or history of substance abuse within 12 months prior to enrollment that, in the physician investigator’s opinion, could interfere with reliable participation 16. In the physician investigator’s opinion, is unable to communicate reliably, is unlikely to adhere to study requirements, or has a condition that would limit completion of the study 17. Any other chronic or clinically significant medical condition that in the opinion of investigator would jeopardize the safety or rights of the participant or potentially impairs immune response or threatens conduct of the study according to protocol 18. Study site employee Adult: 19 Year-44 Year 18 Year(s) 50 Year(s) Both
ETHICS APPROVAL
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 26/05/2023 Makerere University School of Public Health Research Ethics Committee
Ethics Committee Address
Street address City Postal code Country
Upper Mulago Hill Road Kampala 7072 Uganda
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome 1. Occurrence and severity of solicited local and systemic adverse events (AEs) following candidate vaccine administration 2. Occurrence, severity, and relationship to vaccination of unsolicited adverse events after candidate vaccine administration 3. Occurrence of serious adverse events (SAEs) following candidate vaccine administration 4. Occurrence of adverse events of special interest (AESIs) following candidate vaccine administration Outcome 1: up to seven days after vaccination, Outcome 2, 3 and 4: From Enrolment to Month 12
Secondary Outcome 1. Quantify IgG binding antibodies to HIV Env in terms of magnitude, breadth, and durability between Arms 2. Quantify neutralizing antibodies to HIV Env in terms of magnitude, breadth, and durability between Arms At Final Analysis
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
Makerere University Walter Reed Project Plot 42 Nakasero Road Kampala 16524 Uganda
FUNDING SOURCES
Name of source Street address City Postal code Country
Division of AIDS N/A Maryland n/a United States of America
National Institute of Allergy and Infectious Diseases n/a Maryland United States of America
US National Institute of Health NA Maryland United States of America
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor The Surgeon General Falls church Virginia n/a United States of America Other Collaborative Groups
COLLABORATORS
Name Street address City Postal code Country
Daniel J. Stieh Archimedesweg Leiden 4-6, 2333 Netherlands
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator Grace Mirembe gmirembe@muwrp.org 0753173740 Plot 42, Nakasero Road
City Postal code Country Position/Affiliation
Kampala 16524 Uganda Research Manager
Role Name Email Phone Street address
Scientific Enquiries Job Kasule jkasule@muwrp.org 0312330400 Plot 42, Nakasero Road
City Postal code Country Position/Affiliation
Kampala 16524 Uganda Medical Officer
Role Name Email Phone Street address
Public Enquiries Hilda Mutebe hmutebe@muwrp.org 0312330400 Plot 42 Nakasero Road
City Postal code Country Position/Affiliation
Kampala 16524 Uganda CQI and Compliance Coordinator
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes Research and clinical information relating to you will be shared with other investigators and the scientific community through presentation or publication; however, you will not be identified by name or other personal information that could be used to identify you. Informed Consent Form 12 months Authorized representatives of the following groups, all of whom are bound by rules of confidentiality not to reveal your identity to others, may need to review your research and/or medical records as part of their responsibilities to protect research participants: • Walter Reed Army Institute of Research Human Subjects Protection Branch • The Department of Defense • Makerere University School of Public Health Institutional Review Board • Uganda National Council for Science and Technology • Uganda National Drug Authority (NDA) • Uganda Ministry of Health • U.S. Food and Drug Administration (FDA) • U.S. Army Medical Research and Development Command (USAMRDC) • U.S. National Institutes of Health (study funder and owner of CH505 TF chTrimer experimental vaccine) • Janssen Vaccines & Prevention (owner of Ad26.Mos4.HIV experimental vaccine) other Key Access Criteria will be as per the RV 591 Data Sharing Agreement
URL Results Available Results Summary Result Posting Date First Journal Publication Date
No
Result Upload 1: Result Upload 2: Result Upload 3: Result Upload 4: Result Upload 5:
Result URL Hyperlinks Link To Protocol
Result URL Hyperlinks
Changes to trial information