E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
In a minority of the population (5-10%) standard vaccines against Hepatitis-B do not induce protective immunity, even after prolonged and repeated vaccination courses. Non- responsiveness to hepatitis-B vaccination poses a severe problem for people with high risk of infection (e.g. medical and laboratory staff, surgeons). Several approaches have been proposed to overcome non- responsiveness, however these work only to a minimal extent leaving too many people unprotected. |
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E.1.1.1 | Medical condition in easily understood language |
There are vaccines against hepatitis-B virus (HBV) that work well in most people. In a minority of the population 'non-responders' (5-10%), these vaccines fail to produce protection against HBV. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Virus Diseases [C02] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary study parameter is the determination the immunogenicity of the HBAI vaccine and how it compares with the standard HBVaxPro-10µg. The immunogenicity will be measured as the antibody titer specific for Hepatitis B which will be collected by the COBAS® system (Roche). The immunogenicity of the different vaccines will be assessed primarily as the percentage of individuals that become seroprotected with an anti HBsAg antibody titer equal or higher than 10mIU/ml. Other measurements of immunogenicity will the the Geometric Mean Titre and frozen PBMC will be used to investigate cellular immunogenicity of the different vaccines. In particular: epitope specificity, differentiation, maturation, and functionality of CD4+ T cells specific for HBsAg. |
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E.2.2 | Secondary objectives of the trial |
The secondary objective is to evaluate the safety and tolerability of the CyTuVax Hepatitis B vaccine in non-responders: assessment of the local and systemic adverse reactions. The time frame for the determination of the vaccine safety is within the first 30 days after first, second, and 45 days after the third vaccination. The whole duration of the study protocol, which include the 3 vaccinations with the IMP and the 6 weeks after, are consider the safety assessment period. Adverse effects will be recorded as described on section 8.1.1 of the present document.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
In good health as determined by the outcome of medical history, physical examination screening/baseline labs and clinical judgment of the clinical investigator Age 18 to 59 years, inclusive at the time of enrollment Willing and able to adhere to the study regimen Having a signed informed consent form Documented non-responders: Subjects with documented one or more cycles of Hepatitis B vaccination (total of 3 or more vaccinations) and titer analysis that show that they have not developed the Hepatitis B antibody titer recommended after standard vaccination: anti-HBsAg antibody titer superior to 10mIU/ml
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E.4 | Principal exclusion criteria |
Any infectious disease at the time of screening and/or enrollment Positive HIV, Hepatitis B virus or Hepatitis C virus serology Known or suspected immune deficiency Known or suspected disease that influences the immune system including chronic allergies that require frequent anti-allergy medication, cancer and transplantation recipients Known or suspected allergy to any of the vaccine components: see IB, IMPD Dialysis patient History of unusual or severe reactions to any previous vaccination History of any neurologic disorder, including epilepsy and autism Use of medication that influences the immune system (immune suppressive treatment or daily use of corticosteroids) Any vaccination within 3 months before screening Blood donation within 1 month before screening Administration of plasma (incl. immunoglobulins) or blood products within 12 months before screening Participation in another clinical trial within 3 months before screening Abnormal pre-treatment laboratory parameters which are clinically relevant according to the investigator Bleeding disorders, or use of medication for bleeding disorders, and use of anti-coagulants Female subjects planning to become pregnant or breastfeeding babies until visit 4 Females: positive urine pregnancy test at screening date Excessive alcohol or controlled drug use - More than 2 alcohol measures per day (one alcohol measure is a beer (250ml) or one glass of wine (125ml) or one strong measure (35ml) or one port/sherry (75ml)). Regular use of controlled drugs Any Hepatitis B vaccination in the last 6 months
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary study endpoint is the immunogenicity of the adjuvanted vaccine. The immunogenicity of the vaccine is assessed as the percentage of subjects that have an anti HBsAg antibody titer higher or equal to 10mIU/ml 6 weeks after the 3rd vaccination. The antibody titers specific for Hepatitis B will be measured using an immunochemistry COBAS assay. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
102 days after the beginning of the study. 42 days after the last vaccination |
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E.5.2 | Secondary end point(s) |
The secondary endpoints for safety are the number and intensity of local and systemic adverse reactions and the determination of the dose. To determine the safety of the adjuvanted vaccine, subjects will be observed during the first 30 minutes after vaccination in order to record the occurrence of acute reactions. A diary will be given to each subject for reporting of adverse events on the day of vaccination and during the next 4 days after the day of vaccination for a total of 5 days. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
102 days after the beginning of the study. 42 days after the last vaccination |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 3 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Last visit of the last subject undergoing the clinical trial. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |