A Double-Blinded, Randomized Influenza Virus Challenge Trial of Recombinant Influenza RG-A/Arkansas/08/2020 (pH1N1) in Healthy Adults to Assess Safety and Optimal Infectious Dose

Status: Recruiting
Location: See all (2) locations...
Intervention Type: Biological, Other
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

This protocol describes a clinical trial to develop and validate a Controlled Human Infection Model (CHIM) for influenza A/Arkansas/08/2020 (pH1N1). The study is designed to determine the optimal infectious dose of the pH1N1 challenge strain for use in future clinical trials evaluating influenza countermeasures. The study will enroll and challenge adult volunteers with the pH1N1 influenza virus challenge or sham inoculations. Given the adaptive design of this trial, the potential number of participants can vary. Depending on the pathway recommended by the PSRT and followed in the Trial Schema, the study population can range from around 30 to 120. However, it is anticipated that the final sample size will be around 60 participants receiving pH1N1 challenge product plus approximately 4 persons receiving a sham inoculation. Participants will be pre-screened for health and for serological HAI antibody titers of \</1:40 against the challenge strain. Eligible participants will be enrolled sequentially into challenge cohorts and will be randomly assigned to receive a single dose of either sham inoculation or the interventional study product at a dose between 10\^6 to 10\^7 TCID50 (or 10\^5 TCID50 if needed). Dose titration will be conducted under an adaptive escalation schedule whereby dosing will start at 10\^6 TCID50 and escalate to the next dose if a pre-determined symptomatic influenza attack rate and clinical symptom score thresholds are not met and if the dose is determined to be safe with no pre-defined halting criteria being met. The primary objectives of this study are to determine the optimal infectious dose of a pH1N1 viral challenge to cause laboratory-confirmed clinical influenza and to assess the safety profile of pH1N1 viral challenge.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 55
Healthy Volunteers: t
View:

• Provides signed and dated informed consent form prior to the initiation of any trial procedures.

• Able to understand and agrees to comply with all planned trial procedures and to be available for all study visits.

• Age \>/= 18 and \</= 55 years at time of enrollment.

• Must agree to collection of venous blood and nasal absorption specimens per protocol and enrollment in DMID 19-0025 biorepository protocol for use of residual/repository research blood specimens.

• In good general health.\*

• \*Good health, as determined by medical history, medication use and physical examination to evaluate ongoing chronic medical or psychiatric diagnoses or conditions, defined as those that have been present for at least 90 days, which would not affect the assessment of the safety of participants or the immunogenicity of challenge. These medical diagnoses or conditions should be stable for the last 90 days -- no hospitalizations, emergency room or urgent care for condition (excluding musculoskeletal conditions). If a participant has an ongoing symptomatic condition for which they have had or have ongoing medical investigations but have not yet received a diagnosis or treatment plan, they may not be in good health, as determined by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572. Participants may be on a medical intervention (such as device or medication) only if the condition or disease being treated is stable and not deteriorating, the medications are not listed in the Exclusion Criteria and treatment poses no additional risk to participant safety or assessment of adverse events. This also includes no change in prescription medication, dose, or frequency as a result of new symptoms or deterioration of the condition or disease being treated in the 30 days prior to enrollment. Any prescription change that is due to change of health care provider, insurance company, etc., or that is done for financial reasons, as long as in the same class of medication, will not be considered a deviation of this inclusion criterion. Any change in prescription medication due to improvement of a condition or disease outcome (e.g., lowering of the dosage or frequency), as determined by the site Principal Investigator (PI) or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572, will not be considered a deviation of this inclusion criterion.

• Able to take oral medication and willing to receive oseltamivir phosphate and/or baloxavir marboxil as part of the study.

• Participants of childbearing potential\* agree to the use of acceptable forms of contraception\*\* for at least 30 days prior to enrollment and agree to use such a method during study participation.

• \*Childbearing potential in a participant is defined as not sterilized via tubal ligation, bilateral oophorectomy, salpingectomy, hysterectomy, or successful Essure(R) placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or \<1 year since last menses if menopausal.

• \*\*Acceptable forms of primary contraception include true abstinence (100% of time no insertional sexual intercourse), or, if heterosexual intercourse is anticipated, monogamous relationship with a vasectomized partner who has been vasectomized for 180 days or more prior to enrollment, intrauterine devices, birth control pills, condoms, and injectable/implantable/insertable/transdermal hormonal birth control products. Must use at least one acceptable form of contraception for at least 30 days prior to enrollment and through study completion.

• Non-smoker or non-habitual smoker\* of tobacco, e-cigarettes, or marijuana

• \*A non-habitual smoker is a person who smokes no more than four cigarettes, other tobacco products, e-cigarettes (to include vaping and Juul products), and/or marijuana in a week.

• No self-reported or known history of alcoholism within the 2 years prior to enrollment.

⁃ No self-reported or known history of illicit drug use for at least 30 days prior to enrollment.

⁃ Agrees not to use the listed prescription or over the counter medications\* within 7 days prior to confinement and through the confinement period\*\*.

⁃ \*Oseltamivir, zanamivir, peramivir, baloxavir marboxil, amantadine, rimantadine, aspirin, intranasal steroids, decongestants, antihistamines, and non-steroidal anti-inflammatory drugs (NSAIDs)

⁃ \*\*An exception can be made with the approval of the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572

⁃ Screening pulse is 55 to 100 beats per minute, inclusive\*

⁃ \*Screening pulse values in the normal range or with grade 1 abnormalities deemed not clinically significant by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572 are considered acceptable.

⁃ Screening systolic blood pressure is 90 to 140 mmHg, inclusive\*

⁃ \*Screening systolic blood pressure values in the normal range or with grade 1 abnormalities deemed not clinically significant by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572 are considered acceptable.

⁃ Screening diastolic blood pressure is 55 to 90 mmHg, inclusive\*

⁃ \*Screening diastolic blood pressure values in the normal range or with grade 1 abnormalities deemed not clinically significant by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572 are considered acceptable.

⁃ Screening SpO2 \>/= 95 percent

⁃ Screening respiratory rate is \</= 16

⁃ Screening oral temperature is \<100.4 degrees Fahrenheit

⁃ Screening body mass index (BMI) \>/=18.5 and \<40 kg/m\^2 at screening 19 Screening

⁃ Screening lab test results are within acceptable parameters:\*

∙ White blood cell (WBC), Absolute lymphocyte count (ALC), Hemoglobin (Hgb), Platelet (PLT), Alanine transferase (ALT), and Creatinine (Cr).

‣ Lab tests within normal range or with grade 1 abnormalities deemed not clinically significant by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572 are considered acceptable. Low creatinine and low ALT values are acceptable for trial inclusion as they are not considered to be clinically significant.

⁃ Has a negative test result for hepatitis B surface antigen, hepatitis C virus antibody\*, or HIV types 1 or 2 antibodies at screening.

⁃ \*Persons testing positive for hepatitis C virus antibody with a history of treatment and a negative HCV viral load may be acceptable in the opinion of the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572.

⁃ Electrocardiogram (ECG) and chest X-ray (CXR) at screening are within normal range or are not deemed clinically significant\*

⁃ \*As determined by the site PI or designated clinician licensed to make medical diagnoses and listed on Form FDA 1572.

⁃ Negative respiratory virus panel (including influenza A and B, and SARS-CoV-2) by certified polymerase chain reaction (PCR)-based assay on Day -2 and Day -1.

⁃ Agrees to remain in the confinement unit for at least 6 days after enrollment and until they meet discharge criteria.

⁃ Agrees to adhere to lifestyle considerations during the study. Note: Deviations of lifestyle considerations will be reported as protocol deviations but not as eligibility deviations.

Locations
United States
Maryland
University of Maryland, School of Medicine, Center for Vaccine Development and Global Health
RECRUITING
Baltimore
North Carolina
Duke Vaccine and Trials Unit
RECRUITING
Durham
Contact Information
Primary
Meagan Deming
mdeming@som.umaryland.edu
14107068333
Time Frame
Start Date: 2025-09-10
Estimated Completion Date: 2025-12-06
Participants
Target number of participants: 120
Treatments
Experimental: Cohort 1A
Subjects will randomly be administered a single intranasal virus (RG) -A/Arkansas/08/2020 (pH1N1) at a dose of 10\^6 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the Protocol Safety Review Team (PSRT) agrees that the dose is safe then Cohort 1B and Cohort 2A will begin. If proven unsafe the dose will be de-escalated to Cohort XA. N=20
Experimental: Cohort 1B
Subjects will randomly be administered a single intranasal virus (RG) -A/Arkansas/08/2020 (pH1N1) at a dose of 10\^6 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the PSRT agrees that the dose is safe then Cohort 1C and Cohort 2A will begin. If proven unsafe the dose will be de-escalated to Cohort XA. N=20
Experimental: Cohort 1C
Subjects will randomly be administered a single intranasal virus (RG) -A/Arkansas/08/2020 (pH1N1) at a dose of 10\^6 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the PSRT agrees that the dose is safe then Cohort 2A will begin. If proven unsafe the dose will be de-escalated to Cohort XA. N=20
Experimental: Cohort 2A
Subjects will randomly be administered a single intranasal virus (RG) -A/Arkansas/08/2020 (pH1N1) at a dose of 10\^7 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the PSRT agrees that the dose is safe then Cohort 2B will begin. N=20
Experimental: Cohort 2B
Subjects will randomly be administered a single intranasal virus, (RG) -A/Arkansas/08/2020 (pH1N1), at a dose of 10\^7 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the PSRT agrees that the dose is safe then Cohort 2C will begin. N=20
Experimental: Cohort 2C
Subjects will randomly be administered a single intranasal virus, (RG) -A/Arkansas/08/2020 (pH1N1), at a dose of 10\^7 TCID50. One of the subjects will receive a sham dose of 0 TCID50. N=20
Experimental: Cohort XA
Subjects will randomly be administered a single intranasal virus, (RG) -A/Arkansas/08/2020 (pH1N1), at a dose of 10\^5 TCID50. One of the subjects will receive a sham dose of 0 TCID50. De-escalation will occur after PSRT review of Cohort 1A, Cohort 1B, and Cohort 1C. If the PSRT agrees that the dose is safe then Cohort XB will begin. N=20
Experimental: Cohort XB
Subjects will randomly be administered a single intranasal virus, (RG) -A/Arkansas/08/2020 (pH1N1), at a dose of 10\^5 TCID50. One of the subjects will receive a sham dose of 0 TCID50. If the PSRT agrees that the dose is safe then Cohort XC will begin. N=20
Experimental: Cohort XC
Subjects will randomly be administered a single intranasal virus, (RG) -A/Arkansas/08/2020 (pH1N1), at a dose of 10\^5 TCID50. One of the subjects will receive a sham dose of 0 TCID50. N=20
Related Therapeutic Areas
Sponsors
Leads: National Institute of Allergy and Infectious Diseases (NIAID)

This content was sourced from clinicaltrials.gov