Clinical Trials

MainTitle

An HIV Vaccine Trial in Individuals Who Started ART During Primary or Chronic Infection (EHVAT01)

This study is not yet open for participant recruitment. (see Contacts and Locations)

Verified April 2018 by French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)

Sponsor
French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)

Collaborator
European Commission
Swiss Government
Medical Research Council
FIT Biotech Ltd.
Fred Hutchinson Cancer Research Center
University College, London
Centre Hospitalier Universitaire Vaudois
Imperial College London
Istituto Nazionale Malattie Infettive Lazaro Spallanzani
Universitätsklinikum Hamburg-Eppendorf
Institut d'Investigacions Biomèdiques August Pi i Sunyer
Henri Mondor University Hospital
European Georges Pompidou Hospital
Saint-Louis Hospital, Paris, France

Information provided by (Responsible Party)
French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)
ClinicalTrials.gov Identifier
NCT02972450

First received: November 10, 2016
Last updated: April 26, 2018
Last Verified: April 2018
History of Changes
Purpose

Purpose

EVHA T01 is an international, phase I/II, multicentre, multi-stage, double-blind study that will evaluate at least three experimental arms compared to placebo control in HIV-1 infected participants to see if one or more has a clinically relevant impact on the control of viral replication.

Condition Intervention Phase
HIV-1-infection

Biological : GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine
Biological : GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine+ Vedolizumab
Drug : Vedolizumab 300 MG [Entyvio]
Other : Placebo
Phase 1
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase I/II Randomised Therapeutic HIV Vaccine Trial in Individuals Who Started Antiretrovirals During Primary or Chronic Infection

Further study details as provided by French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS):

Primary Outcome Measures

  • Efficacy: Time from treatment interruption to the earliest of reaching HIV RNA ≥ 10,000 copies/ml or resuming antiretroviral therapy for any reason over a period of 24 weeks. [ Time Frame: Time from treatment interruption (scheduled for 12 weeks after completing the immunisation schedule) to the earliest of reaching HIV RNA ≥ 10,000 copies/ml or resuming antiretroviral therapy for any reason over a period of 24 weeks. ]
  • Safety: A clinical decision to discontinue the regimen for an adverse event that is considered related to product [ Time Frame: From randomisation ]
Secondary Outcome Measures:
  • Grade 3 and worse solicited clinical and laboratory adverse events [ Time Frame: From randomisation to study completion, about 60 weeks. ]
  • Any event leading to interruption in the vaccine schedule [ Time Frame: From randomisation to study completion, about 60 weeks. ]
  • Any event that results in resuming treatment during the ATI [ Time Frame: From randomisation to study completion, about 60 weeks. ]
  • Serious Adverse Events [ Time Frame: From randomisation to 30 days after the last protocol visit ]
  • Other clinical and laboratory adverse events [ Time Frame: From randomisation to study completion, about 60 weeks. ]
  • Time to VL suppression after restarting ART [ Time Frame: From randomisation to VL suppression after restarting ART ]
Other Outcome Measures:
  • Secondary Immunological Outcomes [ Time Frame: From randomisation ]
    Response rate, magnitude and polyfunctionality of vaccine induced CD4 and CD8 T-cell responses.
  • Secondary Virological efficacy outcome measures [ Time Frame: From randomisation ]
    Level of HIV total DNA and Cell Associated (CA) HIV RNA Quantification

Estimated Enrollment: 192
Study Start Date: June 2018
Estimated Study Completion Date: December 2021
Estimated Primary Completion Date: March 2021 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
Experimental: Injection only: Active:placebo (3:1)
GTU-MultiHIV B-clade + MVA HIV-B: GTU-MultiHIV B-clade - 2 mg of DNA in 1ml encoding a multi HIV antigen (synthetic fusion protein) administered intramuscularly into the non-dominant deltoid muscle at weeks 0 and 4 and MVA HIV-B 0.5ml(1 x108 pfu/ml) MVA encoding the full-length codon-optimized sequence of Gag administered intramuscularly into the non-dominant deltoid muscle at week 12.
Biological: GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine
  • The vaccine is a solution of HIV MVA vectors (see section 1.3.2) in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0).
  • 0.5ml of ANRS MVA HIV-B (1 x 108 pfu/ml) or placebo for MVA (S8 buffer) will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm. Participants will be observed for one hour after the injection.

Biological: GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine+ Vedolizumab
  • The vaccine is a solution of HIV MVA vectors (see section 1.3.2) in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0).
  • 0.5ml of ANRS MVA HIV-B (1 x 108 pfu/ml) or placebo for MVA (S8 buffer) will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm. Participants will be observed for one hour after the injection. Vedolizumab is administered as an intravenous infusion over 30 mins in the dominant arm. After infusion, the line should be flushed with 30mls of normal saline.

Experimental: Infusion only: Active:placebo (3:1)
Vedolizumab will be administered in the participant's dominant arm as an intravenous infusion over 30 mins.
Drug: Vedolizumab 300 MG [Entyvio]

Vedolizumab is administered as an intravenous infusion over 30 mins in the dominant arm. After infusion, the line should be flushed with 30mls of normal saline.

Experimental: Injection and Infusion: Active:placebo (3:1)
GTU-MultiHIV B-clade + MVA HIV-B + Vedolizumab
Biological: GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine
  • The vaccine is a solution of HIV MVA vectors (see section 1.3.2) in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0).
  • 0.5ml of ANRS MVA HIV-B (1 x 108 pfu/ml) or placebo for MVA (S8 buffer) will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm. Participants will be observed for one hour after the injection.

Biological: GTU-MultiHIV B-clade vaccine + MVA HIV-B HIV vaccine+ Vedolizumab
  • The vaccine is a solution of HIV MVA vectors (see section 1.3.2) in S08 buffer (10mM Tris/hydrochloride (Tris/HCl), Saccharose 5% (w/v), 10mM Sodium Glutamate (Na Glu), 50mM Sodium Chloride (NaCl), water PPI, pH 8.0).
  • 0.5ml of ANRS MVA HIV-B (1 x 108 pfu/ml) or placebo for MVA (S8 buffer) will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm. Participants will be observed for one hour after the injection. Vedolizumab is administered as an intravenous infusion over 30 mins in the dominant arm. After infusion, the line should be flushed with 30mls of normal saline.

Drug: Vedolizumab 300 MG [Entyvio]

Vedolizumab is administered as an intravenous infusion over 30 mins in the dominant arm. After infusion, the line should be flushed with 30mls of normal saline.

Placebo Comparator: Placebo
Placebo1 for DNA: Sodium chloride for injection, 0.9% in 1ml administered intramuscularly into the non-dominant deltoid muscle at weeks 0 and 4. Placebo 2 for MVA: S08 buffer in 0.5ml administered intramuscularly into the non-dominant deltoid muscle at week 12. Placebo for mAb: Sodium Chloride (NaCl) for infusion, 0.9% in 250 ml infusion bags.
Other: Placebo
  • Placebo for MVA it is a solution composed of S08 buffer (as for the MVA vaccine) that will be administered intramuscularly in the deltoid muscle of the non-dominant upper arm. Participants will be observed for one hour after the injection.
  • Placebo for GTU-MultiHIV B-clade vaccine: Sodium Chloride (NaCl) for infusion, 0.9%.
  • Placebo for Vedolizumab: Sodium Chloride (NaCl) for infusion, 0.9% in 250 ml infusion bags.

Detailed Description:

The randomization ratio is 1:1:1:1 for vaccine: vedolizumab: combination: placebo in one of 3 schedules.
The study contains a phase I component in order to evaluate the local and systemic reactogenicity following the first administration of products in the first 12 participants. The phase I will consist of a slow enrolment of the first 12 participants who will be randomised at a maximum rate of 1 per week for 4 weeks, then 2 per week for 4 weeks before increasing to 4 or more per week. The IDMC will review of cumulative adverse event data through to and including the first safety visit in the 12th participant and their recommendation will be sought with regard to expanding recruitment.
The phase II component will assess the effectiveness and safety of the three experimental strategies upon viral control following analytic treatment interruption (ATI). The phase II component is divided into two stages, an interim efficacy stage and a final efficacy stage. There will be a pause in enrolment after 88 participants have been enrolled. A planned interim review by the IDMC at the end of the first stage will provide an opportunity to modify the design of subsequent stages or the recruitment strategy.
Screening will take place during the 6 weeks prior to randomisation. Eligible participants will be enrolled at week 0 and randomised to vaccine, vedolizumab, the combination of vaccine and vedolizumab or matched placebos. Participants and study staff will be aware of the schedule the participant is randomised to, with a third allocated to injections, a third to infusions and a third to the combination of injections and infusions. Only staff authorised to prepare the products will know who is randomised to active product or placebo within each schedule in a ratio of 3:1 respectively.
The vaccine regimen will start at week 0 and the vedolizumab regimen at week 2, each with matched placebo.
Participants will continue on cART during the first 24 weeks covering the vaccination period and 5 of 6 vedolizumab/placebo infusions.
Treatment will then be interrupted and resumed when the viral load is confirmed to have rebounded to ≥10,000 copies/ml, or the CD4 falls to ≤350 cells/mm3, or there is evidence of disease progression, or they have completed 24 weeks of treatment interruption.

Eligibility

Eligibility

Ages Eligible for Study: 18 Years to 65 Years  
Sexes Eligible for Study: All  
Accepts Healthy Volunteers: No  

Criteria

Inclusion Criteria

  1. HIV-1-infected
  2. Aged 18 - 65 years old on the day of screening
  3. Weight >50kg
  4. Written informed consent
  5. Nadir CD4 count > 300 cells/mm3
  6. CD4 count at screening > 600 cells/mm3
  7. Viral load, <50 copies/ml at screening.
  8. Started cART after 2009 and on cART for at least one year prior to screening.
  9. Willing to interrupt cART for up to 24weeks and change cART regimen if required.
  10. If sexually active, willing to use a reliable method of reducing the risk of transmission to their sexual partners during treatment interruption (which could include PrEP for their sexual partners)
  11. If heterosexually active and able to have children, willing to use a highly effective method of contraception with partner (combined oral contraceptive pill; injectable or implanted contraceptive; IUD/IUS; physiological or anatomical sterility (in self or partner) from 2 weeks before enrolment until 18 weeks after the last injection/infusion.
  12. If women of childbearing potential, willing to undergo urine pregnancy tests prior to administration of an injection or an infusion.
  13. Willing to avoid all other vaccines within 4 weeks of scheduled study injections
  14. Willing and able to comply with visit schedule and provide blood samples
  15. Being covered by medical insurance or in National Healthcare System


Exclusion Criteria:
    1. Pregnant or lactating
    2. HIV-2 infection (either isolated or associated with HIV-1)
    3. VL >200 copies/ml on 2 occasions in the 12 months prior to screening
    4. Previous interruptions in cART
    5. Previous virological failures defined by loss of virological suppression with the presence of resistant mutations
    6. Haemoglobin (Hb <12g/dL for males, <11g/dL for females)
    7. Concomitant or previous conditions that preclude injection of vaccines/infusion of monoclonal antibody and PML in the past
    8. History of experimental vaccinations against HIV
    9. Previous treatment with chemotherapy (except for chemotherapy injected into skin lesions for Kaposi's sarcoma)
    10. Treatment with systemic corticoids or immuno-suppressive agents ongoing or in the previous 12 weeks before randomisation in the trial
    11. Received natalizumab or rituximab ever in the past.
    12. Received a TNF blocker in the past 60 days.
    13. Administration of an inactivated vaccine within 30 days or a live vaccine within 60 days prior to randomisation
    14. Presence of a skin condition or marking that precludes inspection of the injection/infusion site
    15. History of cancer (except basal cellular skin carcinoma or Kaposi's sarcoma)
    16. History of significant neurological disease, cardiovascular disease (angina, myocardial infarction, transient ischemic attack, stroke); participants with controlled blood pressure are eligible.
    17. Personal history of clinical autoimmune disease or reactive arthritis or family history of rheumtaoid arthritis (parents or siblings)
    18. Ongoing diseases including uncontrolled active severe infection, cardiac, pulmonary (excluding mild asthma), thyroid, renal or neurological (peripheral or central) diseases
    19. Active or latent tuberculosis (unless prophylaxis in past as per local practice) - (participant must be screened for tuberculosis before starting infusions, according to routine practice)
    20. Presence of pathogenic bacteria or parasites in faeces at screening
    21. Participating in another biomedical research study within 30 days of randomisation.
    22. Known hypersensitivity to any component of the vaccine formulations used in this trial including aminoglycosides and eggs or have severe or multiple allergies to drugs or pharmaceutical agents, or any hypersensitivity to the active substance or to any of the excipients of vedolizumab.
    23. Liver disease including hepatitis B (surface antigen positive) or hepatitis C (antigen or PCR positive)
    24. A clinically significant abnormality on ECG
    25. Hypernatraemia or hyperchloraemia.
    26. History of severe local or general reaction to vaccination defined as
      1. local: extensive, indurated redness and swelling involving most 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
    27. Grade 2 or worse routine laboratory parameters (see Appendix 4 for definitions).
    Hyperbilirubinaemia to be considered an exclusion criterion only when confirmed to be conjugated bilirubinaemia

contacts and locations

Contacts and Locations

Choosing to participate in a study is an important personal decision.Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02972450

Contacts

Contact:   Silvia Forcat, PhD +44 (0)20 7670 4825 s.forcat@ucl.ac.uk
Contact:   Liz Brodnicki +44 (0)20 7670 4783 e.brodnicki@ucl.ac.uk

Sponsors and Collaborators

French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)
European Commission
Swiss Government
Medical Research Council
FIT Biotech Ltd.
Fred Hutchinson Cancer Research Center
University College, London
Centre Hospitalier Universitaire Vaudois
Imperial College London
Istituto Nazionale Malattie Infettive Lazaro Spallanzani
Universitätsklinikum Hamburg-Eppendorf
Institut d'Investigacions Biomèdiques August Pi i Sunyer
Henri Mondor University Hospital
European Georges Pompidou Hospital
Saint-Louis Hospital, Paris, France

Investigators

Study Director: Yves Levy, MD Institut National de la Santé Et de la Recherche Médicale, France
More Information

More Information


Responsible Party: French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS)  
ClinicalTrials.gov Identifier: NCT02972450   History of Changes  
Other Study ID Numbers: EHVA T01/ANRS VRI05  
Study First Received: November 10, 2016  
Last Updated: April 26, 2018  
Individual Participant Data    
Plan to Share IPD: No  

Studies a U.S. FDA-regulated Drug Product: No  
Studies a U.S. FDA-regulated Device Product: No  

Additional relevant MeSH terms:
Infection
Communicable Diseases
Vaccines
Vedolizumab

ClinicalTrials.gov processed this data on December 14, 2018
This information is provided by ClinicalTrials.gov.