The aim of the trial is to assess the safety, tolerability and immunogenicity of two doses of RUTI® vaccine administered four weeks apart after one month pre-treatment with INH. The trial will be double-blinded, randomized and placebo-controlled with 96 subjects (48 HIV- and 48 HIV+ subjects). Three different RUTI® doses and placebo will be tested, randomizing assigned both in HIV+ and HIV- subjects. Each subject will be randomized to receive one of the four treatments (placebo, 5, 25, 50 μg), after completion of one month INH pre-treatment (one tablet of 300mg/day, vp.o.). Each subject will receive two administrations of the same treatment, 28 days apart. Subjects will be monitored until one month after the second inoculation with RUTI®.
RUTI is a therapeutic vaccine made from virulent M.tuberculosis bacteria, grown in stressful conditions, fragmented, detoxified, heat inactivated (FCMtb) and liposomed. RUTI provides a strong humoral and cellular immune response against antigens from active growing and latent bacilli but also against structural antigens, as it has been proved in animal models of latent tuberculosis infection and in phase I clinical trial of Healthy Volunteers. The vaccine has been designed to be used against Latent Tuberculosis Infection as a therapeutic vaccine after 1-month of chemotheraputic treatment, instead the current treatment based on 6-9 months of chemotherapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
95
dose:5 micrograms of FCMtb (Fragmented cells of M. tuberculosis); given subcutaneously twice, on days 28 and 56.
dose:25 micrograms of FCMtb (Fragmented cells of M. tuberculosis); given subcutaneously twice, on days 28 and 56.
dose:50 micrograms of FCMtb (Fragmented cells of M. tuberculosis); given subcutaneously twice, on days 28 and 56.
Placebo of the vaccine RUTI; given subcutaneously twice, on days 28 and 56.
Parexel Int. Bloemfontein
Bloemfontein, South Africa
Parexel Int. George
George, South Africa
Parexel Int. Port Elizabeth
Port Elizabeth, South Africa
Local tolerability
The investigator will evaluate the site of injection for redness, pain, swelling, and induration and functional limitation. Redness, swelling and induration will be evaluated and recorded on the CRF as: 0 = absent, 1 = mild, 2 = moderate, 3 = severe. If present, the extent of the reaction will be measured in mm. Pain will be recorded, after questioning the subjects, by means of a Visual Analogue Scale (VAS from 0 to 100). The presence of abscess, ulceration or necrosis will also be evaluated, measured and adequately documented.
Time frame: 84 days
Focal Tolerability
Evaluation of the hilar lymph nodes for inflammation: An un-contrasted thoracic computerised tomographic scan will be performed to evaluate the change in size of the hilar lymph nodes.
Time frame: 84 days
Systemic tolerability
Body temperature ≥38ºC, asthenia, sweating, malaise, headache, dizziness, nausea, myalgia, arthralgia, rash and generalised pruritus
Time frame: 84 days
Vital Signs and physical examination
Blood pressure (systolic and diastolic), pulse, respiratory rate, body temperature and full physical examination will be assessed
Time frame: 84 days
ECG
The following ECG parameters will be measured: Bits Frequency Heart rate, PR, QRS, QT and QTc (Bazett) intervals. Any other anomaly on the ECG (such as U wave, ischaemia, rhythm and conduction disturbances) will be evaluated by the investigator
Time frame: 84 days
Laboratory Tests
Blood samples for serum chemistry and haematology and urine sample for urinalysis will be taken under fasting conditions for evaluation of laboratory safety parameters
Time frame: 84 days
Immunogenicity
Samples to perform immunogenicity testing will be collected at specified visits. Cellular mediated immunity (ELISPOT and ELISA techniques), IFN-gama Spot Forming Units after stimulation for 18 hours with five stimuli, WHO assay (stimulating whole blood 7days with PPD) and TIGRA (TSPOT TB assay). Peripheral blood mononuclear cells will be frozen for future immune assays. Sera will be frozen to be further tested for the antibody-mediated immunity against M.tuberculosis antigens
Time frame: 63 days
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