This study is a multicenter, double-blind, randomized, placebo-controlled Phase III trial designed to evaluate the efficacy and safety of the GamTBvac recombinant subunit tuberculosis vaccine for the prevention of active non-HIV-associated pulmonary tuberculosis. The study is divided into three stages. A total of 9,500 volunteers are planned to be enrolled in the study. Stage 1: A total of 354 volunteers with no history of pulmonary tuberculosis will be enrolled. Volunteers will be randomized in a 1:1 ratio into one of two groups receiving either GamTBvac or placebo. Within each group, stratification will be performed according to the presence or absence of a risk factor (smoking). Based on the results of this stage, the safety of the GamTBvac vaccine will be evaluated according to the criteria specified in the study objectives for Stage 1. Stage 2: A total of 2,146 volunteers with a history of active pulmonary tuberculosis that resulted in cure without residual changes or with minor residual changes, without aggravating factors, and who at the time of participation are registered and under follow-up in Dispensary Group III will be enrolled. Volunteers will be randomized in a 1:1 ratio into one of two groups receiving either GamTBvac or placebo. Based on the results of this stage, the prophylactic efficacy and safety of the GamTBvac vaccine will be evaluated according to the criteria specified in the study objectives for Stage 2. In the absence of statistically significant data on vaccine efficacy by Visit 6 (24 months ± 30 days), the study will proceed to Stage 3. In the event that statistically significant data on the prophylactic efficacy of GamTBvac are obtained by Visit 6 (24 months ± 30 days), the study will be terminated. Stage 3: Up to 7,000 volunteers with no history of active pulmonary tuberculosis will be enrolled. Volunteers will be randomized in a 1:1 ratio into one of two groups receiving either GamTBvac or placebo. Within each group, stratification will be performed according to the presence or absence of a risk factor (smoking). Based on the results of this stage, the safety and prophylactic efficacy of the GamTBvac vaccine will be evaluated according to the criteria specified in the study objectives for Stage 3.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
9,500
City hospital #40
Saint Petersburg, Russia
Efficacy assessment - Stage 1
Efficacy will be assessed in volunteers aged 18 years and older. All study participants will be informed of the potential signs and symptoms indicative of pulmonary tuberculosis and will be instructed to report to the study site promptly should any such symptoms develop, in order to undergo an Unscheduled Visit. For Stage 1, the primary efficacy endpoint will be the incidence rate of respiratory tuberculosis. The diagnosis will be confirmed by the presence of pulmonary foci or infiltrations (physiological parameter) as determined by chest radiography (diagnostic test).
Time frame: 24 months after vaccination
Primary endpoint for Stage 2 of the study
The prophylactic efficacy of the GamTBvac vaccine will be assessed by comparing the incidence rate of active pulmonary tuberculosis cases between the study groups during the post-vaccination follow-up period in volunteers with a prior history of active respiratory tuberculosis, at 24 month after the first vaccination.
Time frame: 24 months after vaccination
Primary endpoint for Stage 3 of the study
The prophylactic efficacy of the GamTBvac vaccine will be assessed by comparing the incidence rate of active pulmonary tuberculosis cases between the study groups during the post-vaccination follow-up period in volunteers with no prior history of active respiratory tuberculosis, at 24 months after the first vaccination.
Time frame: 24 months after vaccination
Safety Endpoint Analysis
Safety analyses will be performed in the safety population (SAF). The number and percentage of volunteers with adverse events (AEs) and serious adverse events (SAEs) will be tabulated by system organ class (SOC) and preferred term (PT) according to the MedDRA dictionary, by relationship to the investigational product.
Time frame: 24 months after the vaccination
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