This is a phase III, randomized, comparator-controlled, double-blind, multicenter study to evaluate lot-to-lot consistency of three lots of a PIKA Rabies Vaccine, immunogenicity and safety in healthy adults using a post-exposure prophylaxis schedule. It is also the aim of this study to evaluate non-inferiority and superiority of the PIKA Rabies Vaccine compared to the rabies vaccine comparator ChiroRab.
This is a phase III, randomized, comparator-controlled, double-blind, multicenter study to evaluate lot-to-lot consistency of three lots of a PIKA Rabies Vaccine, immunogenicity and safety in healthy adults using a post-exposure prophylaxis schedule. It is also the aim of this study to evaluate non-inferiority and superiority of the PIKA Rabies Vaccine compared to the rabies vaccine comparator ChiroRab. A total of 4,500 subjects will be enrolled in the study randomized into 2:1 with 3000 subjects allocated to PIKA rabies vaccine and 1,500 allocated to receive the comparator rabies vaccine ChiroRab . There will be two study Groups: Group 1 (20%) and Group 2 (80%). Within each study group, subjects will be randomly allocated in a 2:2:2:3 ratios to receive 1 of the 3 lots of PIKA rabies vaccine or ChiroRab. The ChiroRab group will receive the classic Essen 5 dose regimen (1-1-1-1-1 schedule on Days 0, 3, 7, 14 and 28), whilst the PIKA rabies vaccine group will receive an accelerated regimen (2-2-1 schedule with a double-dose injection on Days 0 and 3 and a single-dose injection on Day 7). For blinding purposes, normal saline will be injected on Days 14 and 28 for PIKA rabies group and Days 0 and 3 for ChiroRab group. Group 1 will enrol a total of 900 subjects, approximately 20% of the total sample population. Subjects will be randomized at 2:2:2:3 ratio (PIKA lot #1: 200 subjects, PIKA lot #2: 200 subjects, PIKA lot #3: 200 and 300 will be randomized to receive ChiroRab). Blood will be collected pre-vaccination (Day 0) and post-vaccination on Days 7, 14, 28, 90, 180 and 365 to evaluate the primary immunogenicity, safety and secondary immunogenicity endpoints. Subjects will be followed up for the whole study period through clinic visits or phone calls. The first 50 participants randomized in each of the 3 PIKA lots and that for the ChiroRab in Goup 1 (200 in total) will form the safety subset and will have additional blood draw for safety laboratory parameters for CBC platelet, urinalysis, serum chemistry and coagulation on Day 0 (prior to vaccination), Day 7 and Day 28. After completion of enrolment in Group 1, Group 2 will enrol the remaining 3,600 subjects at 2:2:2:3 randomization ratio (PIKA lot #1: 800 subjects, PIKA lot #2: 800 subjects, PIKA lot #3: 800 and 1,200 will be randomized to receive ChiroRab). Blood will be collected pre-vaccination on Day 0, 7 and 365 to evaluate key secondary immunogenicity endpoints of superiority, persistence and durability of immune response as well as co-primary safety objective. Subjects will be followed up for the whole study period through clinic visits or phone calls. After each vaccination, all subjects will be observed in the clinical site for at least 30 minutes for immediate reactions and will be followed up for solicited AEs by diary cards 7 days post each vaccination and unsolicited AEs will be collected through Day 41 post first vaccination. All subjects will be monitored for SAEs, SUSARs, AESIs, and AEs leading to study withdrawal for the whole study period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
4,500
PIKA rabies vaccine
Active Comparator
Al-Shifa Trust Eye Hospital
Islamabad, Pakistan
Ziauddin University
Karachi, Pakistan
Central Park Teaching Hospital
Lahore, Pakistan
TDF-Lakeview,Muntinlupa
City of Muntinlupa, Philippines
Primary Immunogenicity
GMTs of rabies virus neutralizing antibodies (RVNA) at Day 14 to demonstrate lot-to-lot consistency in all subjects enrolled in Group 1
Time frame: 14 days post-vaccination
Primary Immunogenicity
RVNA seroconversion rate differences at Day 14 in all subjects enrolled in Group 1.
Time frame: 14 days post-vaccination
Co-primary Safety(solicited AEs)
Incidence of solicited local and systemic reactions on the day of each study vaccination
Time frame: 7 days after each vaccination.
Co-primary Safety(unsolicited AEs)
Incidence of unsolicited adverse events
Time frame: From day of first vaccination through 14 days after the last vaccination
Co-primary Safety(SAEs)
Incidence of serious adverse events (SAEs), suspected unexpected serious adverse reactions (SUSARs), adverse events of special interest (AESIs) and AEs leading to withdrawal
Time frame: through study completion, an average of 1 year
Co-primary Safety
Incidence of significant changes in the clinical laboratory test results, vital signs and physical examination by study visits.
Time frame: through study completion, an average of 1 year
Secondary Immunogenicity
RVNA seroconversion rate differences at Day 28 and Day 42 in all subjects enrolled in Group 1
Time frame: Day 28 and Day 42
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Las Pinas Doctor's Hospital
Las Piñas, Philippines
PGH
Manila, Philippines
TDF - San Pablo, Laguna
San Pablo, Philippines
Secondary Immunogenicity
RVNA seroconversion rate differences at Day 7 in all subjects (Group 1 and Group 2)
Time frame: Day 7
Secondary Immunogenicity
GMTs of rabies virus neutralizing antibodies (RVNA) on Day 14, 28 and 42(Group 1)
Time frame: Day 14, 28 and 42
Secondary Immunogenicity
GMTs of rabies virus neutralizing antibodies (RVNA) on Day 90 and 180 for Group 1 only and Day 365 for all subjects (Group 1 and Group 2) subjects (Group 1 and Group 2).
Time frame: Day 90 and 180 for Group 1 only and Day 365 for all subjects (Group 1 and Group 2).
Secondary Immunogenicity
RVNA seroconversion rate differences on Day 90 and 180 for Group 1 only and Day 365 for all subjects (Group 1 and Group 2)
Time frame: Day 90 and 180 for Group 1 only and Day 365 for all subjects (Group 1 and Group 2)