Clesrovimab is an FDA-approved antibody drug recommended for infants younger than 8 months who are entering their first respiratory syncytial virus (RSV) season and whose mothers did not receive an RSV vaccine during pregnancy. It is given to help prevent severe RSV illness. This study will measure clesrovimab and other RSV antibodies in infants' blood and noses to learn how much of the drug reaches the nose, how long the antibodies remain, and how antibody levels change if an infant becomes infected with RSV.
The study will enroll 24 infants younger than 8 months who are entering their first RSV season. The study includes minors and may include newborn infants. Written permission will be obtained from a parent or legally authorized representative before any study procedures occur. Infant assent will not be obtained because the participants are too young to provide it. Each infant will receive one injection of clesrovimab as part of the usual care recommended to prevent serious RSV illness. Study staff will collect blood and nasal samples before the injection, at either Day 8 or Day 45, and at Day 181 after injection. Parent or legally authorized representative will also complete one safety follow-up visit by phone call at either Day 8 or Day 45. Each infant will participate for about six months after receiving clesrovimab. Recruitment will invite families of eligible infants through the Emory Children's Center-Vaccine Research Clinic (ECC-VRC), Emory and community outreach, healthcare clinics, electronic health record messages, advertisements, and approved online recruitment methods. Blood, nasal samples, and study data will be stored for the planned study tests. Remaining samples will be stored without information that directly identifies the infant, such as the infant's name or date of birth (de-identified), until the planned tests are complete and the study is closed. They will not be stored for unrelated future research. Study records will be kept as required by Emory, the study sponsor, and applicable rules.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Clesrovimab (ENFLONSIA™) is a commercially available product that is administered as part of standard-of-care RSV prevention.
Emory Children's Center-Vaccine Research Clinic
Atlanta, Georgia, United States
Geometric mean concentration (GMC) of serum RSV pre-fusion (preF) binding IgG antibodies
RSV pre-fusion (preF) IgG binding antibodies in serum specimens will be quantified. Assay results will be reported as concentrations (arbitrary units per milliliter, AU/mL) derived from a calibrated standard curve. Serum RSV preF IgG concentrations will be summarized as geometric mean concentrations (GMC) at each study timepoint.
Time frame: Baseline (Day 1), assigned early follow-up timepoint (Day 8 or Day 45) and Day 181
Geometric mean concentration (GMC) of nasal RSV pre-fusion (preF) binding IgG antibodies
RSV pre-fusion (preF) IgG binding antibodies in nasal specimens will be quantified. Assay results will be reported as concentrations (arbitrary units per milliliter, AU/mL) derived from a calibrated standard curve. For nasal specimens, RSV preF IgG concentrations will be normalized to total human IgG concentration. Normalized nasal antibody values will be summarized as GMC.
Time frame: Baseline (Day 1), assigned early follow-up timepoint (Day 8 or Day 45) and Day 181
Geometric mean titers (GMT) of serum RSV-A neutralizing antibodies
Serum RSV neutralizing antibody titers will be measured using a microneutralization assay. Neutralizing antibody titers will be reported as reciprocal dilution EC50 titers (the serum dilution resulting in 50% neutralization) and summarized as geometric mean titers (GMTs).
Time frame: Baseline (Day 1), assigned early follow-up timepoint (Day 8 or Day 45) and Day 181
Serum Geometric mean concentration (GMC) of clesrovimab
Serum clesrovimab concentrations will be reported in concentration units and summarized as geometric mean concentrations (GMC) at each study timepoint.
Time frame: Baseline (Day 1), assigned early follow-up timepoint (Day 8 or Day 45) and Day 181
Urea-normalized GMC of clesrovimab in the nasal mucosa
Christina Rostad, MD
CONTACT
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Enrollment
24
Clesrovimab concentrations will be normalized to urea concentration for nasal samples to account for variability in epithelial lining fluid dilution. Urea-normalized nasal clesrovimab concentrations will be summarized as GMC.
Time frame: Baseline (Day 1), assigned early follow-up timepoint (Day 8 or Day 45) and Day 181