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NCT03824236

A Study to Evaluate the Efficacy, Immunogenicity and Safety in a Sporozoite Challenge Model of a Fractional Booster Dose of GSK Biologicals' Candidate Malaria Vaccine Administered to Previously Vaccinated Healthy Malaria-naïve Adults

Completed Phase 2 Results posted Last updated 14 August 2020
What this trial tests

Phase 2 trial testing RTS,S/AS01E (SB257049) in Malaria in 61 participants. Completed in 26 September 2019.

Timeline
5 February 2019
Primary endpoint
30 April 2019
26 September 2019

Quick facts

Lead sponsorGlaxoSmithKline
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designparallel
Maskingnone
Primary purposeprevention
Enrollment61
Start date5 February 2019
Primary completion30 April 2019
Estimated completion26 September 2019
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

GlaxoSmithKline — full company profile →

Who can join

Adults 18 to 55, any sex, with Malaria. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Subjects Reporting Plasmodium Falciparum (P. Falciparum) Parasitemia (Defined by a Positive Blood Slide) Following Sporozoite Challenge (in All Study Groups Versus Infectivity Controls) Primary · During the sporozoite challenge dose follow-up period (from Day 22 up to Day 50)

Occurrence of P. falciparum parasitemia (defined by a positive blood slide) following sporozoite challenge. Post-challenge, parasitemia was determined by microscopy of Giemsa-stained thick blood films (smear). Microscopy was performed on thick smears using a validated standard operation procedure. P. falciparum infection was defined as asexual blood stage P. falciparum parasite density greater than (\>) 0 detected by blood slide reading. For the analysis of proportion affected (relative risk), all subjects included in the analysis were considered at risk of infection and no censoring or elimin

GroupValue95% CI
P-Fx Group12
NP-Fx Group11
Infectivity Control Group11
Time to Onset of P. Falciparum Parasitemia (Defined by a Positive Blood Slide) Following Sporozoite Challenge Secondary · During the sporozoite challenge period starting at Day 22 (after the vaccine dose administered at Day 1), up to Day 50

For the analyses of time to onset of parasitemia (Kaplan-Meyer and log-rank), time at risk started on first day of challenge. Time at risk was censored on Day 50 (28 days post challenge), drop-out date, start date of anti-malarial treatment or date meeting an endpoint, whichever occured first. Time-at-risk was calculated as: censor date - date challenge + 1.

GroupValue95% CI
P-Fx Group14.6± 1.9
NP-Fx Group14.1± 1.6
Infectivity Control Group11.6± 0.9
Anti- Circumsporozoite (CS) Repeat Region Antibody Concentrations Secondary · At Day 1, prior to challenge (Day 22), 28 days post-challenge (Day 50) and at study end (Day 190)

Anti-CS antibody concentrations are presented as Geometric Mean Concentrations (GMCs), expressed in Enzyme-linked immunosorbent assay Unit per milliliter (EU/mL). The cut-off for the assay was equal to 1.9 EU/mL. GMC calculations are performed by taking the inverse logarithm of the mean of the log concentration transformations. Antibody concentrations below the cut-off of the assay will be given an arbitrary value of half the cut-off of the assay for the purpose of GMC calculation.

Day 1
GroupValue95% CI
P-Fx Group32.824.5 – 44.1
NP-Fx Group7.23.9 – 13.4
Day 22
GroupValue95% CI
P-Fx Group87.367.0 – 113.9
NP-Fx Group37.323.4 – 59.5
Day 50
GroupValue95% CI
P-Fx Group77.859.5 – 101.8
NP-Fx Group25.715.3 – 43.2
Day 190
GroupValue95% CI
P-Fx Group49.737.7 – 65.7
NP-Fx Group12.76.9 – 23.4
Anti-Hepatitis B (HBs) Immunoglobulin G (IgG) Antibody Concentrations Secondary · At Day 1, prior to challenge (Day 22), 28 days post-challenge (Day 50) and at study end (Day 190)

Anti-HBs IgG antibody concentrations are presented as Geometric Mean Concentrations (GMCs), expressed in milli-International Unit per milliliter (mIU/mL). The cut-off for the assay was equal to 6.2 mIU/mL. GMC calculations are performed by taking the inverse logarithm of the mean of the log concentration transformations. Antibody concentrations below the cut-off of the assay will be given an arbitrary value of half the cut-off of the assay for the purpose of GMC calculation.

Day 1
GroupValue95% CI
P-Fx Group77884822.8 – 12576.4
NP-Fx Group6608.13147.2 – 13874.8
Day 22
GroupValue95% CI
P-Fx Group25344.516377.3 – 39221.5
NP-Fx Group29271.318417.1 – 46522.4
Day 50
GroupValue95% CI
P-Fx Group21203.114058.2 – 31979.2
NP-Fx Group19894.811569.4 – 34211.1
Day 190
GroupValue95% CI
P-Fx Group11593.97446.0 – 18052.6
NP-Fx Group9092.54652.8 – 17768.4
Number of Subjects With Any Solicited Local Adverse Events (AEs) in the Booster Vaccination Groups Secondary · Within 7 days after vaccination (day of vaccination and 6 subsequent days) in the booster vaccination groups

Solicited local AEs assessed are erythema, pain and swelling. Any occurrence of AE regardless of intensity grade are reported. Any Erythema or any Swelling symptom = any symptom recorded with a surface diameter greater than 0 millimeter.

Erythema
GroupValue95% CI
P-Fx Group8
NP-Fx Group4
Pain
GroupValue95% CI
P-Fx Group11
NP-Fx Group10
Swelling
GroupValue95% CI
P-Fx Group4
NP-Fx Group4
Number of Subjects With Any Solicited General AEs in the Booster Vaccination Groups Secondary · Within 7 days after vaccination (day of vaccination and 6 subsequent days) in the booster vaccination groups

Solicited general AEs assessed are fatigue, gastrointestinal symptoms (nausea, vomiting, diarrhea and/or abdominal pain), headache and fever. Any occurrence of symptom regardless of intensity grade and relationship to the vaccination. Fever was defined as temperature equal or greater than 37.5 °C (preferably oral route measure).

Fatigue
GroupValue95% CI
P-Fx Group7
NP-Fx Group4
Gastrointestinal symptoms
GroupValue95% CI
P-Fx Group2
NP-Fx Group0
Headache
GroupValue95% CI
P-Fx Group6
NP-Fx Group5
Fever
GroupValue95% CI
P-Fx Group3
NP-Fx Group0
Number of Subjects With Any Unsolicited AEs After Vaccination, in the Booster Vaccination Groups Secondary · Up to 21 days after booster vaccination period (day of vaccination and 20 subsequent days), after booster vaccination

An unsolicited adverse event is any untoward medical occurrence in a clinical investigation subject, temporally associated with use of a medicinal product, whether or not considered related to the medicinal product. An unsolicited adverse event is any event reported in addition to those solicited during the clinical study and any solicited symptom with onset outside the specified period of follow-up for solicited symptoms.

GroupValue95% CI
P-Fx Group5
NP-Fx Group1
Number of Subjects With Any Unsolicited AEs After Challenge, in All Study Groups Secondary · Within 29 days after challenge (day of challenge and 28 subsequent days)

An adverse event is any untoward medical occurrence in a clinical investigation subject, temporally associated with use of a medicinal product, whether or not considered related to the medicinal product.

GroupValue95% CI
P-Fx Group19
NP-Fx Group19
Infectivity Control Group12
Number of Subjects With AEs of Specific Interest (Potential Immune-mediated Diseases [pIMDs] and Meningitis), in All Study Groups Secondary · From Day 1 up to study conclusion (Day 190)

AEs of specific interest are potential immune-mediated diseases (pIMDs) and meningitis. pIMDs are a subset of AEs that include autoimmune diseases and other inflammatory and/or neurologic disorders of interest which may or may not have an autoimmune etiology.

GroupValue95% CI
P-Fx Group0
NP-Fx Group0
Infectivity Control Group0
Number of Subjects With Serious Adverse Events (SAEs) (Any, Fatal or Related to Investigational Vaccine) During the Whole Study Period, in All Study Groups Secondary · From Day 1 up to study conclusion (Day 190)

An SAE is any untoward medical occurrence that results in death, is life threatening, requires hospitalization or prolongation of hospitalization, results in disability/incapacity or is a congenital anomaly/birth defect in the offspring of a study subject.

Any SAEs
GroupValue95% CI
P-Fx Group2
NP-Fx Group0
Infectivity Control Group0
Related SAEs
GroupValue95% CI
P-Fx Group0
NP-Fx Group0
Infectivity Control Group0
Fatal SAEs
GroupValue95% CI
P-Fx Group0
NP-Fx Group0
Infectivity Control Group0
Number of Subjects With Abnormal Laboratory Values Secondary · At screening, Day(D)1, D8, D22 (day of first parasitemia) and D50 (28 days post-challenge) for the booster vaccination groups; and at screening, D22 (day of first parasitemia) and D50 (28 days post-challenge) for the infectivity control subjects

Biochemistry (Alanine Aminotransferase \[ALT\], Aspartate Aminotransferase \[AST\] and Creatinine) and hematological (Hemoglobin, Platelets, White Blood Cells \[WBC\] decrease and WBC increase) laboratory values were presented according to toxicity grading scales and tabulated by group. Grading scale adapted from FDA guidance for industry: toxicity grading scale for healthy adult and adolescent volunteers enrolled in preventive vaccine clinical trials (September 2007).

ALT, Screening, Grade 0
GroupValue95% CI
P-Fx Group24
NP-Fx Group23
Infectivity Control Group11
ALT, Screening, Grade 1
GroupValue95% CI
P-Fx Group1
NP-Fx Group1
Infectivity Control Group1
ALT, Day 1, Grade 0
GroupValue95% CI
P-Fx Group25
NP-Fx Group23
ALT, Day 1, Grade 1
GroupValue95% CI
P-Fx Group0
NP-Fx Group1
ALT, Day 8, Grade 0
GroupValue95% CI
P-Fx Group24
NP-Fx Group24
ALT, Day 8, Grade 1
GroupValue95% CI
P-Fx Group1
NP-Fx Group0
ALT, Day 22, Grade 0
GroupValue95% CI
P-Fx Group23
NP-Fx Group23
Infectivity Control Group12
ALT, Day 22, Grade 1
GroupValue95% CI
P-Fx Group2
NP-Fx Group1
Infectivity Control Group0

Adverse events — posted to ClinicalTrials.gov

Time frame: Solicited AEs were collected within the 7-day post-booster period. Unsolicited AEs were collected within the 21-day post-booster or within the 29-day post-challenge period. SAEs were collected from Day 1 up to study conclusion (Day 190).. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

P-Fx Group
Serious: 2/25 (8%)
Deaths: 0/25
NP-Fx Group
Serious: 0/24 (0%)
Deaths: 0/24
Infectivity Control Group
Serious: 0/12 (0%)
Deaths: 0/12

Serious adverse events (3 terms)

ReactionSystemP-Fx GroupNP-Fx GroupInfectivity Control Group
HypobarismInjury, poisoning and procedural complications
InjuryInjury, poisoning and procedural complications
Road traffic accidentInjury, poisoning and procedural complications
Other adverse events (43 terms — click to expand)

ReactionSystemP-Fx GroupNP-Fx GroupInfectivity Control Group
MalariaInfections and infestations
Injection site painGeneral disorders
FatigueGeneral disorders
HeadacheNervous system disorders
Injection site erythemaGeneral disorders
MyalgiaMusculoskeletal and connective tissue disorders
Injection site swellingGeneral disorders
Upper respiratory tract infectionInfections and infestations
ChillsGeneral disorders
PyrexiaGeneral disorders
Back painMusculoskeletal and connective tissue disorders
NauseaGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
Feeling hotGeneral disorders
MalaiseGeneral disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
DiarrhoeaGastrointestinal disorders
Gastrointestinal disorderGastrointestinal disorders
RhinorrhoeaRespiratory, thoracic and mediastinal disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
Arthropod biteInjury, poisoning and procedural complications
Peripheral swellingGeneral disorders
ThirstGeneral disorders
InfectionInfections and infestations
Neck painMusculoskeletal and connective tissue disorders
Joint swellingMusculoskeletal and connective tissue disorders
Muscle tightnessMusculoskeletal and connective tissue disorders
Musculoskeletal stiffnessMusculoskeletal and connective tissue disorders
Pain in extremityMusculoskeletal and connective tissue disorders
Joint warmthMusculoskeletal and connective tissue disorders
Abdominal painGastrointestinal disorders
VomitingGastrointestinal disorders
Abdominal discomfortGastrointestinal disorders
DyspepsiaGastrointestinal disorders
SneezingRespiratory, thoracic and mediastinal disorders
CoughRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
Paranasal sinus discomfortRespiratory, thoracic and mediastinal disorders
Sinus congestionRespiratory, thoracic and mediastinal disorders
Post procedural discomfortInjury, poisoning and procedural complications

Most-reported serious reactions: Hypobarism, Injury, Road traffic accident.

Data from ClinicalTrials.gov NCT03824236 adverse events section.

Sponsor's own description

MALARIA-092 (NCT03162614) study was designed to evaluate the efficacy, immunogenicity and safety of various dose schedules and formulations of GSK Biologicals' candidate malaria vaccine (RTS,S/AS01E) in healthy malaria-naïve subjects aged 18-55 years. The purpose of this study (follow-up to MALARIA-092 \[NCT03162614\] study) is to evaluate if protection can be extended with an additional Fx booster dose and if unprotected subjects can be protected following a Fx booster dose. In this booster study, subjects from MALARIA-092 (NCT03162614) study who completed vaccination and challenge will receive a Fx booster dose of RTS,S/AS01E and undergo a second controlled human malaria infection (CHMI) three to four weeks after vaccination. Additionally, subjects will be newly enrolled and will only undergo the sporozoite challenge as infectivity controls.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Immunomodulatory Nanosystems.
    Feng X, Xu W, Li Z, Song W, et al · · 2019 · cited 252× · PMID 31508270 · DOI 10.1002/advs.201900101
  2. Virus-like particle vaccinology, from bench to bedside.
    Mohsen MO, Bachmann MF. · · 2022 · cited 181× · PMID 35962190 · DOI 10.1038/s41423-022-00897-8
  3. A phase IIA extension study evaluating the effect of booster vaccination with a fractional dose of RTS,S/AS01<sub>E</sub> in a controlled human malaria infection challenge.
    Moon JE, Greenleaf ME, Regules JA, Debois M, et al · · 2021 · cited 13× · PMID 34593270 · DOI 10.1016/j.vaccine.2021.09.024
  4. Identification of RTS,S/AS01 vaccine-induced humoral biomarkers predictive of protection against controlled human malaria infection.
    Spreng RL, Seaton KE, Lin L, Hilliard S, et al · · 2024 · cited 3× · PMID 39377226 · DOI 10.1172/jci.insight.178801

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