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Clinical Trial for the Evaluation of Three Regimens of Influenza Vaccination in Kidney Transplant Recipients

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ClinicalTrials.gov Identifier: NCT02104869
Recruitment Status : Completed
First Posted : April 4, 2014
Last Update Posted : July 21, 2015
Sponsor:
Collaborator:
Fundação de Amparo à Pesquisa do Estado de São Paulo
Information provided by (Responsible Party):
Butantan Institute

Brief Summary:

This will be an open label, parallel, randomized clinical trial that will evaluate the immunogenicity and safety of the trivalent influenza vaccine (inactivated and fragmented) produced by Instituto Butantan among adult kidney transplant recipients, when administered in three vaccination regimens: i) the recommended dose; ii) a single double dose; iii) two doses administered with a 21 day interval.

The randomization ratio among the three groups of kidney transplant recipients will be 1:1, and 60 participants will be included in each group. After vaccination all participants will be followed for 26 weeks.

In addition, 15 healthy adults will be included as a control group, and will receive the recommended dose.

The study hypothesis is that a different vaccination regimen can improve the immune response of kidney transplant recipients after vaccination with the trivalent influenza vaccine (inactivated and fragmented).


Condition or disease Intervention/treatment Phase
Human Influenza Biological: Trivalent influenza vaccine (inactivated and fragmented). Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 195 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Open Label Parallel Randomized Clinical Trial to Evaluate the Immunogenicity of Three Regimens of the Trivalent Influenza Vaccine (Inactivated and Fragmented) in Kidney Transplant Recipients
Study Start Date : April 2014
Actual Primary Completion Date : August 2014
Actual Study Completion Date : March 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Recommended dose (kidney transplant)

Intervention: trivalent influenza vaccine (inactivated and fragmented).

Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg).

Dose: single 0.5 mL dose.

Biological: Trivalent influenza vaccine (inactivated and fragmented).
Active Comparator: Healthy adults

Intervention: trivalent influenza vaccine (inactivated and fragmented).

Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg).

Dose: single 0.5 mL dose.

Biological: Trivalent influenza vaccine (inactivated and fragmented).
Experimental: Single double dose (kidney transplant)

Intervention: trivalent influenza vaccine (inactivated and fragmented).

Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg).

Dose: single 1.0 mL dose.

Biological: Trivalent influenza vaccine (inactivated and fragmented).
Experimental: Two sequential doses (kidney transplant)

Intervention: trivalent influenza vaccine (inactivated and fragmented).

Dosage form: each 0.5 mL dose of the vaccine contains Myxovirus influenzae strains propagated in embryonated chicken eggs, equivalent to: A/California/7/2009 (H1N1) pdm09 (15 mcg of hemagglutinin); A/Texas/50/2012 (H3N2) (15 mcg of hemagglutinin); B/Massachusetts/2/2012 (15 mcg of hemagglutinin); Thimerosal (2 mcg).

Dose: two 0.5 mL doses 21 days apart.

Biological: Trivalent influenza vaccine (inactivated and fragmented).



Primary Outcome Measures :
  1. Percentage of Seroconversion. [ Time Frame: 21 days (+7 days) after vaccination. ]
    Seroconversion will be defined as HI titers ≥1:40 post-vaccination among subjects with pre-vaccination HI titers <1:10, or as a 4-fold increase in post-vaccination HI titers among subjects with pre -vaccination HI titers ≥ 1:10.

  2. Percentage of Seroprotection [ Time Frame: 21 days (+7 days) after vaccination. ]
    Seroprotection will be defined as post-vaccinations HI titers ≥1:40.

  3. Increase in the geometric mean titers of HI post-vaccination. [ Time Frame: 21 days (+7 days) after vaccination. ]

Secondary Outcome Measures :
  1. Solicited and unsolicited local and systemic adverse reactions. [ Time Frame: Until day 3 post-vaccination. ]


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Ages Eligible for Study:   18 Years to 59 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Kidney Transplant Recipients

Inclusion Criteria:

  • Kidney transplant for more than 30 days;
  • 18 to 59 years of age;
  • Functioning graft (patients without an indication for dialysis at the time, regardless of the glomerular filtration rate);
  • Ability to understand and engage with all procedures required for participation in the study;
  • Willingness to participate documented by the signature of the ICF.

Exclusion Criteria:

  • Double transplant (other organ besides the kidney);
  • Graft loss;
  • HIV infection or malignancy;
  • Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product;
  • Any acute condition and/or fever within 7 days prior to vaccination or axillary temperature greater than 37,8°C on the day of vaccination;
  • Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 21 days after inclusion in the study;
  • Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements;
  • Use of any investigational product within 42 days prior to the inclusion in the study (visit V0) or scheduled to receive it after the inclusion in the study (visit V0);
  • Inclusion in another clinical trial six months prior to vaccination;
  • Denies permission for biological material storage for future research as defined in ICF;
  • Any other condition that, in the investigator's opinion or of his representative, might put at risk the safety/rights of a potential participant or could hamper his/her compliance with the protocol.

Healthy Adults

Inclusion Criteria:

  • Healthy adults of both sexes with 18 to 59 years of age;
  • Be available to participate during the entire study period;
  • Demonstrate intent to participate in the study, documented by signing the IC.

Exclusion Criteria:

  • Evidence of active neurological, cardiac, pulmonary, hepatic or renal disease as clinical history, physical examination and/or laboratory results;
  • Compromised immune system diseases including: diabetes mellitus, cancer (except basal cell carcinoma) and autoimmune diseases;
  • Behavioral, cognitive or psychiatric disease that in the opinion of the principal investigator or his representative physician, affects the participant ability to understand and cooperate with all study protocol requirements;
  • Abusive usage of alcohol or drugs in the past 12 months that has caused medical, professional or family problems, indicated by clinical history;
  • Known systemic hypersensitivity to any component of the vaccine, thimerosal, neomycin, formaldehyde, Triton X-100 (octoxynol 9), egg or chicken protein, any drug or substance which contain the same components of the vaccine or after previous administration of this product;
  • Diagnosis of asthma with a history of hospitalization in the last six months due to illness;
  • Any acute illness and/or fever in the 7 days prior to study inclusion or axillary temperature greater than 37.8 ° C on the day of vaccination (visit V0);
  • Use of corticosteroids (except topical or nasal) or other immunosuppressive drugs within 42 days before study initiation/baseline. It will be considered immunosuppressive dose of corticosteroids the equivalent to a dose ≥10 mg of prednisone per day for over 14 days;
  • Use of anticoagulant medication;
  • Have received live virus vaccine within 28 days or killed virus vaccine in the last 14 days prior to vaccination, or have a scheduled immunization during the first 42 days after receiving the investigational product;
  • History of asplenia;
  • Have received blood products in the past six months, including transfusions or immunoglobulin, or scheduled administration of blood products or immunoglobulin for the first 42 days after vaccination; -Use of any investigational product within 42 days before or after receiving this - study vaccination;
  • Has participated in another clinical trial six months prior to vaccination;
  • Denies permission for biological material storage for future research as defined in ICF;
  • Any other condition that might put in risk the safety/rights of a potential participant or hurdle his/her compliance with this protocol in investigator's opinion or his representative physician.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02104869


Locations
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Brazil
Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Divisão de Clínica Urológica e Divisão de Moléstias Infecciosas
São Paulo, Brazil, 05403-010
Sponsors and Collaborators
Butantan Institute
Fundação de Amparo à Pesquisa do Estado de São Paulo
Investigators
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Study Director: Alexander R Precioso, MD, PhD Instituto Butantan

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Responsible Party: Butantan Institute
ClinicalTrials.gov Identifier: NCT02104869     History of Changes
Other Study ID Numbers: FLU-03-IB
U1111-1155-2836 ( Other Identifier: WHO-UTN )
First Posted: April 4, 2014    Key Record Dates
Last Update Posted: July 21, 2015
Last Verified: July 2015
Keywords provided by Butantan Institute:
Influenza vaccine
Additional relevant MeSH terms:
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Influenza, Human
Orthomyxoviridae Infections
RNA Virus Infections
Virus Diseases
Respiratory Tract Infections
Respiratory Tract Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs