About this trial
This protocol describes a clinical trial to develop and validate a Controlled Human Infection Model (CHIM) for influenza A/Arkansas/08/2020 (pH1N1). The study is designed to determine the optimal infectious dose of the pH1N1 challenge strain for use in future clinical trials evaluating influenza countermeasures. The study will enroll and challenge adult volunteers with the pH1N1 influenza virus challenge or sham inoculations. Given the adaptive design of this trial, the potential number of participants can vary. Depending on the pathway recommended by the PSRT and followed in the Trial Schema, the study population can range from around 30 to 99. The anticipated final sample size will be approximately 90 receiving pH1N1 challenge product plus and 6 persons receiving a sham inoculation. Participants will be pre-screened for health and for serological HAI antibody titers of \</1:40 against the challenge strain. Eligible participants will be enrolled sequentially into challenge cohorts and will be randomly assigned to receive a single dose of either sham inoculation or the interventional study product at a dose between 10\^6 to 10\^7 TCID50 (or 10\^5 TCID50 if needed). Dose titration will be conducted under an adaptive escalation schedule whereby dosing will start at 10\^6 TCID50 and escalate to the next dose if a pre-determined symptomatic influenza attack rate and clinical symptom score thresholds are not met and if the dose is determined to be safe with no pre-defined halting criteria being met.
The primary objectives of this study are to determine the optimal infectious dose of a pH1N1 viral challenge to cause laboratory-confirmed clinical influenza and to assess the safety profile of pH1N1 viral challenge.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Provides signed and dated informed consent form prior to the initiation of any trial procedures.
Able to understand and agrees to comply with all planned trial procedures and to be available for all study visits.
Age >/= 18 and </= 55 years at time of enrollment.
Must agree to collection of venous blood and nasal absorption specimens per protocol and enrollment in DMID 19-0025 biorepository protocol for use of residual/repository research blood specimens.
Disqualifiers
Able to take oral medication and willing to receive oseltamivir phosphate and/or baloxavir marboxil as part of the study.
Participants of childbearing potential* agree to the use of acceptable forms of contraception** for at least 30 days prior to enrollment and agree to use such a method during study participation.
Non-smoker or non-habitual smoker* of tobacco, e-cigarettes, or marijuana
No self-reported or known history of alcoholism within the 2 years prior to enrollment.
Trial design
Parallel
Treatments tested in this trial
A/Arkansas/08/2020 (pH1N1)
Biological/VaccineGMP-grade, cell-based influenza A (pH1N1) virus (Lot #24-005), derived via reverse genetics for use in controlled human infection studies.
Sham/Diluent (1X SPG+Arg+Gel)
Other interventionSterile diluent containing 1X Sucrose Phosphate Glutamate (SPG), 1% arginine, and 1% hydrolyzed gelatin, used as a sham comparator in the human challenge trial.
Treatment groups
12
Treatment groupsSee each treatment group below.
Trial outcomes
Primary outcomes
Number and percentage of participants reporting a related SAE at any time from the time of the first challenge inoculation.
Number and percentage of participants reporting any related AE from the time of the first challenge inoculation.
Number and percentage of participants with symptomatic influenza virus infection.
"Symptomatic influenza virus infection" is defined as meeting both of these criteria: 1. Viral shedding detected in NP swab specimens by qualitative RT-PCR; and 2. A cumulative symptom score \>/=6 using a Modified Jackson Score.
Number of related adverse events (AE) reported from the time of the first challenge inoculation.
Secondary outcomes
Duration of viral shedding quantified by number of days of qualitative RT-PCR influenza detections in NP swab samples
Using qualitative RT-PCR by dose and study day
Geometric Mean Fold Rise (GMFR).
Geometric Mean Titers (GMTs).
HAI and MN antibody geometric mean titers (GMTs) at baseline.
Sponsors and contacts
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