EBOla Post-Exposure Prophylaxis

Trial statusNot yet recruiting
Trial phasePhase 3
Trial typeInterventional
Biological sexAll
AgeNot listed
SponsorANRS, Emerging Infectious Diseases

About this trial

EBO-PEP is a multicentre, multi-epidemic, phase III, comparative, controlled, randomised, strict superiority trial in two unblinded parallel arms.

The trial will be open during EVD epidemics and will recruit asymptomatic participants at high risk of developing EVD.

Participants will be randomized (1:1) into one of two trial arms:

* Arm 1 (ERV): Ervebo D0 (72 million PFU IM) * Arm 2 (ERV+IMZ): Ervebo D0 (72 million PFU IM) + Inmazeb IV (150 mg/kg) D0 + Ervebo D56 (revaccination)

Definition of high-risk:

Direct contact with a person with EBOV PCR-confirmed EVD with diarrhea, vomiting or external bleeding ("wet symptoms"), or with their body fluids; Direct contact with the dead body of a person with confirmed or probable EVD; Needlestick with a syringe contaminated by the blood of a person with confirmed or probable EVD; Or a child born to or breastfed by an individual with EVD

Trial follow-up All participants are monitored daily for a minimum of 21 days.

Some visits are conducted in person at the investigation site, also called the Post-Exposure Prophylaxis (PEP) center:

* at Day 5, Day 10, and Day 21 for the ERV arm, * at Day 5, Day 10, Day 21, and Day 56 for the ERV+IMZ arm. Other visits are conducted at home or by phone, in collaboration with the Ministry of Health's surveillance team.

Participants in the ERV+IMZ arm have an in-person visit at Day 56 to be revaccinated with the Ervebo vaccine to compensate for potential inhibition of the vaccine response when Ervebo is administered simultaneously with Inmazeb.

Participants in the ERV arm have a phone visit at Day 56. For all participants, a phone visit is scheduled at Day 60. It corresponds to the last visit for all trial participants.

Follow-up in Case of Hospitalisation In case of clinical signs suggestive of EVD, participants enter the suspected case management pathway at the Ebola Treatment Center (ETC).

If EVD is confirmed by EBOV PCR, participants are allowed at the ETC, and their study samples are discontinued. They continue to be followed by the research team, and daily data are collected throughout their stay at the ETC until they are discharged alive or deceased. The day of discharge from the ETC marks the end of follow-up in the study for these participants.

Of note, participants in the ERV+IMZ arm who have confirmed EVD are not revaccinated at day 56.

Of note, participants in the ERV+IMZ arm who have confirmed EVD are not revaccinated at day 56.

If EVD is not confirmed, participants continue to be followed up by the PEP center according to the protocol.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Last high-risk contact within the last 5 days

No sign or symptoms of EVD

Signed and dated informed consent from participants over the age of majority to participate in the trial or from a representative of parental authority for minor participants.

History of vaccination with Ervebo or any other EVD vaccine within the last 5 years (self-reported by the participant)

Disqualifiers

None

Trial design

Design model

Parallel

Treatments tested in this trial

  • Ervebo

    Biological/Vaccine

    Ebola Zaire vaccine (rVSV∆G-ZEBOV-GP, live, attenuated) ≥ 72 million PFU, composed of the Indiana strain of recombinant vesicular stomatitis virus (rVSV) with a deletion of the envelope glycoprotein (G) of VSV replaced by the surface glycoprotein (GP) of the Kikwit 1995 strain of Ebola virus Zaire (ZEBOV)

  • Inmazeb

    Biological/Vaccine

    Inmazeb (REGN-EB3), developed by Regeneron, is a cocktail of 3 neutralising humanised mAbs directed against 3 epitopes of the EBOV GP (atoltivimab, maftivimab and odesivimab). It is indicated for the treatment of EVD in adult patients (including pregnant women) and in children, including neonates born to mothers with confirmed EVD.

Treatment groups

160 Participants
are divided into 2 treatment groups
Group A: Ervebo vaccine aloneActive comparator 1 intervention
Group B: Ervebo + InmazebExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Proportion of participants with EBOV PCR-confirmed symptomatic EVD

EVD rate

Time frame
Between Day 1 and Day 21

Secondary outcomes

1

Proportion of participants with EBOV PCR-confirmed symptomatic EVD

EVD rate

Time frame
Between Day 1 and Day 60
2

Safety and tolerance

Proportion of participants with a grade 3 or higher Adverse Event

Time frame
Between Day 1 and Day 60
3

Severity of EVD

Proportion of participants admitted to the Ebola Treatment Center with confirmed EVD meeting at least one of the following criteria: * Nucleoprotein cycle threshold (NP Ct) \< 22 * KDIGO stage 3 * ASAT or ALAT \> 5N * External bleeding * AVPU score * NEWS2 score ≥ 7

Time frame
Between Day 1 and Day 60
4

Proportion of participants with asymptomatic EVD

Rate of PCR-confirmed EVD

Time frame
Between Day 1 and Day 21

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

ANRS, Emerging Infectious Diseases

Lead sponsor

Alliance for International Medical Action

Collaborator

Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG)

Collaborator

Medecins Sans Frontieres, Netherlands

Collaborator

Barcelona Institute for Global Health

Collaborator

University of Bordeaux

Collaborator

INSERM UMR S 1136

Collaborator

Agence Nationale de Sécurité Sanitaire de Guinée (ANSS)

Collaborator

National Institute for Biomedical Research DRC

Collaborator

Cheikh Anta Diop University, Senegal

Collaborator

PACCI Program

Collaborator

The PANdemic preparedness plaTform for Health and Emerging infectious Response

Collaborator

University of Sierra Leone

Collaborator

National Public Health Institute of Liberia

Collaborator

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