Title

Entolimod on Immunosenescence in Healthy Geriatric Subjects Receiving Influenza Vaccination
A Randomized, Double-Blind, Placebo-Controlled, Single-Administration, Dose-Escalation Study of Entolimod on Immunosenescence in Healthy Geriatric Subjects Receiving Influenza Vaccination
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    Entolimod ...
  • Study Participants

    61
Researchers are evaluating the safety and effectiveness of a single administration of entolimod when administered at the same time as the influenza vaccine (flu vaccine).
Study Started
Oct 30
2019
Primary Completion
Mar 30
2022
Study Completion
Mar 30
2022
Results Posted
Jun 22
2023
Last Update
Jun 22
2023

Drug Entolimod

Intramuscular (IM) single dose administration. Entolimod is provided as a sterile, clear, colorless or slightly yellow liquid for IM injection.

  • Other names: CBLB502

Drug Placebo

Intramuscular (IM) single dose administration, no active ingredient. A matching placebo is provided as a sterile, clear, colorless to slightly yellow liquid for IM injection in prefilled vials that are identical in appearance to the vials containing active drug.

Drug Influenza vaccine

Intramuscular (IM) single dose administration. Fluzone, high-dose split virion influenza virus vaccine, Sanofi Pasteur

  • Other names: Fluzone

Entolimod 1 mcg Experimental

Subjects will receive entolimod as a single dose administered intramuscularly (1mcg)

Entolimod 3 mcg Experimental

Subjects will receive entolimod as a single dose administered intramuscularly (3mcg)

Entolimod 10 mcg Experimental

Subjects will receive entolimod as a single dose administered intramuscularly (10mcg)

Placebo Placebo Comparator

Subjects will receive a placebo as a single dose administered intramuscularly (no study drug); placebo that looks exactly like the study drug, but contains no active ingredient.

Criteria

Inclusion:

Men and women of age 65 years and older at the time of enrollment
Eligible to receive Fluzone High-Dose
Female subjects must be past menopause and not pregnant
No history of anaphylactic reaction to gelatin, neomycin, or other vaccine component
Must not have had the flu vaccine within the past 90 days
Medically stable with no exacerbations or changes in medication regimen for chronic diseases in the past 3 months and no hospitalizations in the past 6 months
Must be able to read/write English in order to provide informed consent and comply with study procedures
Expected to be available for the duration of the study

Exclusion:

Receipt of any other vaccines within the past 30 days prior to enrollment
Acute illness within the last 7 days
History of hypersensitivity to the flu vaccine or its components (including gelatin, formaldehyde, octoxinol, thimerosal, and chicken protein).
History of Guillain Barré syndrome (GBS)
History of bleeding disorders
Medical contraindication to treatment with vaccine as indicated by a history of autoimmune disease, immune deficiency, or hypersensitivity to other vaccines.
Unstable major cardiovascular, renal, endocrine, immunological or hepatic disorder
Systolic blood pressure (SBP) < 110 mmHg or orthostatic hypotension [>20 mmHg fall in SBP or >10 mmHg fall in diastolic blood pressure (DBP) with standing] at the time of screening.
Evidence of an ongoing systemic bacterial, fungal, or viral infection (including upper respiratory tract infections) (within 14 days prior to entolimod administration). Note: Subjects with localized fungal infections of skin or nails are eligible.
Clinical signs of febrile illness (temperature >99.5oF)
Baseline vital signs with ≥Grade 2 abnormalities

Significant cardiovascular disease (e.g., myocardial infarction, arterial thromboembolism, cerebrovascular thromboembolism, venous thromboembolism) within 6 months prior to study drug administration; symptomatic dysrhythmias or unstable dysrhythmias requiring medical therapy; angina requiring therapy; symptomatic peripheral vascular disease; New York Heart Association Class 3 or 4 congestive heart failure; or uncontrolled Grade ≥3 hypertension (diastolic blood pressure ≥100 mmHg or systolic blood pressure ≥160 mmHg) despite antihypertensive therapy.

o Significant screening ECG abnormalities, including unstable cardiac arrhythmia requiring medication, atrial fibrillation, 2nd-degree atrioventricular (AV) block type II, 3rd degree AV block, or Grade ≥2 bradycardia (within 14 days prior to entolimod administration).

Inadequate hepatic function (within 14 days prior to entolimod administration):

Serum alanine aminotransferase (ALT) ≥3 × upper limit of normal (ULN) (Grade ≥1).
Serum aspartate aminotransferase (AST) ≥3 × ULN (Grade ≥1)
Serum alkaline phosphatase (ALP) ≥5 × ULN (Grade ≥2)
Serum bilirubin ≥1.5 × ULN (Grade ≥1)

Positive antiviral serology:

Positive hepatitis C virus (HCV) antibody or positive HCV ribonucleic acid (RNA) by quantitative PCR.
Positive hepatitis B surface antigen (HBsAg) and negative hepatitis B core (HBc) antibody or undetectable hepatitis B (HBV) deoxyribonucleic acid (DNA) by quantitative polymerase chain reaction (PCR) testing.
Positive human immunodeficiency virus (HIV) antibody.
Use of medication that might interact with the flu vaccine including (but not limited to) specifically: aminopyrine, phenytoin sodium, theophylline, and warfarin sodium.
Any ongoing treatment with immunosuppressive or immune-stimulant therapy
Ongoing use of systemic corticosteroids.
Blood or blood products given within the three months prior to vaccination and two months after vaccination
Current and/or expected receipt of chemotherapy, radiation therapy or any other cytotoxic or immunosuppressive therapy [i.e. more than 10 mg of prednisone given daily or on alternative days for 2 weeks or more in the past 3 months]
Receipt of another investigational pharmaceutical product within 60 days of treatment
Diagnosis of Parkinson's Disease, previous stroke, or significant cognitive impairment (defined as MMSE <20)
Other concerns that in the opinion of the PI would preclude a subject from participating in study procedures or from completing the study.

Summary

Entolimod 1 mcg

Entolimod 3 mcg

Entolimod 10 mcg

Placebo

All Events

Event Type Organ System Event Term Entolimod 1 mcg Entolimod 3 mcg Entolimod 10 mcg Placebo

Change in Anti- A/H1N1 Antibody Titer

Change of the anti- A/H1N1 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month.

Entolimod 1 mcg

65.0
titer (Mean)
Standard Deviation: 137.23

Entolimod 3 mcg

73.2
titer (Mean)
Standard Deviation: 111.43

Entolimod 10 mcg

88.4
titer (Mean)
Standard Deviation: 123.74

Placebo

20.3
titer (Mean)
Standard Deviation: 48.56

Change in Anti-A/H3N2 Antibody Titer

Change of the anti-A/H3N2 influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month.

Entolimod 1 mcg

58.4
titer (Mean)
Standard Deviation: 90.57

Entolimod 3 mcg

81.6
titer (Mean)
Standard Deviation: 138.59

Entolimod 10 mcg

28.0
titer (Mean)
Standard Deviation: 30.98

Placebo

39.1
titer (Mean)
Standard Deviation: 79.84

Adverse Events

The number of adverse events (AEs) related to dose limiting toxicities (DLTs); laboratory abnormalities; oxygen saturation and vital sign changes, and adverse electrocardiogram (ECG) findings for 1 year

Entolimod 1 mcg

39.0
adverse event

Entolimod 3 mcg

27.0
adverse event

Entolimod 10 mcg

23.0
adverse event

Placebo

26.0
adverse event

Change in Anti-B Antibody Titer

Change of the anti-B influenza virus strains serum circulating antibodies (as assessed using hemagglutination inhibition (HAI) assay) levels from baseline to 1 month..

Entolimod 1 mcg

11.6
titer (Mean)
Standard Deviation: 18.93

Entolimod 3 mcg

28.3
titer (Mean)
Standard Deviation: 67.06

Entolimod 10 mcg

45.0
titer (Mean)
Standard Deviation: 56.48

Placebo

10.0
titer (Mean)
Standard Deviation: 18.26

Change in Grip Strength

Measured by a grip dynamometer as reported in units of pounds.

Entolimod 1 mcg

4.6
pounds (Mean)
Standard Deviation: 17.20

Entolimod 3 mcg

1.1
pounds (Mean)
Standard Deviation: 4.87

Entolimod 10 mcg

Placebo

-0.7
pounds (Mean)
Standard Deviation: 2.68

Change in 6-minute Walk Test

Distance a subject is able to walk over 6 minutes over a hard flat surface

Entolimod 1 mcg

5.1
meters (Mean)
Standard Deviation: 25.64

Entolimod 3 mcg

11.0
meters (Mean)
Standard Deviation: 36.39

Entolimod 10 mcg

4.5
meters (Mean)
Standard Deviation: 9.83

Placebo

-15.8
meters (Mean)
Standard Deviation: 66.73

Change in Body Mass Index (BMI)

Subject's BMI calculated as weight in kilograms divided by height in meters squared. Uses measurements of height and weight obtained during study (with appropriate metric conversions)

Entolimod 1 mcg

0.3
kg/m^2 (Mean)
Standard Deviation: 0.58

Entolimod 3 mcg

0.1
kg/m^2 (Mean)
Standard Deviation: 0.67

Entolimod 10 mcg

-0.2
kg/m^2 (Mean)
Standard Deviation: 0.97

Placebo

0.1
kg/m^2 (Mean)
Standard Deviation: 0.57

Time of Onset for Upper-respiratory Infections

Subject self-reporting of the number of days to develop an upper-respiratory infection

Entolimod 1 mcg

152.5
days (Mean)
Standard Deviation: 127.4

Entolimod 3 mcg

302.3
days (Mean)
Standard Deviation: 112.4

Entolimod 10 mcg

339.0
days (Mean)
Standard Deviation: 0

Placebo

157.0
days (Mean)
Standard Deviation: 114.3

Upper Respiratory Infections

The total number of subjects to self-report an upper-respiratory infection

Entolimod 1 mcg

Entolimod 3 mcg

Entolimod 10 mcg

Placebo

Change in Frailty

Change in self-reported 5 items frail scale. Frail scale scores range from 0-5, 1 point for each component, 0 = best 5 = worst (robust=0 points; pre-frail=0-1 points; frail 3-5 points)

Entolimod 1 mcg

-0.1
score on a scale (Mean)
Standard Deviation: 0.4

Entolimod 3 mcg

-0.2
score on a scale (Mean)
Standard Deviation: 0.6

Entolimod 10 mcg

-0.2
score on a scale (Mean)
Standard Deviation: 0.6

Placebo

0.1
score on a scale (Mean)
Standard Deviation: 0.5

Total

61
Participants

Age, Continuous

72.6
years (Mean)
Standard Deviation: 6.01

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Entolimod 1 mcg

Entolimod 3 mcg

Entolimod 10 mcg

Placebo