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Trial registered on ANZCTR
Registration number
ACTRN12623001249640
Ethics application status
Approved
Date submitted
3/11/2023
Date registered
1/12/2023
Date last updated
1/12/2023
Date data sharing statement initially provided
1/12/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
Immune response to a third COVID-19 vaccine dose in people with multiple sclerosis receiving B cell-depleting therapy
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Scientific title
Immunogenicity of a third COVID-19 vaccine dose in people with multiple sclerosis receiving B cell-depleting therapy
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Secondary ID [1]
310892
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multiple Sclerosis
331945
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Immunosuppression
331946
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COVID-19 vaccination
331948
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Condition category
Condition code
Neurological
328676
328676
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0
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Multiple sclerosis
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Infection
328677
328677
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0
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Other infectious diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Trial is non-interventional - participants will be recruited who are receiving ongoing treatment for multiple sclerosis of ocrelizumab monoclonal antibody by intravenous infusion (600 mg, 6 monthly) as part of routine care. Participants are eligible if they have received an infusion within 12 months of the 3rd COVID-19 vaccine dose (see inclusion criteria).
Participants will receive a COVID-19 mRNA vaccine dose (BNT162b2 Pfizer or mRNA1273 Moderna) as third dose as part of routine care, i.e. a single dose of 30ug/0.3mL or 50ug/0.25mL. Time interval since administration of second dose is not a determinant of eligibility.
Participants will be required to provide a peripheral blood sample immediately prior to vaccination, and a second peripheral blood sample four weeks after vaccination (requiring a return visit to the centre for this purpose).
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Intervention code [1]
327316
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Diagnosis / Prognosis
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Comparator / control treatment
Trial is non-interventional - participants will be recruited who are receiving ongoing treatment for multiple sclerosis of natalizumab monoclonal antibody by intravenous infusion (300 mg, monthly) as part of routine care. Participants are eligible if they have received an infusion within 12 months of the 3rd COVID-19 vaccine dose (see inclusion criteria).
Participants will receive a COVID-19 mRNA vaccine dose (BNT162b2 Pfizer or mRNA1273 Moderna) as third dose as part of routine care, i.e. a single dose of 30ug/0.3mL or 50ug/0.25mL. Time interval since administration of second dose is not a determinant of eligibility.
Participants will be required to provide a peripheral blood sample immediately prior to vaccination, and a second peripheral blood sample four weeks after vaccination (requiring a return visit to the centre for this purpose).
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Control group
Active
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Outcomes
Primary outcome [1]
336481
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Any change in the proportion of participants who achieve effective neutralisation of live SARS-CoV-2 A.2.2, where effective neutralisation is defined as equal to or greater than 20.2% of mean IC50 of first-wave convalescent patients
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Assessment method [1]
336481
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Live virus neutralisation by post-vaccination serum (IC50)
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Timepoint [1]
336481
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Four weeks post third COVID-19 vaccine dose
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Primary outcome [2]
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Any change in the proportion of participants who achieve effective neutralisation of live SARS-CoV-2 omicron BA.5, where effective neutralisation is defined as equal to or greater than 20.2% of mean IC50 of first-wave convalescent patients
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Assessment method [2]
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Live virus neutralisation by post-vaccination serum (IC50)
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Timepoint [2]
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Four weeks post third COVID-19 vaccine dose
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Secondary outcome [1]
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T cell response
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Assessment method [1]
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IFNg ELISpot (spot forming units following 18h stimulation of peripheral blood mononuclear cells with overlapping (11aa) peptides derived from the full-length SARS-CoV-2 (Ancestral) Spike protein
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Timepoint [1]
428537
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Change in response (immediately) pre to (4 weeks) post third COVID-19 mRNA vaccine dose
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Secondary outcome [2]
428538
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Post-vaccination anti-SARS-CoV-2 (Ancestral) Spike IgG
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Assessment method [2]
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Serum titre of anti-SARS-CoV-2 (Ancestral) Spike IgG (in-house, full-length Spike protein).
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Timepoint [2]
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4 weeks post 3rd COVID-19 mRNA vaccine dose
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Secondary outcome [3]
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Exploratory - Association of Peripheral Blood Immune Phenotype with antibody response to vaccination
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Assessment method [3]
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Multiparameter flow cytometry of peripheral blood mononuclear cells
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Timepoint [3]
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Immediately prior to third COVID-19 mRNA vaccine dose
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Secondary outcome [4]
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Post-vaccination anti-SARS-CoV-2 (Ancestral) Spike receptor-binding domain IgG
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Assessment method [4]
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Elecsys - cobas diagnostic system
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Timepoint [4]
429010
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Four weeks post 3rd COVID-19 mRNA vaccine dose
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Secondary outcome [5]
429011
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Post-vaccination anti-SARS-CoV-2 (Ancestral) Spike IgM
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Assessment method [5]
429011
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Serum titre of anti-SARS-CoV-2 (Ancestral) Spike IgM (in-house, full-length Spike protein).
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Timepoint [5]
429011
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4 weeks post 3rd COVID-19 mRNA vaccine dose
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Secondary outcome [6]
429012
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Post-vaccination anti-SARS-CoV-2 (Ancestral) Spike IgA
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Assessment method [6]
429012
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Serum titre of anti-SARS-CoV-2 (Ancestral) Spike IgA (in-house, full-length Spike protein).
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Timepoint [6]
429012
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4 weeks post 3rd COVID-19 mRNA vaccine dose
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Eligibility
Key inclusion criteria
-Ability to understand requirements of the study, provide written informed consent and attend follow-up
-Age 18+ years
-Diagnosis of relapsing-remitting MS (RRMS), primary progressive MS (PPMS) or secondary progressive MS (SPMS)
-Receiving ocrelizumab or natalizumab as primary treatment with the last dose received within 24 months of vaccine administration
-Have elected to receive a third COVID-19 vaccine dose with a Therapeutic Goods Administration (TGA) approved mRNA-platform vaccine
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-Unable to provide written informed consent
-Acutely ill at the time of screening
-Is pregnant
-Known or suspected allergy or history of anaphylaxis to the vaccine or its excipients
-Has significant, uncontrolled disease or comorbidity (endocrine, cardiovascular, gastrointestinal, hepatic, renal, respiratory)
-Immunodeficiency (primary or secondary to infection e.g. HIV or cancer)
-Receiving systemic immunosuppressive agents including steroids - other than those required as per standard ocrelizumab or natalizumab treatment protocol
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
11/11/2021
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Date of last participant enrolment
Anticipated
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Actual
31/08/2022
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Date of last data collection
Anticipated
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Actual
30/09/2023
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Sample size
Target
55
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Accrual to date
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Final
53
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
315150
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Charities/Societies/Foundations
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Name [1]
315150
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Health Services Charitable Gifts Board
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Address [1]
315150
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Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000
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Country [1]
315150
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Australia
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Primary sponsor type
Hospital
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Name
Royal Adelaide Hospital
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Address
1 Port Road, Adelaide, South Australia 5000
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Country
Australia
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Secondary sponsor category [1]
317168
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None
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Name [1]
317168
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Address [1]
317168
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Country [1]
317168
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314086
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [1]
314086
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Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000
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Ethics committee country [1]
314086
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Australia
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Date submitted for ethics approval [1]
314086
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11/08/2021
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Approval date [1]
314086
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20/08/2021
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Ethics approval number [1]
314086
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15083
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Summary
Brief summary
Evaluate immunity provided to people with multiple sclerosis (pwMS) receiving B cell depleting therapy with ocrelizumab by a third mRNA-platform COVID-19 vaccine dose. Immunity was evaluated by comparison with pwMS receiving treatment the non-depleting drug natalizumab and through comparison against a correlate of real-world protection against infection. Peripheral blood immune cells were analysed in order to describe how the altered immune system in pwMS receiving ocrelizumab is associated with vaccine response, and to identify potential predictors of immune response to stratify poor responders for antiviral prophylaxis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
130362
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A/Prof Pravin Hissaria
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Address
130362
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Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000
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Country
130362
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Australia
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Phone
130362
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+6108 8222 3489
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Fax
130362
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Email
130362
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[email protected]
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Contact person for public queries
Name
130363
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Pravin Hissaria
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Address
130363
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Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000
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Country
130363
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Australia
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Phone
130363
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+6108 8222 3489
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Fax
130363
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Email
130363
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[email protected]
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Contact person for scientific queries
Name
130364
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Griffith Perkins
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Address
130364
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Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia 5000
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Country
130364
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Australia
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Phone
130364
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+610883130138
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Fax
130364
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Email
130364
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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