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Completed

NCT Number: NCT03961555

Comparison of SYN023 to Human Rabies Immune Globulin in Post Exposure Prophylaxis of Rabies

This is a Phase 2b, double blinded, randomized study of SYN023 compared to HyperRab® (a licensed Rabies immune globulin from human sources, HRIG) for the prevention of rabies as part of post-exposure prophylaxis (PEP). The trial will enroll sequentially two different risk substrata of WHO Category 3 rabies exposure which are Low Risk Group (LRG) and Normal Risk Group (NRG). The enrollment will be stepwise while subject's data will be reviewed by data and safety monitoring board (DSMB) to confirm the safety and permit for next enrollment. Besides, rabies vaccine would be administered within 75 minutes after Study Drug in each group.

This trial is proposed to further the licensure of SYN023 to provide an effective PEP alternative available to those exposed persons who need such a product. A placebo-controlled rabies trial is unethical thus HRIG is selected as the control group. Rabies immune globulin from equine and human sources (HRIG) have been evaluated in many trials and HRIG is the standard of care in the United States.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Baguio General Hospital and Medical Center, Baguio City, Benguet, Philippines

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

(Low Risk Group):

Subjects must meet all of the following criteria at the time of subject ID assignment:

  • History of dog, cat, mongoose, fox, ferret, skunk, bat or raccoon bite to trunk, leg, ankle or foot, or lick or scratch with, or of broken skin or mucous membrane saliva or neural tissue contamination, unprotected physical bat contact, scratch or saliva contamination of the head or neck without broken skin all ≤ 54 hours
  • Has completed the written informed consent process and signed informed consent document
  • Males and females
  • Is age equal or more than 18 years on Study Day 1
  • Agrees to stay in contact with the study site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study
  • Lives within 2 hour journey by available transportation to study center
  • For female subjects: agrees to avoid pregnancy from Study Day 1 through Study Day 121. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, intrauterine device (IUD), or the combination of a condom or diaphragm with spermicide

Inclusion criteria

(Normal Risk Group)

Subjects must meet all of the following criteria at the time of subject ID assignment:

  • History of dog, cat, mongoose, fox, ferret, skunk, bat or raccoon bite to any body part, lick or scratch with, or of broken skin, mucous membrane saliva or neural tissue contamination, or unprotected physical bat contact all ≤ 54 hours from post exposure prophylaxis (PEP)
  • Has completed the written informed consent process and signed informed consent document.
  • Males and females
  • Is age equal or more than 18 years on Study Day 1
  • Agrees to stay in contact with the study site for the duration of the study, provide updated contact information as necessary, and has no current plans to move from the study area for the duration of the study
  • Lives within 2 hour journey by available transportation to study center
  • For female subjects: agrees to avoid pregnancy from agrees to avoid pregnancy from Study Day 1 through Study Day 121. Women physically capable of pregnancy (not sterilized and still menstruating or within 1 year of the last menses if menopausal) in sexual relationships with men must use an acceptable method of avoiding pregnancy during this period. Acceptable methods of avoiding pregnancy include a sterile sexual partner, sexual abstinence (not engaging in sexual intercourse), hormonal contraceptives (oral, injection, transdermal patch, or implant), vaginal ring, intrauterine device (IUD), or the combination of a condom or diaphragm with spermicide

Exclusion criteria

Subjects must have had none of the following at the time of subject ID assignment:

  • Clinical evidence of rabies infection
  • Category 3 exposure > 54 hours before Study Drug receipt
  • History or serological evidence of previous rabies vaccination
  • Previous receipt of equine or human rabies globulin
  • History of hypersensitivity reaction to equine or human immunoglobulin.
  • Received immunoglobulin or blood products within 42 days before Study Day 1
  • Received any investigational drug therapy or investigational vaccine within 60 days before Study Day 1
  • Planned participation in any other investigational study during the study period.
  • Receiving systemic immunosuppressant medication such as systemic corticosteroids but not limited to systemic corticosteroids
  • History or laboratory evidence of any past, present, or possible immunodeficiency state including but not limited to any laboratory indication of HIV infection
  • Previous medical history that may compromise the safety of the subject in the study according to the opinion of the principal investigator
  • History or evidence on physical examination of any systemic disease or any acute or chronic illness that, in the opinion of the investigator, may interfere with the evaluation of the safety or activity of SYN023
  • Pregnancy (results of the urine pregnancy test MUST be known before enrollment)

Treatment and study plan

SYN023

Biological

it is administered by direct injection into the wound or by subcutaneous or intramuscular injection when this is not possible

HRIG (HyperRab)

Biological

it is administered by direct injection into the wound or by subcutaneous or intramuscular injection when this is not possible

Rabies vaccine

Biological

it should be administered in deltoid muscle

Other names: RabAvert, Rabipur

Primary outcomes

  1. Rabies Virus Neutralizing Activity (RVNA) of Geometric Mean Concentration (GMC) at Study Day 8

    Time frame: Day 8

    Rabies Virus Neutralizing Activity (RVNA) was assessed using Rapid Fluorescent Focus Inhibition Test (RFFIT).

  2. Rabies Virus Neutralizing Activity (RVNA) of Geometric Mean Concentration (GMC) at Study Day 99

    Time frame: Day 99

    Rabies Virus Neutralizing Activity (RVNA) was assessed using Rapid Fluorescent Focus Inhibition Test (RFFIT).

  3. Percentage of Participants With Rabies Virus Neutralizing Activity (RVNA) ≥0.5 IU/mL at Study Day 99

    Time frame: Day 99

    Rabies Virus Neutralizing Activity (RVNA) was assessed using Rapid Fluorescent Focus Inhibition Test (RFFIT).

  4. Cases of Probable and Confirmed Rabies

    Time frame: Day 1 to Day 365

    Case Classification Human Rabies

    • Suspected: A case that is compatible with the clinical case definition
    • Probable: A suspected case (above) plus history of contact with a suspected rabid animal.
    • Confirmed: A suspected case that is laboratory-confirmed.

Secondary outcomes

  1. Rabies Virus Neutralizing Activity (RVNA) of Geometric Mean Concentration (GMC) at Study Day 4

    Time frame: Day 4

    Rabies Virus Neutralizing Activity (RVNA) was assessed using Rapid Fluorescent Focus Inhibition Test (RFFIT).

  2. Area Under the Efficacy Curve for the Geometric Mean Concentration (GMC) of Rabies Virus Neutralizing Activity (RVNA)

    Time frame: Day 1 to Day 15

    Rabies Virus Neutralizing Activity (RVNA) was assessed using Rapid Fluorescent Focus Inhibition Test (RFFIT). Area Under the Efficacy Curve for the GMC of RVNA from Study Day 1 to Day 15 after administration (AUEC1-15)

Other outcomes

  1. Maximum Observed Serum Concentration (Cmax)

    Time frame: Day 1 to Day 99

    The Cmax of CTB011 and CTB012 derived from non-compartmental analysis.

  2. Time of Maximum Observed Serum Concentration (Tmax)

    Time frame: Day 1 to Day 99

    The Tmax of CTB011 and CTB012 derived from non-compartmental analysis.

  3. Area Under the Serum Concentration-time Curve From Time 0 on Study Day 1 to Last Time Point (AUC1-t)

    Time frame: Day 1 to Day 99

    The Area Under the Serum Concentration-time Curve From Time 0 on Study Day 1 to Last Time Point (AUC1-t) of CTB011 and CTB012 derived from non-compartmental analysis.

  4. Area Under the Serum Concentration-time Curve From Time 0 on Study Day 1 to Infinity (AUC1-inf)

    Time frame: Day 1 to Day 99

    The Area Under the Serum Concentration-time Curve From Time 0 on Study Day 1 to Infinity (AUC1-inf) of CTB011 and CTB012 derived from non-compartmental analysis.

  5. Terminal Half-life (t1/2)

    Time frame: Day 1 to Day 99

    The t1/2 of CTB011 and CTB012 derived from non-compartmental analysis.

  6. Terminal Elimination Rate Constant (λz)

    Time frame: Day 1 to Day 99

    The λz of CTB011 and CTB012 derived from non-compartmental analysis.

  7. Apparent Clearance (CL/F)

    Time frame: Day 1 to Day 99

    The CL/F of CTB011 and CTB012 derived from non-compartmental analysis.

  8. Apparent Volume of Distribution (Vd/F)

    Time frame: Day 1 to Day 99

    The Vd/F of CTB011 and CTB012 derived from non-compartmental analysis.

  9. Anti-CTB011 and Anti-CTB012 Antibody

    Time frame: Day 1 to Day 99

    Count of Subjects With Antibodies (CTB011 and CTB012) Status by Time Point

  10. Number of Subjects With at Least 1 Adverse Event

    Time frame: Solicited adverse events: Day 1 to day 8, Unsolicited adverse events:Day 1 to day 43

    The number of subjects with at least 1 unsolicited or solicited adverse events. Solicited adverse events: subjects were specifically asked about local adverse events (injection site pain, tenderness, redness swelling, warmth, skin disruption, regional lymphadenopathy) and non-local adverse events (headache, arthralgia, myalgia, rash, pruritus, urticaria, dyspnea, chest pain, cough, fever, chills) up to Study Day 8. Unsolicited adverse events were collected from Study Day 1 to Study Day 43.

Sponsors and collaborators

Lead sponsor

Synermore Biologics Co., Ltd.

Industry

Collaborators

  • Synermore Biologics USA Limited

Registry information

Official study title

A Phase 2b Randomized Blinded Study to Evaluate SYN023 Compared to Human Rabies Immune Globulin in Post Exposure Prophylaxis of Rabies in Adults With Different Rabies Exposure Risks

Acronym: ARPEP

Important dates

Study start
2019
Primary completion
2021
Study completion
2021
First posted
May 23, 2019
Registry last updated
Jun 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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