Infectious Disease
Live biotherapeutics may be paradigm shift in C. difficile GIs have been waiting for
September 23, 2023
4 min read
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Nearly half a million Americans are diagnosed with Clostridioides difficile infection each year. Although often treated with antibiotics, C. difficile recurrence is possible. However, recently developed therapies may change this paradigm.
Within the past year, the FDA has approved live biotherapeutics, Rebyota and Vowst, for the prevention of recurring C. difficile infection in patients who failed treatment with antibiotics. Additionally, Zinplava (zalutumumab, Merck), a fully humanized, monoclonal antibody, is being compared with fecal microbiota transplantation for the prevention of C. diff in patients with inflammatory bowel disease.
Nearly half a million Americans are diagnosed with Clostridioides difficile infection each year. In case you missed any of it, Healio recaps the latest on these preventative therapies and what clinicians should know about them.
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These preventative strategies are being studied in other gastrointestinal and non-GI conditions as well as how they interact with medications. Healio has closely followed these clinical trials throughout the year, reporting on breakthroughs and setbacks alike. In case you missed any of it, Healio recaps the latest on these preventative therapies and what clinicians should know about them.
VIDEO: ‘Robust’ data analysis establishes safety of Rebyota for recurrent C. difficile
In a Healio video exclusive, Lindy Bancke, PharmD, outlines results from the “largest safety evaluation to date” for Rebyota, the first FDA-approved, microbiota-based treatment for prevention of recurrent Clostridioides difficile infection.
“There is a significant patient, health care provider and financial burden to address the continued dysbiosis, or disruption of the gut microbiome, and to reduce the associated risks that come with that,” Bancke, vice president of global clinical operations in the U.S. at Ferring Pharmaceuticals, said. “Rebyota is the first and only single-dose FDA-approved microbiota-based treatment for the prevention of recurrence of C. diff infection in individuals 18 years of age and older following antibiotic treatment.” Watch video.
VIDEO: Low risk for congestive heart failure exacerbation with Zinplava for C. difficile
In this Healio video exclusive, Paul Feuerstadt, MD, FACG, AGAF, recaps results from a real-world analysis of Zinplava for prevention of recurrent Clostridioides difficile infection in patients with congestive heart failure.
“C. difficile is a major problem in the United States,” Feuerstadt, assistant clinical professor of medicine at Yale University School of Medicine and attending gastroenterologist at PACT Gastroenterology Center, said. “It is estimated about a half a million people will be diagnosed with this infection on an annual basis. Watch video.
VIDEO: No change in concomitant medications after Rebyota for recurrent C. difficile, IBD
Treatment with Rebyota did not affect concurrent medication use in patients with inflammatory bowel disease and recurrent Clostridioides difficile infection, Jessica R. Allegretti, MD, MPH, explains in this Healio video.
Allegretti presented data at Digestive Disease Week on safety outcomes and concomitant medication changes after treatment with Rebyota (fecal microbiota, live-jslm/RBX2660, Ferring Pharmaceuticals) — the first microbiota-based, live biotherapeutic product approved by the FDA to prevent recurrent C. difficile infection in adults after antibiotic treatment. Watch video.
VIDEO: Rebyota safe, effective when given via colonoscopy for recurrent C. difficile
In a Healio video exclusive, Paul Feuerstadt, MD, FACG, AGAF, discusses data showing consistent safety and efficacy of Rebyota when administered via colonoscopy for prevention of recurrent Clostridioides difficile infection.
“C. difficile is a major problem for people in the United States; it is the most common health care-associated infection,” Feuerstadt, assistant clinical professor of medicine at the Yale University School of Medicine and attending gastroenterologist at the PACT Gastroenterology Center, said. “If we treat patients with totally correct antimicrobials, up to 35% of them will recur after initial infection. After that, up to 45% and thereafter up to 60%. This is where treatments called microbiota restoration therapies fit in.” Watch video.
FDA approves Vowst as first oral microbiota biotherapeutic for recurrent C. difficile
The FDA has approved Vowst, the first orally administered fecal microbiota product indicated for the prevention of recurrent Clostridioides difficile infection in adults following antibacterial treatment. With this approval, Vowst (SER-109, Seres Therapeutics) becomes the second microbiota-based live biotherapeutic approved for recurrent C. difficile infection following the approval of Rebyota (fecal microbiota, live-jslm; Ferring Pharmaceuticals) in 2022. Read more.
C. difficile infection recurrence after FMT higher than previously reported in IBD
More than 20% of patients with inflammatory bowel disease experienced recurrent Clostridioides difficile infection 1 year after fecal microbiota transplantation, according to data presented at Digestive Disease Week.
“While there are data on the short-term efficacy of FMT for eradicating C. diff infections in patients with IBD, there is less known about longer-term outcomes,” Edward V. Loftus Jr., MD, the Maxine and Jack Zarrow Family Professor of Gastroenterology at the Mayo Clinic, told Healio. “We assessed our experience with longer follow-up time, focused our attention on patients with moderate to severe colonic IBD activity and found that the recurrence rate of C. diff infection was higher than previously reported, and that about one-third of patients ultimately required colectomy.” Read more.
Bezlotoxumab, fecal microbiota transplant similarly effective in preventing recurrent CDI
Bezlotoxumab and fecal microbiota transplantation were similarly effective at preventing both early and late recurrent Clostridioides difficile infection, according to a study published in Open Forum Infectious Diseases.
“This study was prompted by the idea of knowing the current status (indications, therapeutic success) of the treatment (bezlotoxumab and/or fecal microbiota transplantation) that we administer to our patients,” Sofia de la Villa, MD, infectious disease specialist at the Hospital General Universitario Gregorio Marañón, told Healio. Read more.
Novel alternative to fecal microbiota therapy prevents recurrent CDI in study
A novel oral microbiome-directed therapy called VE303 successfully prevented recurrent Clostridioides difficile infection in adults at high risk for recurrence, researchers found.
“C. difficile is a leading nosocomial pathogen, with considerable morbidity and mortality,” Jeffrey L. Silber, MD, chief medical officer of Vedanta Biosciences, told Healio. “Despite initial improvement with a course of antibiotics, at least 20% of patients with [C. difficile infection (CDI)] suffer a recurrence within a few weeks. Once someone suffers a recurrence, the probability of additional recurrences is 40% or higher.” Read more.
FDA approves fecal microbiota biotherapeutic for recurrent C. difficile infection
The FDA has approved Rebyota, a microbiota-based live biotherapeutic indicated for the prevention of recurrent Clostridioides difficile infection in adults after antibiotic treatment, Ferring Pharmaceuticals announced in a press release. The approval comes after an FDA panel voted in favor of Rebyota (fecal microbiota, live-jslm; Ferring Pharmaceuticals) in September 2022, with the Vaccines and Related Biological Products Advisory Committee voting 13-4 in favor of the availability of adequate data supporting effectiveness and 12-4, with one abstention, in favor of the availability of adequate data supporting safety. Read more.
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