- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03527056
Pilot Study Using Oral Capsule FMT to Decolonize GI CRE
October 21, 2019 updated by: University of California, Los Angeles
Pilot Study Using Oral Capsule Fecal Microbiota Transplant To Decolonize Gastrointestinal Carbapenem-Resistant Enterobacteriaceae (CRE)
Carbapenem-Resistant Enterobacteriaceae (CRE) are bacteria that have become resistant to carbapenems by producing enzymes that break down carbapenems.
The prevalence of CRE continues to rise globally but the treatment options are extremely limited.
In case series, isolation of CRE from any site, whether there is clinical infection or not, has been associated with all-cause hospital mortality ranging from 29% to 52%.
There are no known methods for reliably decolonizing gastrointestinal (GI) CRE.
In rare case reports, fecal microbiota transplant (FMT) has successfully eradicated gastrointestinal colonization of CRE, but there has been no larger study further investigating this.
FMT via oral capsules is the least invasive method and has demonstrated efficacy and short-term safety in treating patients with recurrent Clostridium difficile infections.
Therefore, the investigators propose this pilot study to determine the effectiveness of oral capsule fecal transplantation in the decolonization of gastrointestinal CRE.
Study Overview
Status
Withdrawn
Intervention / Treatment
Study Type
Interventional
Phase
- Early Phase 1
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Outpatient
- Have intestinal carriage of CRE
Exclusion Criteria:
- Pregnant
- Peripheral WBC >12 x 10^9/L and/or temperature >38 degrees Celsius
- Swallowing dysfunction or known chronic aspiration
- Delayed gastric emptying
- History of intestinal obstruction
- Active CRE infection
- Acute exacerbation of underlying comorbid condition
- Severely immunocompromised patients
- Inflammatory bowel disease
- Allergies to ingredients Generally Recognized as Safe
- Adverse event attributable to previous FMT
- Concomitant antibiotic use or antibiotic use 48 hours before FMT
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Oral capsule fecal transplantation
Enrolled patients who have screened positive for CRE in the stool will receive fecal transplant via OpenBiome oral capsules.
The patient is given 90 minutes to swallow all capsules and does not require any anesthesia or sedation.
Stool samples to test for CRE will be taken 10 days and 30 days after the fecal transplant.
|
This is a parallel arm study.
All participants in the experimental arm will receive a single fecal transplantation via oral capsules to determine effectiveness and safety in decolonizing gastrointestinal CRE.
Other Names:
|
No Intervention: Observation
Enrolled patients who have screened positive for CRE in the stool will have stool samples to test for CRE taken 10 days and 30 days after initial enrollment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of participants with CRE decolonization at day 10 (+/- 3 days) after fecal transplant
Time Frame: 10 days
|
CRE decolonization is defined by absence of CRE on stool culture using standard clinical laboratory techniques.
Stool samples will be collected 10 days after FMT.
|
10 days
|
Proportion of participants with an adverse event through day 10 (+/- 3 days) after FMT
Time Frame: 10 days
|
Telephone calls are made to participants 10 days after FMT to assess for adverse event, severe adverse event, and adverse events of special interest (newly acquired transmissible infectious diseases).
|
10 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of participants with CRE decolonization at month 1 (+/-5 days) after FMT
Time Frame: 1 month
|
CRE decolonization is defined by absence of CRE on stool culture using standard clinical laboratory techniques.
Stool samples will be collected 30 days after FMT.
|
1 month
|
Proportion of participants with CRE infection at day 10 (+/-3 days) and month 1 (+/-5 days) after FMT
Time Frame: 1 month
|
CRE infection will be defined as an associated bacteremia, urinary tract infection, wound-related infection or other clinical infection deemed to be CRE associated at the discretion of the treating physician.
|
1 month
|
Proportion of participants with an adverse event, severe adverse event, or adverse events of special interest through month 1 (+/-5 days) after FMT.
Time Frame: 1 month
|
Telephone calls are made to participants 1 month after FMT to assess for adverse event, severe adverse event, and adverse events of special interest (newly acquired transmissible infectious diseases).
|
1 month
|
Proportion of participants with a severe adverse event at month 6 (+/-14 days) after FMT.
Time Frame: 6 months
|
Telephone calls are made to participants 6 months after FMT to assess for severe adverse event.
|
6 months
|
Proportion of participants with microbial engraftment assessed by microbiome disruption index (MDI) (MDI-community and MDI-species) measured by 16s ribosomal RNA at time of enrollment, day 10 (+/-3 days) and month 1 (+/-5 days) after FMT
Time Frame: 1 month
|
Stool samples collected at baseline before FMT, day 10 after FMT, 1 month after FMT will be sent for 16s sequencing.
|
1 month
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Zachary Rubin, MD, University of California, Los Angeles
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
June 1, 2019
Primary Completion (Actual)
September 24, 2019
Study Completion (Actual)
September 24, 2019
Study Registration Dates
First Submitted
May 4, 2018
First Submitted That Met QC Criteria
May 4, 2018
First Posted (Actual)
May 16, 2018
Study Record Updates
Last Update Posted (Actual)
October 23, 2019
Last Update Submitted That Met QC Criteria
October 21, 2019
Last Verified
October 1, 2019
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-001946
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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