Microbiota Restoration Therapy for Recurrent Clostridium Difficile Infection (PUNCHCD2)
23 de diciembre de 2020 actualizado por: Rebiotix Inc.
A Phase 2B Prospective, Randomized, Double-blinded, Placebo-controlled Clinical Study Demonstrating the Efficacy and Safety of Rebiotix RBX2660 (Microbiota Suspension) for the Treatment of Recurrent Clostridium Difficile Infection
This is the first prospective, multi-center, double-blinded, randomized controlled study of a microbiota suspension derived from intestinal microbes.
Patients who have had at least two recurrences of C. difficile infection (CDI) after a primary episode and have completed at least two rounds of standard-of-care oral antibiotic therapy or have had at least two episodes of severe CDI resulting in hospitalization may be eligible for the study.
Patients whose CDI returns in less than 8 weeks after the last assigned study treatment may be eligible to receive up to 2 treatments with RBX2660 in the open-label portion of the study.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
This is the first prospective, multi-center, double-blinded, randomized controlled study of a microbiota suspension derived from intestinal microbes.
The primary assessments for this study are (i) efficacy of RBX2660 compared to placebo at 8 weeks and (ii) safety via assessment of adverse events.
Study visits are at 1-, 4- and 8-weeks after treatment with additional follow-up at 3, 6 12 and 24 months post treatment.
Patients who have had at least two recurrences of C. difficile infection (CDI) after a primary episode and have completed at least two rounds of standard-of-care oral antibiotic therapy or have had at least two episodes of severe CDI resulting in hospitalization may be eligible for the study.
Patients whose CDI returns in less than 8 weeks after the last assigned study treatment may be eligible to receive up to 2 treatments with RBX2660 in the open-label portion of the study.
Tipo de estudio
Intervencionista
Inscripción (Actual)
150
Fase
- Fase 2
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
British Columbia
-
Vancouver, British Columbia, Canadá, V5Z 1M9
- University of British Columbia
-
-
Ontario
-
Hamilton, Ontario, Canadá, L8N 4A6
- St. Joseph's Hospital
-
-
-
-
Arizona
-
Phoenix, Arizona, Estados Unidos, 85054
- Mayo Clinic Arizona
-
-
Colorado
-
Aurora, Colorado, Estados Unidos, 80045
- University of Colorado
-
-
Florida
-
Jacksonville, Florida, Estados Unidos, 32256
- Borland-Groover Clinic
-
-
Idaho
-
Idaho Falls, Idaho, Estados Unidos, 83404
- Grand Teton Research Group
-
-
Illinois
-
Chicago, Illinois, Estados Unidos, 60637
- University of Chicago
-
Chicago, Illinois, Estados Unidos, 60153
- Loyola University Chicago
-
-
Indiana
-
Indianapolis, Indiana, Estados Unidos, 46260
- Infectious Diseases of Indiana
-
-
Maryland
-
Chevy Chase, Maryland, Estados Unidos, 20815
- Chevy Chase Clinical Research
-
-
Michigan
-
Detroit, Michigan, Estados Unidos, 48202
- Henry Ford Health System
-
-
Minnesota
-
Rochester, Minnesota, Estados Unidos, 55905
- Mayo Clinic Minnesota
-
Saint Paul, Minnesota, Estados Unidos, 55101
- Regions Hospital
-
-
Missouri
-
Saint Louis, Missouri, Estados Unidos, 63110
- Washington University School of Medicine
-
-
New York
-
Flushing, New York, Estados Unidos, 11355
- New York Hospital Queens
-
New York, New York, Estados Unidos, 10065
- New York-Presbyterian Hospital/Weill Cornell Medical College
-
Rochester, New York, Estados Unidos, 14618
- Gastroenterology Group of Rochester
-
-
North Dakota
-
Fargo, North Dakota, Estados Unidos, 58122
- Sanford Health
-
-
Ohio
-
Cleveland, Ohio, Estados Unidos, 44106
- Louis Stokes Cleveland VA Medical Center
-
Lima, Ohio, Estados Unidos, 45801
- Regional Infectious Diseases and Infusion Center
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Estados Unidos, 19104
- Hospital of the University of Pennsylvania
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- ≥ 18 years
- Medical record documentation of recurrent CDI either: a) at least two recurrences after a primary episode and has completed at least two rounds of standard-of-care oral antibiotic therapy or b) has had at least two episodes of severe CDI resulting in hospitalization.
- Documented history that the subject's recurrent CDI is controlled while on antibiotics even if the subject is not currently on antibiotics.
- A positive stool test for the presence of C. difficile within 60 days prior to enrollment.
Exclusion Criteria:
- A known history of continued C. difficile diarrhea while taking on a course of antibiotics prescribed for CDI treatment.
- Requires antibiotic therapy for a condition other than recurrent CDI.
- Previous fecal transplant prior to study enrollment.
- History of inflammatory bowel disease (IBD), e.g., ulcerative colitis, Crohn's disease, or microscopic colitis.
- History of irritable bowel syndrome (IBS).
- History of chronic diarrhea.
- History of celiac disease.
- Colostomy.
- Planned surgery requiring perioperative antibiotics within 6 months of study enrollment.
- Life expectancy of < 12 months.
- Compromised immune system.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación cruzada
- Enmascaramiento: Triple
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Comparador activo: Group A
Two enemas of RBX2660 (microbiota suspension) administered 7 days apart
|
A suspension of intestinal microbes
|
|
Comparador de placebos: Group B
Two enemas of placebo administered 7 days apart
|
A suspension of saline and cryoprotectant
|
|
Comparador activo: Group C
1 enema of RBX2660 (microbiota suspension) and 1 enema of placebo administered 7 days apart
|
A suspension of intestinal microbes
A suspension of saline and cryoprotectant
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Treatment Success of Group A (2 Doses of RBX2660) vs Group B (2 Doses of Placebo) (ITT)
Periodo de tiempo: 8 weeks after last assigned study treatment
|
The primary endpoint is to evaluate treatment success, defined as the absence of CDAD without the need for retreatment with C. difficile anti-infective therapy or fecal transplant (FT) at 56 days after administration of the last assigned study enema, of Group A (two enemas of RBX2660) vs. Group B (two enemas of placebo).
|
8 weeks after last assigned study treatment
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Treatment Success Between Group C (1 Enema of RBX2660 and 1 Enema of Placebo) vs Group B (Two Enemas of Placebo) (ITT)
Periodo de tiempo: 8-weeks
|
Treatment Success was defined as the absence of CDAD without the need for retreatment with C. difficile anti-infective therapy or fecal transplant (FT) at 56 days after administration of the last assigned study enema
|
8-weeks
|
|
Treatment Success Evaluated Between Group A (Two Enemas of RBX2660) Versus Group C (1 Enema of RBX2660 and 1 Enema of Placebo) (ITT)
Periodo de tiempo: 8-weeks
|
Treatment success, defined as the absence of CDAD without the need for retreatment with C. difficile anti-infective therapy or fecal transplant (FT) at 56 days after administration of the last assigned study enema.
|
8-weeks
|
|
SF-36 Scores Obtained at the 1-week, 4-week, and 8-week Assessments Visits During the Double-blind Period as Compared to Baseline (ITT)
Periodo de tiempo: 8-week
|
The validated SF-36 scale was used to identify changes to quality of life (QoL) following study treatment.
Each component is analyzed on a norm-based scoring (0-100) with a higher score representing an improvement in QoL.
|
8-week
|
|
Time to CDAD Recurrence After Completion of the Assigned Study Treatment for Group A vs. Group B (ITT)
Periodo de tiempo: 8-weeks
|
Time to CDI Recurrence was evaluated using Kaplan-Meier Analysis and expressed by percentage of subjects who were recurrence free at a certain time point (every 7 days) from completion of the last blinded enema.
|
8-weeks
|
|
Time to CDAD Recurrence After Completion of the Assigned Study Treatment for Group C vs. Group B (ITT)
Periodo de tiempo: 8-weeks
|
Time to CDI Recurrence was evaluated using Kaplan-Meier Analysis and expressed by percentage of subjects who were recurrence free at a certain time point (every 7 days) from completion of the last blinded enema.
|
8-weeks
|
|
Time to CDAD Recurrence After Completion of the Assigned Study Treatment for Group A vs. Group C (ITT)
Periodo de tiempo: 8-weeks
|
Time to CDI Recurrence was evaluated using Kaplan-Meier Analysis and expressed by percentage of subjects who were recurrence free at a certain time point (every 7 days) from completion of the last blinded enema.
|
8-weeks
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Silla de estudio: Teena Chopra, MD MPH, Wayne State University
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- van Nood E, Vrieze A, Nieuwdorp M, Fuentes S, Zoetendal EG, de Vos WM, Visser CE, Kuijper EJ, Bartelsman JF, Tijssen JG, Speelman P, Dijkgraaf MG, Keller JJ. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013 Jan 31;368(5):407-15. doi: 10.1056/NEJMoa1205037. Epub 2013 Jan 16.
- Gough E, Shaikh H, Manges AR. Systematic review of intestinal microbiota transplantation (fecal bacteriotherapy) for recurrent Clostridium difficile infection. Clin Infect Dis. 2011 Nov;53(10):994-1002. doi: 10.1093/cid/cir632.
- Moayyedi P, Marshall JK, Yuan Y, Hunt R. Canadian Association of Gastroenterology position statement: fecal microbiota transplant therapy. Can J Gastroenterol Hepatol. 2014 Feb;28(2):66-8. doi: 10.1155/2014/346590. No abstract available.
- Kwak S, Choi J, Hink T, Reske KA, Blount K, Jones C, Bost MH, Sun X, Burnham CD, Dubberke ER, Dantas G; CDC Prevention Epicenter Program. Impact of investigational microbiota therapeutic RBX2660 on the gut microbiome and resistome revealed by a placebo-controlled clinical trial. Microbiome. 2020 Aug 31;8(1):125. doi: 10.1186/s40168-020-00907-9.
- Dubberke ER, Lee CH, Orenstein R, Khanna S, Hecht G, Gerding DN. Results From a Randomized, Placebo-Controlled Clinical Trial of a RBX2660-A Microbiota-Based Drug for the Prevention of Recurrent Clostridium difficile Infection. Clin Infect Dis. 2018 Sep 28;67(8):1198-1204. doi: 10.1093/cid/ciy259.
Enlaces Útiles
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de diciembre de 2014
Finalización primaria (Actual)
1 de enero de 2016
Finalización del estudio (Actual)
1 de enero de 2018
Fechas de registro del estudio
Enviado por primera vez
19 de noviembre de 2014
Primero enviado que cumplió con los criterios de control de calidad
20 de noviembre de 2014
Publicado por primera vez (Estimar)
24 de noviembre de 2014
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
15 de enero de 2021
Última actualización enviada que cumplió con los criterios de control de calidad
23 de diciembre de 2020
Última verificación
1 de diciembre de 2020
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Enfermedades del Sistema Digestivo
- Procesos Patológicos
- Infecciones
- Atributos de la enfermedad
- Enfermedades Gastrointestinales
- Gastroenteritis
- Enfermedades intestinales
- Infecciones bacterianas
- Infecciones bacterianas y micosis
- Infecciones por bacterias grampositivas
- Reaparición
- Enterocolitis
- Infecciones por Clostridium
Otros números de identificación del estudio
- 2014-01
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .