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Treatment of Recurrent Clostridium Difficile Infection With RBX7455

Primary Purpose

Clostridium Difficile Infection

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RBX7455
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Clostridium Difficile Infection

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  1. ≥ 18 years old.
  2. Medical record documentation of recurrent CDI, defined as at least one recurrence after a primary episode and has completed at least two rounds of standard-of-care oral antibiotic therapy. Study subjects will have their diarrhea resolved, i.e., would be having less than 3 watery bowel movements at the time of study enrollment for 48 hours or more.
  3. A positive stool test for the presence of C. difficile within 30 days prior to enrollment and standard C. difficile treatment.
  4. Willing and able to swallow capsules.
  5. Agrees to abstain from non-dietary probiotics for the duration of the study.
  6. Agrees to abstain from vancomycin, metronidazole, fidaxomicin, rifaximin, nitazoxanide and IVIG for the duration of the study unless prescribed to treat recurrent CDI.
  7. Agrees to stop proton pump inhibitors or H2 blocker medications.
  8. Agrees to practice a form of effective contraception during study participation.
  9. Has a negative urine pregnancy test at the time of enrollment (females of child-bearing potential only).
  10. Willing and able to provide informed consent and HIPAA authorization.
  11. Willing and able to complete the required Subject Diary.
  12. Willing and able to meet all study requirements, including attending all assessment visits and phone calls.

Exclusion criteria:

  1. A known history of continued CDI diarrhea, despite being on a course of antibiotics prescribed for CDI treatment.
  2. Requires continuous antibiotic therapy for a condition other than CDI.
  3. Previous fecal transplant.
  4. Previous treatment with RBX2660.
  5. Diagnosis of inflammatory bowel disease (IBD), e.g., ulcerative colitis, Crohn's disease, or microscopic colitis.
  6. Diagnosis of irritable bowel syndrome (IBS) as determined by Rome III criteria.
  7. History of chronic diarrhea.
  8. History of celiac disease.
  9. Disease symptoms caused by a confirmed intestinal pathogen other than C. difficile.
  10. Unable to stop proton pump inhibitors or H2 blocker medications.
  11. Colostomy.
  12. Intra-abdominal surgery within the last 60 days.
  13. Evidence of active, severe colitis.
  14. History of short gut syndrome.
  15. Requires the regular use of medications to manage bowel hypermotility.
  16. Planned therapy in the next 3 months that may cause diarrhea (e.g., chemotherapy).
  17. Planned surgery requiring perioperative antibiotics within 3 months of study enrollment.
  18. Life expectancy of < 6 months.
  19. Compromised immune system (e.g., HIV infection; AIDS-defining diagnosis or CD4 <200/mm3; inherited/primary immune disorders; immunodeficient or immunosuppressed due to a medical condition or medication; current or recent (< 90 days) treatment with chemotherapy; or current or recent (< 90 days) treatment with immunosuppressant medications.
  20. Taking systemic steroids (≥ 20 mg a day or prednisone-equivalent) or is expected to be on steroids after enrollment through 8 weeks after completing the assigned study treatment.
  21. An absolute neutrophil count of <1000 cells/µL.
  22. Known or suspected current (< 90 days) illicit drug use. Note: marijuana use is allowed.
  23. Pregnant, breastfeeding, or intends to become pregnant during study participation.
  24. Participating in a clinical trial of another investigational product (drug, device or other) and has not completed the required follow-up period.
  25. Subject, in the opinion of the investigator, for whatever reason, should be excluded from the study.

Sites / Locations

  • Mayo Clinic in Rochester

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

RBX7455 Group A

RBX7455 Group B

RBX7455 Group C

RBX7455 Group D

Arm Description

4 days of 4 capsules twice daily RBX7455 for 10 subjects.

2 days of 4 capsules twice daily RBX7455 for 10 subjects.

2 days of 2 capsules twice daily RBX7455 for 10 subjects.

2 days of 1 capsule twice daily RBX7455 for 10 subjects.

Outcomes

Primary Outcome Measures

Time to recurrence of Clostridium Difficile Infection (CDI)
Number of patients experiencing adverse events

Secondary Outcome Measures

Full Information

First Posted
December 1, 2016
Last Updated
December 7, 2020
Sponsor
Mayo Clinic
Collaborators
Rebiotix Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02981316
Brief Title
Treatment of Recurrent Clostridium Difficile Infection With RBX7455
Official Title
Treatment of Recurrent Clostridium Difficile Infection With RBX7455: A Dose-ranging, Prospective, Single Center, Open Label Phase I Trial
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
November 2016 (undefined)
Primary Completion Date
July 22, 2020 (Actual)
Study Completion Date
July 22, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mayo Clinic
Collaborators
Rebiotix Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to demonstrate the efficacy and safety of RBX7455 for the treatment of recurrent CDI in subjects who have had at least one recurrence after a primary episode (i.e., at least two episodes) and have completed at least two rounds of standard-of-care oral antibiotic therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clostridium Difficile Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RBX7455 Group A
Arm Type
Active Comparator
Arm Description
4 days of 4 capsules twice daily RBX7455 for 10 subjects.
Arm Title
RBX7455 Group B
Arm Type
Active Comparator
Arm Description
2 days of 4 capsules twice daily RBX7455 for 10 subjects.
Arm Title
RBX7455 Group C
Arm Type
Active Comparator
Arm Description
2 days of 2 capsules twice daily RBX7455 for 10 subjects.
Arm Title
RBX7455 Group D
Arm Type
Active Comparator
Arm Description
2 days of 1 capsule twice daily RBX7455 for 10 subjects.
Intervention Type
Biological
Intervention Name(s)
RBX7455
Intervention Description
Microbiota capsule(s) given twice daily in the morning, and in the evening.
Primary Outcome Measure Information:
Title
Time to recurrence of Clostridium Difficile Infection (CDI)
Time Frame
approximately 8 weeks
Title
Number of patients experiencing adverse events
Time Frame
approximately 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: ≥ 18 years old. Medical record documentation of recurrent CDI, defined as at least one recurrence after a primary episode and has completed at least two rounds of standard-of-care oral antibiotic therapy. Study subjects will have their diarrhea resolved, i.e., would be having less than 3 watery bowel movements at the time of study enrollment for 48 hours or more. A positive stool test for the presence of C. difficile within 30 days prior to enrollment and standard C. difficile treatment. Willing and able to swallow capsules. Agrees to abstain from non-dietary probiotics for the duration of the study. Agrees to abstain from vancomycin, metronidazole, fidaxomicin, rifaximin, nitazoxanide and IVIG for the duration of the study unless prescribed to treat recurrent CDI. Agrees to stop proton pump inhibitors or H2 blocker medications. Agrees to practice a form of effective contraception during study participation. Has a negative urine pregnancy test at the time of enrollment (females of child-bearing potential only). Willing and able to provide informed consent and HIPAA authorization. Willing and able to complete the required Subject Diary. Willing and able to meet all study requirements, including attending all assessment visits and phone calls. Exclusion criteria: A known history of continued CDI diarrhea, despite being on a course of antibiotics prescribed for CDI treatment. Requires continuous antibiotic therapy for a condition other than CDI. Previous fecal transplant. Previous treatment with RBX2660. Diagnosis of inflammatory bowel disease (IBD), e.g., ulcerative colitis, Crohn's disease, or microscopic colitis. Diagnosis of irritable bowel syndrome (IBS) as determined by Rome III criteria. History of chronic diarrhea. History of celiac disease. Disease symptoms caused by a confirmed intestinal pathogen other than C. difficile. Unable to stop proton pump inhibitors or H2 blocker medications. Colostomy. Intra-abdominal surgery within the last 60 days. Evidence of active, severe colitis. History of short gut syndrome. Requires the regular use of medications to manage bowel hypermotility. Planned therapy in the next 3 months that may cause diarrhea (e.g., chemotherapy). Planned surgery requiring perioperative antibiotics within 3 months of study enrollment. Life expectancy of < 6 months. Compromised immune system (e.g., HIV infection; AIDS-defining diagnosis or CD4 <200/mm3; inherited/primary immune disorders; immunodeficient or immunosuppressed due to a medical condition or medication; current or recent (< 90 days) treatment with chemotherapy; or current or recent (< 90 days) treatment with immunosuppressant medications. Taking systemic steroids (≥ 20 mg a day or prednisone-equivalent) or is expected to be on steroids after enrollment through 8 weeks after completing the assigned study treatment. An absolute neutrophil count of <1000 cells/µL. Known or suspected current (< 90 days) illicit drug use. Note: marijuana use is allowed. Pregnant, breastfeeding, or intends to become pregnant during study participation. Participating in a clinical trial of another investigational product (drug, device or other) and has not completed the required follow-up period. Subject, in the opinion of the investigator, for whatever reason, should be excluded from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sahil Khanna
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32966574
Citation
Khanna S, Pardi DS, Jones C, Shannon WD, Gonzalez C, Blount K. RBX7455, a Non-frozen, Orally Administered Investigational Live Biotherapeutic, Is Safe, Effective, and Shifts Patients' Microbiomes in a Phase 1 Study for Recurrent Clostridioides difficile Infections. Clin Infect Dis. 2021 Oct 5;73(7):e1613-e1620. doi: 10.1093/cid/ciaa1430.
Results Reference
derived
Links:
URL
https://www.mayo.edu/research/clinical-trials
Description
Mayo Clinic Clinical Trials

Learn more about this trial

Treatment of Recurrent Clostridium Difficile Infection With RBX7455

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