Alterations in Microbial Diversity are Associated with Treatment Success with RBX2660, a Microbiota-Based Drug for the Prevention of Recurrent Clostridium difficile Infection: Results from PUNCH CD 2: a Randomized Double-Blind Placebo-Controlled Trials

Sahil Khanna, MBBS, MS; Gail Hecht, MD; Erik Dubberke,MD, MSPH; Robert Orenstein, DO; Christine Lee, MD; Dale Gerding, MD

Presentation image for Alterations in Microbial Diversity are Associated with Treatment Success with RBX2660, a Microbiota-Based Drug for the Prevention of Recurrent  Clostridium difficile Infection: Results from PUNCH CD 2: a Randomized Double-Blind Placebo-Controlled Trial Digestive Diseases Week 2017

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Digestive Diseases Week
May 6-9, 2017, Chicago, IL

Summary

  • One dose of RBX2660 administered via enema is more effective than placebo for recurrent CDI
  • Responders to RBX2660
    • Distinct microbiome changes from baseline in contrast to those who fail active treatment
  • Responders to RBX2660
    • Different microbiota composition than responders to placebo
  • Placebo responders demonstrate no changes in microbiota composition after treatment

Conclusions

  • RBX2660 administered via enema is an effective treatment for recurrent CDI
  • Responders to active therapy have distinct microbiome profiles compared to failures
    • Importance of bacterial engraftment
  • Response to active therapy but not to placebo correlates with changes from baseline microbiome
  • Changes in microbial profiles after microbiota-based therapies may predict treatment response