Enema Administration of RBX2660 (microbiota suspension) for Recurrent C. difficile Infection: Lessons Learned from the PUNCH CD Study

Arnab Ray, MD, Ochsner Clinic, New Orleans, LA; Robert Hardi, MD, Digestive Care, Chevy Chase, MD; Mayur S. Ramesh, MD, Henry Ford Health System; Mary Kay Sobcinski, RN, MHA, Rebiotix Inc., Roseville, MN

Purpose

Fecal transplantation is gaining increasing acceptance as an effective method of treating recurrent Clostridium difficile infection (CDI). However, there are many unknowns about the therapy including questions about administration. Administration via colonoscopy, nasogastric or nasoduodenal tube, and enema have been reported in the literature. Definitive superiority has not been established for any one method.

We report on lessons learned about enema administration of RBX2660 (microbiota suspension) for the treatment of recurrent CDI in the context of a 60-day interim analysis of the PUNCH CD phase 2 multicenter safety study. RBX2660, a biologic drug consisting of live human-derived microbes, is a next generation version of fecal transplantation.