ICON-2: FMT and Bezlotoxumab Compared to FMT and Placebo for Patients With IBD and CDI

  • STATUS
    Recruiting
  • End date
    Dec 30, 2023
  • participants needed
    120
  • sponsor
    Brigham and Women's Hospital
Updated on 1 August 2021
diarrhea
microbiota
ulcerative colitis
crohn's disease
enteropathy
fecal microbiota transplantation
clostridium difficile
colitis
ulceration
bezlotoxumab

Summary

This is a randomized controlled trial to assess the clinical and microbiological impacts of FMT in combination with Bezlotoxumab (bezlo) compared to FMT in combination with placebo in patients with both inflammatory bowel disease (IBD) a and clostridium difficile infection (CDI). The investigators will prospectively enroll up to 150 IBD-CDI patients from 4 tertiary care FMT referral centers. Patients will be randomized 1:1 to either receive FMT in combination with Bezlo of FMT and a placebo infusion. Donor stool from healthy donors will be obtained from OpenBiome. OpenBiome is a nonprofit 501(c)(3) organization that provides hospitals with screened, filtered, and frozen material ready for clinical use. Patients will be enrolled and followed prospectively for 3 months post therapy. Stool and blood samples as well as clinical data will be collected at baseline, week 1, 8 and 12.

Details
Condition Gastroenteritis, Intestinal Diseases, Inflammatory bowel disease, Clostridium Difficile Infection, Bowel Dysfunction, inflammatory bowel diseases
Treatment Placebo, Fecal Microbiota Transplantation, Bezlotoxumab
Clinical Study IdentifierNCT03829475
SponsorBrigham and Women's Hospital
Last Modified on1 August 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Adults age 18 or greater
History of 2 episodes of recurrent CDI. CDI is defined as the presence of diarrhea ( Bristol 6 or 7 for 48 hours and a confirmatory test for CDI). Preferred testing will be a two-step method using GDH/EIA toxin, though PCR will be accepted based on hospital availability with confirmation of the most recent episode occurring within the prior 3 months
Confirmed diagnosis of IBD (ulcerative colitis, Crohn's disease or indeterminate colitis)
Undergoing FMT via colonoscopy for CDI as part of standard medical care

Exclusion Criteria

Unable or unwilling to undergo a colonoscopy
Inpatient status, though patients can be screened while inpatients, the must be outpatient for the planned colonoscopy
Anticipated immediate or upcoming surgery within 30 days
Need for continued non-anti-CDI antibiotic therapy
History of total proctocolectomy
Female patients who are pregnant or breastfeeding or plan to become pregnant in the next 6 months
Patients who are unable to give informed consent
Participation in a clinical trial in the preceding 30 days or simultaneously during this trial
Severe food allergy (anaphylaxis or anaphylactoid-like reaction)
Life expectancy < 6 months
Unable to adhere to protocol requirements
Patient who have received an FMT in the past year
Any condition that the physician investigators deems unsafe, including other conditions or medications that the investigator determines that it will put the subject at greater risk from FMT
Patient who is diagnosed with NYHA class 3 or 4 Heart Failure
Lab value of WBC <3.0 x 103/mm3 , Platelets <100 x 103/mm3 , ALT or AST > 1.5 x institutional ULN
EBV or CMV negative if a patient is severely immunosuppressed ( defined as 3 or more immunosuppressing agents)
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