C Difficile Infection

Vowst represents the first oral live microbiota therapeutic approved for recurrent C. difficile infections.

The treatment is the second live microbiota therapeutic approved by the FDA, coming just a few months after the agency approved RBX2660 for recurrent C. difficile infections.

Dr Paul Feuerstadt joins Dr David Hudesmand and Dr Jordan Axelrad in a discussion about treatment approaches for C difficile infections, and the latest advances in treating recurrent infections with fecal microbiota transplantation.

The rate of CDI recurrence through week 9 using the efficacy analysis 3 definition was 13.8% for the high-dose VE303 group, compared to 37% for the low-dose VE303 group and 45.5% for the placebo group.

From a novel topical gene therapy to a multi-pathway targeting HF drug, the second quarter of 2023 is laden with interesting regulatory decisions.

Patients with no prior colonoscopy had significantly higher all-cause mortality and colorectal cancer specific mortality compared to patients with detected colorectal cancer.

Increased age, male sex, COPD, CHF, dependent functional status, and C. difficile infection were associated with increased mortality within 30 days of surgery.

The incidence of mPDAI-defined remission at week 14 was 31% in the vedolizumab group, compared to 10% in the placebo group.

The majority of patients felt it was important for healthcare providers talk to them about the symptoms, possible treatments. In addition, most patients are not prescribed a medication right away.

Among 1660 cases with only PCR data, the cycle threshold was significantly associated with recurrence-free survival.

There were few or no studies investigating education and training, personal protective equipment or monitoring, and evaluation of interventions.

The overall survival after adjusting for tumor stage showed tumor adipose feature was independently prognostic as both a binary feature and as a semiquantitative categorical feature.

The prevalence of CDI in southern China was 11.0% and 13.6% in northern China.

Clostridium difficile and Clostridium perfringens were found in 83% of newborns nursed by formula milk in the second week of life, but all infants by the end of the third week of life.

The results show concomitant recurrent CDI was associated with an IBD flare in 54% of participants. Of this group, 63% received IBD remission-induction therapy before FMT.

The investigators also found that PPIs and vonoprazan had equivalent magnitudes of association with CDI in the matched subgroup.

Recent data during ECCO 23 show ustekinumab results in higher rates of clinical remission and clinical response in patients with inflammatory bowel disease.

Neutropenia, male gender, high serum creatinine, and albumin were all associated with fatal outcomes.

The results show 58% of patients treated with ustekinumab were in clinical remission, while 80% were in clinical response.

The mortality rate ranged from 13.2 deaths per 100,000 live births in 2005 to 8.3 deaths per 100,000 live births in 2020.

Much of the recent focus on drug development in IBD has centered on the IL-23 pathway.

The patients that did not undergo colectomy in the infliximab group were more often re-hospitalized because to the need for intravenous corticosteroids at the two-year follow-up compared to the cyclosporine group.

There was also an inverse correlation between FGF21 levels and nutritional status indicators, including body mass index, albumin level, and cholesterol in patients with inflammatory bowel disease.

The results suggest CRP and fCal could be useful markers of histology and endoscopy outcomes for biologic-naïve patients with inflammatory bowel disease.

This group also had a longer time to event of first IBD-related hospitalization and primary and secondary IBD-related surgery in patients without a history of IBD-related surgery at baseline.

Antibiotic use was not linked to a decrease in infectious complications in either the unadjusted analysis or the adjusted analysis.

The results show methotrexate exposure time and cumulative doses were not predictors for fibrosis, but alcohol was a predictor.

There was no association with microbiome-disturbing agents, but laxatives and antibiotics were independently associated with a more than 2-fold increase in the risk of acquiring an infection.

The most common invasive fungal infection was histoplasmosis and the risk of invasive fungal infections was more than double in patients treated with corticosteroids than it was for patients treated with anti-TNFs.

The results show a placebo-controlled trial is warranted in the future.