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This is a prospective, multicenter, open-label Phase 3 study of a microbiota suspension of intestinal microbes. Patients who have had at least one recurrence of CDI after a primary episode and have completed at least one round of standard-of-care oral antibiotic therapy or have had at least two episodes of severe CDI resulting in hospitalization may be eligible for the study. Subjects may receive a second RBX2660 enema if they are deemed treatment failures following the initial enema per the protocol-specified treatment failure definition.
This is a prospective, multicenter, open-label Phase 3 study of a microbiota suspension of intestinal microbes. The primary assessments for this study are (i) safety via assessment of treatment-emergent adverse events and (ii) efficacy of RBX2660 preventing recurrent episodes of CDI measured at 8 weeks after treatment. Follow-up office visits occur at 1 week and 8 weeks after completing the initial study treatment. Telephone assessments occur at 4 weeks, and 4 and 6 months after the study. Patients who have had at least one recurrence of CDI after a primary episode and have completed at least one round of standard-of-care oral antibiotic therapy or have had at least two episodes of severe CDI resulting in hospitalization may be eligible for the study. Subjects may receive a second RBX2660 enema if they are deemed treatment failures following the initial enema per the protocol-specified treatment failure definition.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active | Experimental | RBX2660 is an enema of a microbiota suspension |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RBX2660 | Drug | RBX2660 is a microbiota suspension administered as an enema |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability of RBX2660 in Subjects With Recurrent CDI. | Number of subjects with investigational product- and/or enema-related treatment-emergent adverse events (TEAEs). | Up to 6 months after last study treatment. |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of RBX2660 Measured at 8 Weeks After Treatment. | The absence of C. difficile diarrhea without the need for retreatment through 8 weeks after administration of the study treatment. | 8 weeks after completing the study treatment |
| Sustained Clinical Response Through 6 Months After Treatment. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Teena Chopra, M.D., M.P.H. | Wayne State University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix | Phoenix | Arizona | 85054 | United States | ||
| North Little Rock |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42286373 | Derived | Chopra T, Van Handel D, Baggott B, Orenstein R, Reveles K, Guthmueller B, Srivastava S, Khanna S. Efficacy Outcomes of Fecal Microbiota, Live-jslm in Preventing Recurrent Clostridioides difficile Infection from Seven Clinical Studies. Infect Dis Ther. 2026 Jun 12. doi: 10.1007/s40121-026-01374-9. Online ahead of print. | |
| 41653256 |
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A total of 793 participants were enrolled/signed informed consent of which 95 were screen failures.
698 subjects were enrolled and were not screen failures. One participant was enrolled but not treated, therefore 697 participants received a dose of RBX2660.
Recruitment was from July 2019 to July 2023 at 56 sites in the US and Canada. Recruitment was performed by trained investigators and study coordinators.
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| ID | Title | Description |
|---|---|---|
| FG000 | Active | RBX2660 is an enema of a microbiota suspension RBX2660: RBX2660 is a microbiota suspension administered as an enema |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | May 26, 2022 | Jul 9, 2024 |
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Treatment success of the presenting CDI recurrence and no new CDI episodes for greater than 8 weeks through 6 months after completing a study treatment assessed by subject phone interview up to 6 months after the last study treatment. |
| 6 months after completing the study treatment |
| North Little Rock |
| Arkansas |
| 72117 |
| United States |
| Oxnard | Oxnard | California | 93030 | United States |
| Aurora | Aurora | Colorado | 80045 | United States |
| Hamden | Hamden | Connecticut | 06518 | United States |
| Gainesville | Gainesville | Florida | 32610 | United States |
| Jacksonville | Jacksonville | Florida | 32224 | United States |
| Naples | Naples | Florida | 34102 | United States |
| Orlando | Orlando | Florida | 32806 | United States |
| Port Orange | Port Orange | Florida | 32127 | United States |
| Atlanta | Atlanta | Georgia | 30309 | United States |
| Decatur | Decatur | Georgia | 30033 | United States |
| Idaho Falls | Idaho Falls | Idaho | 83404 | United States |
| Burr Ridge | Burr Ridge | Illinois | 60527 | United States |
| Gurnee | Gurnee | Illinois | 60035 | United States |
| Fort Wayne | Fort Wayne | Indiana | 46845 | United States |
| Wichita | Wichita | Kansas | 67214 | United States |
| New Orleans | New Orleans | Louisiana | 70121 | United States |
| Shreveport | Shreveport | Louisiana | 71105 | United States |
| Baltimore | Baltimore | Maryland | 21215 | United States |
| Detroit | Detroit | Michigan | 48202 | United States |
| Plymouth | Plymouth | Minnesota | 55446 | United States |
| Rochester | Rochester | Minnesota | 55905 | United States |
| St. Louis | St Louis | Missouri | 63110 | United States |
| New York | New York | New York | 10016 | United States |
| Rochester | Rochester | New York | 14618 | United States |
| Durham | Durham | North Carolina | 27710 | United States |
| Fargo | Fargo | North Dakota | 58122 | United States |
| Cleveland | Cleveland | Ohio | 44195 | United States |
| Oklahoma City | Oklahoma City | Oklahoma | 73102 | United States |
| Philadelphia | Philadelphia | Pennsylvania | 19107 | United States |
| Pittsburgh | Pittsburgh | Pennsylvania | 15213 | United States |
| Wyomissing | Wyomissing | Pennsylvania | 19610 | United States |
| Charleston | Charleston | South Carolina | 29425 | United States |
| Hixon | Hixon | Tennessee | 37434 | United States |
| Nashville | Nashville | Tennessee | 37212 | United States |
| Dallas | Dallas | Texas | 75246 | United States |
| Houston | Houston | Texas | 77030 | United States |
| West Jordan | West Jordan | Utah | 84088 | United States |
| Annandale | Annandale | Virginia | 22003 | United States |
| Springfield | Springfield | Virginia | 22150 | United States |
| Seattle | Seattle | Washington | 98104 | United States |
| Spokane | Spokane | Washington | 99202 | United States |
| Madison | Madison | Wisconsin | 53704 | United States |
| Marshfield | Marshfield | Wisconsin | 54449 | United States |
| Milwaukee | Milwaukee | Wisconsin | 53215 | United States |
| Calgary | Calgary | Alberta | T2N 2T9 | Canada |
| Edmonton | Edmonton | Alberta | T6G 2X8 | Canada |
| Vancouver | Vancouver | British Columbia | V5Z 1M9 | Canada |
| Victoria | Victoria | British Columbia | V8R 1J8 | Canada |
| Moncton | Moncton | New Brunswick | E1C 6Z8 | Canada |
| Skinner AM, Lodise TP, Reilly J, Guthmueller B, Srivastava S, Axelrad JE. Safety and Efficacy of Fecal Microbiota, Live-jslm for Prevention of Recurrent Clostridioides difficile Infection Among Hospitalized Participants in PUNCH CD3-OLS. Infect Dis Ther. 2026 Mar;15(3):889-901. doi: 10.1007/s40121-026-01304-9. Epub 2026 Feb 7. |
| 41245385 | Derived | Lee C, Feuerstadt P, Louie T, Bancke L, Guthmueller B, Harvey A, Hoeyer F, Orenstein R, Dubberke ER, Khanna S. Integrated analysis of the safety of fecal microbiota, live-jslm in adults with recurrent Clostridioides difficile infection from five prospective clinical trials: an update. Ther Adv Gastroenterol. 2025 Nov 12;18:17562848251395566. doi: 10.1177/17562848251395566. eCollection 2025. |
| 40784972 | Derived | Aroniadis OC, Guthmueller B, Dehlin K, Srivastava S, Feuerstadt P, Lembo A, Weber HC. Safety and Efficacy of Fecal Microbiota, Live-jslm to Prevent Recurrent Clostridioides difficile Infection in Participants With Irritable Bowel Syndrome. Infect Dis Ther. 2025 Sep;14(9):2157-2169. doi: 10.1007/s40121-025-01208-0. Epub 2025 Aug 10. |
| 40177588 | Derived | Alonso CD, Tillotson GS, Bidell MR, Guthmueller B, Hoeyer F, Fischer M, Dubberke ER. Safety and Efficacy of Fecal Microbiota, Live-jslm, in Preventing Recurrent Clostridioides difficile Infection in Participants Who Were Mildly to Moderately Immunocompromised in the Phase 3 PUNCH CD3-OLS Study. Open Forum Infect Dis. 2025 Mar 4;12(4):ofaf117. doi: 10.1093/ofid/ofaf117. eCollection 2025 Apr. |
| 39180326 | Derived | Feuerstadt P, Chopra T, Knapple W, Van Hise NW, Dubberke ER, Baggott B, Guthmueller B, Bancke L, Gamborg M, Steiner TS, Van Handel D, Khanna S. PUNCH CD3-OLS: A Phase 3 Prospective Observational Cohort Study to Evaluate the Safety and Efficacy of Fecal Microbiota, Live-jslm (REBYOTA) in Adults With Recurrent Clostridioides difficile Infection. Clin Infect Dis. 2025 Feb 5;80(1):43-51. doi: 10.1093/cid/ciae437. |
| COMPLETED |
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| NOT COMPLETED |
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Safety Population
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| ID | Title | Description |
|---|---|---|
| BG000 | RBX2660 | RBX2660 is a rectally administered microbiota suspension RBX2660: RBX2660 is a microbiota suspension administered rectally |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| |||||||||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| |||||||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| |||||||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| |||||||||||||||||||||||
| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Safety and Tolerability of RBX2660 in Subjects With Recurrent CDI. | Number of subjects with investigational product- and/or enema-related treatment-emergent adverse events (TEAEs). | Safety | Posted | Count of Participants | Participants | Up to 6 months after last study treatment. |
|
|
| ||||||||||||||||||||||||||
| Secondary | Efficacy of RBX2660 Measured at 8 Weeks After Treatment. | The absence of C. difficile diarrhea without the need for retreatment through 8 weeks after administration of the study treatment. | Modified Intent-to-Treat (MITT) | Posted | Count of Participants | Participants | 8 weeks after completing the study treatment |
|
| |||||||||||||||||||||||||||
| Secondary | Sustained Clinical Response Through 6 Months After Treatment. | Treatment success of the presenting CDI recurrence and no new CDI episodes for greater than 8 weeks through 6 months after completing a study treatment assessed by subject phone interview up to 6 months after the last study treatment. | Modified Intent-to-Treat | Posted | Count of Participants | Participants | 6 months after completing the study treatment |
|
|
6 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Active | RBX2660 is an enema of a microbiota suspension RBX2660: RBX2660 is a microbiota suspension administered as an enema | 6 | 697 | 87 | 697 | 265 | 697 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Iron deficiency anaemia | Blood and lymphatic system disorders | Systematic Assessment |
| ||
| Cardiac Failure Congestive | Cardiac disorders | Systematic Assessment |
| ||
| Acute myocardial infarction | Cardiac disorders | Systematic Assessment |
| ||
| Angina pectoris | Cardiac disorders | Systematic Assessment |
| ||
| Atrial fibrillation | Cardiac disorders | Systematic Assessment |
| ||
| Cardiac arrest | Cardiac disorders | Systematic Assessment |
| ||
| Cardiac failure | Cardiac disorders | Systematic Assessment |
| ||
| Cardiac failure acute | Cardiac disorders | Systematic Assessment |
| ||
| Myocardial ischaemia | Cardiac disorders | Systematic Assessment |
| ||
| Spina bifida | Congenital, familial and genetic disorders | Systematic Assessment |
| ||
| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Colitis ulcerative | Gastrointestinal disorders | Systematic Assessment |
| ||
| Haematochezia | Gastrointestinal disorders | Systematic Assessment |
| ||
| Ileus | Gastrointestinal disorders | Systematic Assessment |
| ||
| Small intestinal obstruction | Gastrointestinal disorders | Systematic Assessment |
| ||
| Upper gastrointestingal haemorrhage | Gastrointestinal disorders | Systematic Assessment |
| ||
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
| ||
| Pyrexia | General disorders | Systematic Assessment |
| ||
| Cardiac cirrhosis | Hepatobiliary disorders | Systematic Assessment |
| ||
| Cholangitis acute | Hepatobiliary disorders | Systematic Assessment |
| ||
| Clostridium difficile infection | Infections and infestations | Systematic Assessment |
| ||
| Clostridium difficile colitis | Infections and infestations | Systematic Assessment |
| ||
| Urosepsis | Infections and infestations | Systematic Assessment |
| ||
| Diverticulitis | Infections and infestations | Systematic Assessment |
| ||
| Clostridial sepsis | Infections and infestations | Systematic Assessment |
| ||
| Pneumonia | Infections and infestations | Systematic Assessment |
| ||
| Sepsis | Infections and infestations | Systematic Assessment |
| ||
| Septic shock | Infections and infestations | Systematic Assessment |
| ||
| Bacteraemia | Infections and infestations | Systematic Assessment |
| ||
| Cellulitis | Infections and infestations | Systematic Assessment |
| ||
| Colonic abcess | Infections and infestations | Systematic Assessment |
| ||
| Corona virus infection | Infections and infestations | Systematic Assessment |
| ||
| Device related infection | Infections and infestations | Systematic Assessment |
| ||
| Infected bite | Infections and infestations | Systematic Assessment |
| ||
| Klebsiella bacteraemia | Infections and infestations | Systematic Assessment |
| ||
| Osteomylitis | Infections and infestations | Systematic Assessment |
| ||
| Pneumonia klebsiella | Infections and infestations | Systematic Assessment |
| ||
| Pulmonary sepsis | Infections and infestations | Systematic Assessment |
| ||
| Pyelonephritis | Infections and infestations | Systematic Assessment |
| ||
| Respiratory syncytial virus bronchitis | Infections and infestations | Systematic Assessment |
| ||
| Streptococcal endocarditis | Infections and infestations | Systematic Assessment |
| ||
| Urinary tract infection | Infections and infestations | Systematic Assessment |
| ||
| Fall | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Rib fracture | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Hip fracture | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Post-tramatic pain | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Road traffic accident | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Subarachnoid hemorrhage | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Subdural haematoma | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Alcoholic ketoacidosis | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Dehydration | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Hyperkalaemia | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Back pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Connective tissue disorder | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Endometrial cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
| ||
| Lung adenocarcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
| ||
| Oesophageal adenocarcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
| ||
| Ovarian cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
| ||
| Cerebrolvascular accident | Nervous system disorders | Systematic Assessment |
| ||
| Encephalopathy | Nervous system disorders | Systematic Assessment |
| ||
| Metabolic encephalopathy | Nervous system disorders | Systematic Assessment |
| ||
| Transient ischaemic attack | Nervous system disorders | Systematic Assessment |
| ||
| Alcohol withdrawal syndrome | Psychiatric disorders | Systematic Assessment |
| ||
| Alcoholism | Psychiatric disorders | Systematic Assessment |
| ||
| Mental disorder | Psychiatric disorders | Systematic Assessment |
| ||
| Acute kidney injury | Renal and urinary disorders | Systematic Assessment |
| ||
| Chronic kidney disease | Renal and urinary disorders | Systematic Assessment |
| ||
| Pleural effusion | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Atelectasis | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Chronic obstructive pulmonary disease | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Interstitial lung disease | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
| ||
| Purpura | Skin and subcutaneous tissue disorders | Systematic Assessment |
| ||
| Colostomy | Surgical and medical procedures | Systematic Assessment |
| ||
| Spinal nerve stimulator implantation | Surgical and medical procedures | Systematic Assessment |
| ||
| Hypotension | Vascular disorders | Systematic Assessment |
| ||
| Shock | Vascular disorders | Systematic Assessment |
| ||
| Atrioventricular block complete | Cardiac disorders | Systematic Assessment |
| ||
| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
| ||
| Gastrointestinal hemorrhage | Gastrointestinal disorders | Systematic Assessment |
| ||
| Spinal compression fracture | Injury, poisoning and procedural complications | Systematic Assessment |
| ||
| Ketosis | Metabolism and nutrition disorders | Systematic Assessment |
| ||
| Spinal column stenosis | Musculoskeletal and connective tissue disorders | Systematic Assessment |
| ||
| Breast cancer stage III | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Systematic Assessment |
| ||
| Quadraparesis | Nervous system disorders | Systematic Assessment |
| ||
| Spinal cord compression | Nervous system disorders | Systematic Assessment |
| ||
| Colitis | Gastrointestinal disorders | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
| ||
| Nausea | Gastrointestinal disorders | Systematic Assessment |
| ||
| Abdominal distension | Gastrointestinal disorders | Systematic Assessment |
| ||
| Flatulence | Gastrointestinal disorders | Systematic Assessment |
| ||
| Constipation | Gastrointestinal disorders | Systematic Assessment |
| ||
| Urinary tract infection | Infections and infestations | Systematic Assessment |
|
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Development | Clinical Development | 651-705-8778 | US8-Studyinfo@ferring.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jun 27, 2023 | Jul 9, 2024 | SAP_001.pdf |
| ID | Term |
|---|---|
| D003015 | Clostridium Infections |
| D007239 | Infections |
| D003141 | Communicable Diseases |
| D003967 | Diarrhea |
| D004761 | Enterocolitis, Pseudomembranous |
| ID | Term |
|---|---|
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D004760 | Enterocolitis |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D007410 | Intestinal Diseases |
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| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
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| Title | Denominators | Categories | ||||
|---|---|---|---|---|---|---|
|