| Primary | Segment 2A: Clinical Cure (CC) of Clostridioides Difficile Infection (CDI) Per Protocol (PP)/Modified Intent-to-Treat (mITT) Population | Percentage of patients with CC at the test of cure (TOC) visit on day 12. CC was defined as survival and the resolution of diarrhea in the 24-hour period immediately before end of treatment (EOT--day 10) that was maintained for 48 hours post EOT without a requirement for additional CDI treatment. Diarrhea was defined as 3 or more unformed bowel movements (UBMs) in a 24-hour period; fewer than 3 UBMs was considered as resolution of diarrhea. A UBM was defined as a Type 5, 6, or 7 bowel movement on the Bristol Stool Chart. | 10 participants were analyzed in the modified Intent-to-Treat (mITT) and Per Protocol (PP) populations. The mITT population includes all subjects who were treated and assessed at the TOC visit. The PP population consists of patients in the mITT population with no major protocol deviations. | Posted | | Count of Participants | | Participants | | 12 days | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
| | | Title | Denominators | Categories |
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| | | Title | Measurements |
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| CC at TOC, yes | | | CC at TOC, no | |
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| Primary | Segment 2B Per Protocol (PP) Population: Clinical Cure (CC) of Clostridioides Difficile Infection (CDI) | Percentage of patients with CC at the test of cure (TOC) visit on day 12. CC was defined as survival and the resolution of diarrhea in the 24-hour period immediately before end of treatment (EOT--day 10) that was maintained for 48 hours post EOT without a requirement for additional CDI treatment. Diarrhea was defined as 3 or more unformed bowel movements (UBMs) in a 24-hour period; fewer than 3 UBMs was considered as resolution of diarrhea. A UBM was defined as a Type 5, 6, or 7 bowel movement on the Bristol Stool Chart. | PP participants were those in the ITT population who had no major protocol deviations. The ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Count of Participants | | Participants | | 12 days | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Primary | Segment 2B Intent-to-Treat (ITT) Population: Clinical Cure (CC) of Clostridioides Difficile Infection (CDI) | Percentage of patients with CC at the test of cure (TOC) visit on day 12. CC was defined as survival and the resolution of diarrhea in the 24-hour period immediately before end of treatment (EOT--day 10) that was maintained for 48 hours post EOT without a requirement for additional CDI treatment. Diarrhea was defined as 3 or more unformed bowel movements (UBMs) in a 24-hour period; fewer than 3 UBMs was considered as resolution of diarrhea. A UBM was defined as a Type 5, 6, or 7 bowel movement on the Bristol Stool Chart. | ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Count of Participants | | Participants | | 12 days | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Secondary | Segment 2A: Sustained Clinical Cure (SCC) of Clostridioides Difficile Infection (CDI) Per Protocol (PP)/Modified Intent-to-Treat (mITT) Population | Clinical cure (CC) at the test of cure (TOC) visit (ie, at least 48 hours after end of treatment [day 10]) and no recurrence within 28 days. Recurrence was defined as a new episode of diarrhea (3 or more UBMs in a 24-hour period) with a positive toxin result, using a Sponsor-approved C. difficile free toxin test and, in the opinion of the Investigator, requiring retreatment with an antibacterial agent for C. difficile. | 10 participants were analyzed in the modified Intent-to-Treat (mITT) and Per Protocol (PP) populations. The mITT population includes all subjects who were treated and assessed at the TOC visit. The PP population consists of patients in the mITT population with no major protocol deviations. | Posted | | Count of Participants | | Participants | | 38 days | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
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| Secondary | Segment 2B Per Protocol (PP) Population: Sustained Clinical Cure (SCC) of Clostridioides Difficile Infection (CDI) | Clinical cure (CC) at the test of cure (TOC) visit (ie, at least 48 hours after end of treatment [day 10]) and no recurrence within 28 days. Recurrence was defined as a new episode of diarrhea (3 or more UBMs in a 24-hour period) with a positive toxin result, using a Sponsor-approved C. difficile free toxin test and, in the opinion of the Investigator, requiring retreatment with an antibacterial agent for C. difficile. | PP participants were those in the ITT population who had no major protocol deviations. The ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Count of Participants | | Participants | | 38 days | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Secondary | Segment 2B Intent-to-Treat (ITT) Population: Sustained Clinical Cure (SCC) of Clostridioides Difficile Infection (CDI) | Clinical cure (CC) at the test of cure (TOC) visit (ie, at least 48 hours after end of treatment [day 10]) and no recurrence within 28 days. Recurrence was defined as a new episode of diarrhea (3 or more UBMs in a 24-hour period) with a positive toxin result, using a Sponsor-approved C. difficile free toxin test and, in the opinion of the Investigator, requiring retreatment with an antibacterial agent for C. difficile. | ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Count of Participants | | Participants | | 38 days | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Secondary | Segment 2A: Pharmacokinetics and Systemic Exposure to Ibezapolstat (ACX-362E), Plasma Concentrations | Plasma ibezapolstat concentrations were measured at specified day and time points following dose administration. Amount listed as zero not included in determination of Geometric Mean and CV%. | 3 participants from the original population did not have plasma samples taken and were not included. | Posted | | Geometric Mean | Geometric Coefficient of Variation | ng/mL | | Days 1, 5, and 10: 2 and 4 hours post-dose | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
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| Secondary | Segment 2B: Pharmacokinetics and Systemic Exposure to Ibezapolstat (ACX-362E), Plasma Concentrations | Plasma ibezapolstat concentrations were measured at specified day and time points following dose administration. Amount listed as zero not included in determination of Geometric Mean and CV% | 3 participants from the original population did not have plasma samples taken and were not included. 1 participant from the original population did not receive the study drug and was not included. | Posted | | Geometric Mean | Geometric Coefficient of Variation | ng/mL | | Days 1 and 5: 2 and 4 hours post-dose | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--Double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Secondary | Segment 2A: Pharmacokinetics and Systemic Exposure to Ibezapolstat (ACX-362E), Fecal Concentrations | Fecal ibezapolstat concentrations were measured for specified days following dose administration. Specified days were 3, 5, 8, 10, 12, 20, and 38. Amount listed as zero not included in determination of Geometric Mean and CV%. | Participants with undetectable concentrations were not included in the data. | Posted | | Geometric Mean | Geometric Coefficient of Variation | µg/g | | Days -2, 3, 5, 8,10, 12, 20, 30, and 38 | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
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| Secondary | Segment 2B: Pharmacokinetics and Systemic Exposure to Ibezapolstat (ACX-362E), Fecal Concentrations | Fecal ibezapolstat concentrations were measured for specified days following dose administration. Specified days were 3, 5, 8, 10, 12, and 20. Amount listed as zero not included in determination of Geometric Mean and CV%. | Participants with undetectable concentrations were not included in the data. | Posted | | Geometric Mean | Geometric Coefficient of Variation | µg/g | | Days -2, 3, 5, 8,10,12, 20, 30, and 38 | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--Double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Other Pre-specified | Segment 2A: Time to Resolution of Diarrhea | Time in days from outset of treatment to the first formed bowel movement not followed within the next 24 hours by an unformed bowel movement (UBM), defined as a Type 5, 6, or 7 bowel movement on the Bristol Stool Chart. | 10 participants were analyzed in the modified Intent-to-Treat (mITT) and Per Protocol (PP) populations. The mITT population includes all subjects who were treated and assessed at the TOC visit. The PP population consists of patients in the mITT population with no major protocol deviations. | Posted | | Median | 95% Confidence Interval | Days to resolution of diarrhea | | 10 days | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
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| Other Pre-specified | Segment 2B: Time to Resolution of Diarrhea | Time in days from outset of treatment to the first formed bowel movement not followed within the next 24 hours by an unformed bowel movement (UBM), defined as a Type 5, 6, or 7 bowel movement on the Bristol Stool Chart. | The Per Protocol (PP) population is represented here. PP participants were those in the intention-to-treat (ITT) population who had no major protocol deviations. The ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Median | 95% Confidence Interval | Days to resolution of diarrhea | | 40 days | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--Double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--Double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Other Pre-specified | Segment 2A: Microbiome Effects | The Shannon Diversity Index and Inverse Simpson Diversity Index are used to quantify biodiversity in a community like the gut microbiome, measuring how many different species are present in a community (richness) and how close in numbers different species in the community are to each other (evenness). The Shannon considers both factors while the Inverse Simpson focuses on evenness. The Shannon diversity index is calculated using natural logarithms, and units cancel out in the calculation, so it lacks units. It ranges from 0 to infinity. The Inverse Simpson represents the likelihood of selecting two different individuals from a population. It is a ratio and has no units. It ranges from 0 to 1. For both indexes, higher values indicate greater diversity. | 8 of the 10 participants in Segment 2A provided stool samples and were analyzed. Not all 8 subjects were able to provide samples for all time points, so the data are not continuous. Data is reported as mean increase in biodiversity from the baseline. | Posted | | Mean | Standard Deviation | Index | | Days 10 and 40 | | | | ID | Title | Description |
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| OG000 | Segment 2A: Ibezapolstat (ACX-362E) Open-Label Single-Arm | Participants with diarrhea caused by C. difficile were treated with ibezapolstat 450 mg orally (3 x 150 mg capsules) every 12 hours for 10 days. Study drug was administered with 240 mL water. Participants were followed for recurrence for 28±2 days, regardless of response to ibezapolstat. Safety, tolerability, and efficacy were assessed by the Trial Oversight Committee which then recommended early termination of this segment of the trial and advancement to the 2B Segment because the first 10 patients demonstrated clinical cure. |
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| Other Pre-specified | Segment 2B Per Protocol (PP) Population: Change From Baseline in EuroQoL 5 Dimension 5 Level (EQ-5D-5L) Quality of Life Scores | Change from baseline in each of the 5 dimensions of the EQ-5D-5L score, each scored on a scale of 1-5, with 1 being normal and 5 indicating extreme difficulty or impairment. The 5 dimensions are mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Summary Index Scores (the 5 dimensions combined into a single value) are reported here. Values for the index score ranges from -0.59 to 1, where 1 is the best possible health state. | PP participants were those in the intent-to-treat (ITT) population who had no major protocol deviations. The ITT population is defined as all randomized subjects, analyzed according to their randomized treatment assignment. | Posted | | Mean | Standard Deviation | Summary Index Score | | Days 12, 38, 66, and 94 | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. | | OG001 | Segment 2B: Vancomycin Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received vancomycin every 6 hours (1 capsule 125 mg + 2 placebo capsules every 12 hours or 1 capsule 125 mg every 12 hours). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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| Other Pre-specified | Segment 2B Intent-to-Treat (ITT) Extension Population: Extended Clinical Cure (ECC) of Clostridioides Difficile Infection (CDI) | Clinical cure (CC) at the test of cure (TOC) visit (ie, at least 48 hours after end of treatment [day 10]) and no recurrence within 56 days [day 66] or within 84 days [day 94]. Recurrence was defined as a new episode of diarrhea (3 or more UBMs in a 24-hour period) with a positive toxin result, using a Sponsor-approved C. difficile free toxin test and, in the opinion of the Investigator, requiring retreatment with an antibacterial agent for C. difficile. | Participants from the ITT population were recruited for an extended follow-up period. In the ITT extension population, 1 ibezapolstat subject failed at the CC (Day 12) and 1 vancomycin subject failed at the SCC (Day 38); both failures carried forward to both ECC evaluations. There were no failures post SCC (Day 38). In the ITT extension population who achieved a SCC, 5/5 ibezapolstat-treated participants and 7/7 vancomycin-treated participants experienced no infection recurrence. | Posted | | Count of Participants | | Participants | | 56 days after end of treatment (Day 66) and 84 days after end of treatment (Day 94) | | | | ID | Title | Description |
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| OG000 | Segment 2B: Ibezapolstat Arm--double-blind, Randomized, Active-controlled Clinical Segment | Participants with diarrhea caused by C. difficile who were randomized to this arm received 450 mg ibezapolstat (3 x 150 mg capsules) every 12 hours for 10 days with placebo every 12 hours for 10 days (to maintain blind). Participants were followed for 28±2 days for recurrence. Blinding was maintained by over-encapsulation. |
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