A comprehensive, multi-center US study involving 67 eligible patients examined the effectiveness of fecal microbiota, live-jslm (RBL), as a treatment option for recurrent Clostridioides difficile infection (rCDI). Results indicate a treatment success rate of 77.6% at an 8 week mark. Furthermore, a robust 87% of participants sustained remission at six months, reinforcing the safety and efficacy of RBL for a largely mature, comorbid group frequently exposed to various rCDI risk factors.
RBL, upon its FDA approval in November 2022, was noted as the first microbiota-based product for the prevention of rCDI in adults. The innovative treatment is administered rectally, following standard-of-care antibiotics. The median age of participating patients was 74 years, with the majority having experienced three or more prior CDI recurrences. Advanced age, considerable recurrence of CDI, use of gastric acid suppressants, being immunocompromised, and recent exposure to non-CDI antibiotics were all prevalent risk factors in this group.
To date, the use of RBL has resulted in minimal negative side effects, with only minor leakage reported in 5 patients. For patients aged 65 and over, there was a significant association with a higher risk of recurrence. Achieving the milestone of 6-month follow-up data, 26 out of 30 patients (87%) demonstrated a sustained treatment response. These findings offer relevant insights for healthcare professionals tackling complex rCDI cases, and underscore RBL as an effective intervention to mitigate recurrence risks in everyday practice.
Beyond its role in rCDI prevention, Paul Feuerstadt, MD, FACG, AGAF, notes during an interview, that RBL significantly improves patients’ overall quality of life. Frequent CDI can trigger extensive anxiety, fear, and social isolation, heightening emotional stress akin to post-traumatic experiences. RBL not only tackles the infection but also makes substantial strides in reviving patients’ mental, physical, and social well-being. By doing so, it enables patients to reclaim confidence and segue back to their typical routines.