*Calculated by the rate of
C. diff
recurrence, which was significantly lower in VOWST recipients compared to those receiving antibiotics alone—12% vs. 40%, respectively—a 0.32 relative risk (95% confidence interval, 0.18, 0.58;
P
<0.001).1,2
†Relative risk of 0.46 (95% CI, 0.30, 0.73).
ECOSPOR III was a Phase 3, multicenter, double-blind, randomized, placebo-controlled trial evaluating
C. diff
recurrence at 8 weeks; secondary endpoints at 4, 12, 24 weeks. In the intent-to-treat population, participants received standard-of-care antibiotics (vancomycin/fidaxomicin) and laxative followed by VOWST or placebo. Those lost to follow-up, terminated prematurely, or died prior to end of study time interval counted as a recurrence. Data were rounded to the nearest whole number for presentation.
ECOSPOR IV SECONDARY ENDPOINT
CLINICAL RESPONSE AT 8 WEEKS
AT 8 WEEKS
PERCENTAGE OF PARTICIPANTS WITHOUT C. DIFF RECURRENCE5
ECOSPOR IV was an open-label, single-arm study. The primary outcome evaluated the safety and tolerability of VOWST up to 24 weeks
Limitations: Open-label, single-arm study design yields descriptive results limiting interpretations of efficacy and safety without a comparator
Nearly 1/3 had a first
C. diff
recurrence at baseline
AT 24 WEEKS
86% OF RECIPIENTS
REMAINED RECURRENCE FREE5
ECOSPOR IV evaluated the safety of VOWST (adverse events within 24 weeks); secondary endpoints evaluated
C. diff
recurrence at 4, 8, 12, 24 weeks. Participants received VOWST after standard-of-care antibiotics treatment (vancomycin/fidaxomicin) and laxative. Data were rounded to the nearest whole number for presentation.
REFERENCES: 1.
VOWST [Prescribing Information]. Cambridge, MA: Seres Therapeutics, Inc. and Nestlé Health Science. 04/2023.
2.
Feuerstadt P, Louie TJ, Lashner B, et al.
N Engl J Med. 2022;236:220-229. doi: 10.1056/NEJMoa2106516.
3.
Cohen SH, Louie TJ, Sims M, et al.
JAMA. Published Online: October 19, 2022. doi: 10.1001/jama.2022.16476.
4.
Data on file.
5.
Sims MD, Khanna S, Feuerstadt P, et al.
JAMA Network Open. 2023;6(2):e2255758. doi: 10.1001/jamanetworkopen.2022.55758.
IMPORTANT SAFETY INFORMATION
INDICATION
IMPORTANT SAFETY INFORMATIONWARNINGS AND PRECAUTIONS Transmissible infectious agents:
Because VOWST is manufactured from human fecal matter, it may carry a risk of transmitting infectious agents. Report any infection that is suspected to have been transmitted by VOWST to Aimmune Therapeutics, Inc. at
1-833-246-2566.
Potential presence of food allergens:
VOWST may contain food allergens. The potential to cause adverse reactions due to food allergens is unknown.
ADVERSE REACTIONS
The most common adverse reactions (reported in ≥5% of Vowst-treated participants, and at a rate greater than placebo) were abdominal distension (31.1%), fatigue (22.2%), constipation (14.4%), chills (11.1%), and diarrhea (10.0%).
DRUG INTERACTIONS
Do not administer antibacterials concurrently with VOWST.
INDICATION
VOWST is indicated to prevent the recurrence of
Clostridioides difficile
infection (CDI) in individuals 18 years of age and older following antibacterial treatment for recurrent CDI (rCDI).
Limitation of Use: VOWST is not indicated for treatment of CDI.
This site is intended for healthcare
professionals licensed in the United States only.
STUDY DESIGN
ECOSPOR III
Multicenter, randomized, double-blind, placebo-controlled,
parallel-group trial in adults (≥18 years) with recurrent
C. diff1-3
Primary Endpoint
Recurrence at 8 weeks*
Secondary Endpoints
Adverse events within 24 weeks
Recurrence at 4, 12, 24 weeks*
Recurrence confirmed with C. diff toxin test and ≥3 unformed bowel movements per day over 2 days*
10–21 days of vancomycin (125 mg QID) or fidaxomicin (200 mg BID)
ECOSPOR III efficacy endpoints based on intent-to-treat population.
Data were rounded to the nearest whole number for presentation.
STUDY DESIGN
ECOSPOR IV was an open-label, single arm study
of 263 participants with ≥1
C. diff
recurrences
evaluating the safety of VOWST;
the secondary endpoint was efficacy5
Limitations: open-label study design yields descriptive results limiting interpretations of efficacy and safety without a comparator
ECOSPOR IV
Multicenter, open-label, single-arm trial
in adults (≥18 years) with recurrent
C. diff5
Primary Endpoint
Adverse events within 24 weeks
Secondary Endpoints
Recurrence at 4, 8, 12, 24 weeks
Recurrence confirmed with
C. diff
toxin test
or
PCR
and ≥3 unformed bowel movements per day over 2 days*
10–42 days of vancomycin
or 10–25 days of fidaxomicin
Toxin and PCR testing were utilized to determine initial eligibility. Recurrences while on study were confirmed by toxin testing to ensure study integrity.
†25 placebo recipients and 4 VOWST recipients discontinued ECOSPOR III and enrolled in ECOSPOR IV after experiencing a C. Diff recurrence within 8 weeks.
Data were rounded to the nearest whole number for presentation.