The first and only FDA-approved microbiota-based live biotherapeutic to prevent recurrence of C. difficile infection starting at first recurrence1,2,a
aIn the pivotal phase 3 trial, 32.8% of patients were treated at first recurrence of CDI following antibiotic treatment of CDI.1
REBYOTA WAS STUDIED IN ~1000 PATIENTS ACROSS 5 CLINICAL TRIALS1,3-7,b
|Total Patients Enrolled||N=40||N=150||N=272||N=320||N=483
Patients with recurrent CDI (rCDI)
Composition of live fecal microbes
Absence of CDI diarrhea within 8 weeks
|Study Type||Open-label||Randomized, controlled||Open-label||Randomized, controlled||Open-label|
|Follow-Up Duration||6 months||24 months||24 months||6 months||6 months|
- Participants across 5 trials were not excluded if they had a history of food allergies1
bIn PUNCH™ CD2 and PUNCH™ CD3, participants were excluded if they had a known history of refractory CDI, IBD, IBS, chronic diarrhea, celiac disease, colostomy, active colitis, required antibiotic therapy for another condition, or had a history of fecal matter transplant.1,3,6 PUNCH™ CD3-OLS did not exclude individuals with celiac disease, IBD, IBS, and chronic diarrhea.1
PIVOTAL PUNCH™ CD3 TRIAL
Enrolled 320 patients with documented recurrent CDI (≥1 recurrence after a primary episode of CDIc or ≥2 episodes of severe CDI recurrences resulting in hospitalization within the last year).1,6
Investigator’s choice: Diagnostic test(s) used and selection of antibiotic to address active infection.6,d
PCR was utilized in >70% of PUNCH™ CD3 participants to diagnose qualiﬁed CDI.6
No bowel prep: Patients did not receive bowel prep prior to REBYOTA™ treatment.6
cPatients also must have completed >1 round of SoC antibiotic therapy.6
dCDI diagnosis confirmed 30 days before study enrollment via PCR, EIA, GDH, toxin A or B presence, or other CDI diagnostic test. Antibiotics (vancomycin, vancomycin in combination, fidaxomicin, or other) administered ≥10 consecutive days before washout.6
REBYOTA PREVENTED RECURRENCE OF CDI AT 8 WEEKS
In the pivotal PUNCH™ CD3 trial,
REBYOTA demonstrated a statistically significant 70.6% (126/177) treatment success ratee at 8 weeks.
Placebo was 57.5% (53/85).1,6
Of those patients who saw success, 92.1% (116/126) had a sustained response through 6 months.
Placebo was 90.6% (48/53).1,6
Patients achieved treatment success6
Number of prior CDI episodesf • Agef • Sex • Race
of patients were treated at first recurrence of CDI1,8
FOLLOW-UP RANGED FROM 6 TO 24 MONTHS
Across the 5 trials in the clinical program, 978 patients had at least 1 dose of REBYOTA.1
In the PUNCH™ CD3 trial…
Adverse reactions reported by ≥3% of REBYOTA recipients (and at a rate greater than that reported by placebo recipients) within 8 weeks after receipt of REBYOTA or placebo.1,6,g
|ADVERSE REACTIONS, n (%)1||REBYOTA
|Abdominal pain||16 (8.9%)||6 (6.9%)|
|Diarrhea||13 (7.2%)||3 (3.4%)|
|Abdominal distension||7 (3.9%)||2 (2.3%)|
|Nausea||6 (3.3%)||1 (1.1%)|
Most adverse reactions occurred during the first 2 weeks after treatment1
- Proportion of patients with adverse reactions declined in subsequent 2-week intervals thereafter
- Beyond 2 weeks after treatment only a few single events were reported
Most adverse drug reactions were mild to moderate in severity1
- No life-threatening adverse reaction related to REBYOTA was reported
gAdverse reactions were defined as solicited and unsolicited adverse events that were assessed as definitely, possibly, or probably related to treatment by the study investigator and that occurred within 8 weeks after blinded REBYOTA or placebo administration or until recurrence of CDI.1
ONE COMPLETE MICROBIOME TREATMENT
Delivered within minutes by a healthcare professional9
- Request that patient empty bladder and bowel, if possible
- Place patient in the preferred position: either a left-side or knee-chest position
- Lubricate and insert the administration tube about 5 inches pointed slightly toward the navel
- Hold the administration tube, with other hand open pinch clamp
- Gradually raise, allow REBYOTA to flow via gravity
- Withdraw tube
- Keep patient in position for up to 15 minutes to minimize possible cramping
- It is normal for some product to remain in tube; does not affect treatment
- No specified cleaning of facility in phase 3 trial protocol
- DO NOT administer REBYOTA during antibiotic treatment for CDI
- Administer 24 to 72 hours after the last dose of antibiotics
REBYOTA Support And Reimbursement
Support for providers as well as patients.
There are multiple ways to order REBYOTA: through major specialty distributors, specialty pharmacies, or directly from Ferring.
Sign up to receive information
and updates on REBYOTA
IMPORTANT SAFETY INFORMATION
REBYOTA (fecal microbiota, live – jslm) is indicated for the prevention of recurrence of Clostridioides difficile infection (CDI) in individuals 18 years of age and older, following antibiotic treatment for recurrent CDI.
Limitation of Use
REBYOTA is not indicated for treatment of CDI.
IMPORTANT SAFETY INFORMATION
Do not administer REBYOTA to individuals with a history of a severe allergic reaction (eg, anaphylaxis) to any of the known product components.
Warnings and Precautions
Transmissible infectious agents
Because REBYOTA is manufactured from human fecal matter, it may carry a risk of transmitting infectious agents. Any infection suspected by a physician possibly to have been transmitted by this product should be reported by the physician or other healthcare provider to Ferring Pharmaceuticals Inc.
Management of acute allergic reactions
Appropriate medical treatment must be immediately available in the event an acute anaphylactic reaction occurs following administration of REBYOTA.
Potential presence of food allergens
REBYOTA is manufactured from human fecal material and may contain food allergens. The potential for REBYOTA to cause adverse reactions due to food allergens is unknown.
The most commonly reported (≥3%) adverse reactions occurring in adults following a single dose of REBYOTA were abdominal pain (8.9%), diarrhea (7.2%), abdominal distention (3.9%), flatulence (3.3%), and nausea (3.3%).
Use in Specific Populations
Safety and efficacy of REBYOTA in patients below 18 years of age have not been established.
Of the 978 adults who received REBYOTA, 48.8% were 65 years of age and over (n=477), and 25.7% were 75 years of age and over (n=251). Data from clinical studies of REBYOTA are not sufficient to determine if adults 65 years of age and older respond differently than younger adults.
You are encouraged to report negative side effects of prescription drugs to FDA. Visit www.FDA.gov/medwatch, or call
Please click here for full Prescribing Information.
- REBYOTA. Prescribing information. Parsippany, NJ: Ferring Pharmaceuticals Inc; 2022.
- US Food and Drug Administration. FDA Approves First Fecal Microbiota Product. https://www.fda.gov/news-events/press-announcements/fda-approves-first-fecalmicrobiota-product. Accessed December 1, 2022.
- Orenstein R, Dubberke E, Hardi R, et al. Safety and durability of RBX2660 (microbiota suspension) for recurrent Clostridium difficile infection: results of the PUNCH CD study. Clin Infect Dis. 2016;62(5):596-602. doi:10.1093/cid/civ938.
- Dubberke ER, Lee CH, Orenstein R, Khanna S, Hecht G, Gerding DN. Results from a randomized, placebo-controlled clinical trial of a RBX2660-a microbiota-based drug for the prevention of recurrent Clostridium difficile infection. Clin Infect Dis. 2018;67(8):1198-1204. doi:10.1093/cid/ciy259.
- Orenstein R, Dubberke ER, Khanna S, et al. Durable reduction of Clostridioides difficile infection recurrence and microbiome restoration after treatment with RBX2660: results from an open-label phase 2 clinical trial. BMC Infect Dis. 2022;22(1):245. Published 2022 Mar 12. doi:10.1186/s12879-022-07256-y.
- Khanna S, Assi M, Lee C, et al. Efficacy and safety of RBX2660 in PUNCH CD3, a phase III, randomized, double-blind, placebo-controlled trial with a Bayesian primary analysis for the prevention of recurrent Clostridioides difficile infection. Drugs. 2022;82(15):1527-1538. doi:10.1007/s40265-022-01797-x.
- Khanna S, Dubberke ER, Knapple WL, et al. An ad hoc analysis of a phase 3, open-label study indicates efficacy and safety of RBX2660 in patients with recurrent Clostridioides difficile infection. Oral presentation at: American College of Gastroenterology Annual Meeting; October 2022; Charlotte, NC.
- Khanna S, Tillotson G, Ando M, et al. Efficacy and safety of RBX2660 in patients after first recurrence of Clostridioides difficile infection—results from a randomized, placebo-controlled, phase 3 study. Poster presented at American College of Gastroenterology (ACG) 2022 Annual Scientific Meeting and Postgraduate Course; October 21-26, 2022; Charlotte, North Carolina.
- Ray A, Jones C. Does the donor matter? Donor vs patient effects in the outcome of a next-generation microbiota-based drug trial for recurrent Clostridium difficile infection. Future Microbiol. 2016;11(5):611-616. doi:10.2217/fmb.16.10.