ECOSPOR IV: An Open-Label Study Evaluating SER-109 in Recurrent Clostridioides Difficile Infection

NCT ID: NCT03183141

Last Updated: 2023-04-10

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

263 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-23

Study Completion Date

2022-04-29

Brief Summary

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Cohort 1: Subjects who had a Clostridioides difficile infection (CDI) recurrence in study SERES-012 within 8 weeks of receipt of study drug will be eligible. The purpose of this cohort is to assess safety and efficacy of SER-109 in reducing recurrence of CDI in adults who had a CDI recurrence within 8 weeks after receipt of SER-109 or Placebo in study SERES-012.

Cohort 2: Cohort 2 is an open-label program for subjects who were not part of SERES-012. The purpose of this cohort is to describe safety and tolerability of SER-109 in subjects 18 years of age or older with at least a first recurrence of CDI.

Detailed Description

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Cohort 1 is an open-label extension of study SERES-012. Subjects who had a CDI recurrence in study SERES-012 within 8 weeks of receipt of study drug, have responded to a course of standard of care (SOC) antibiotic treatment, will receive an oral dose of SER-109. A treatment regimen of SER-109 is defined as an oral dose of SER-109 (4 capsules once daily) for 3 consecutive days.

Approximately 30 eligible subjects with recurrent CDI disease from study SERES-012 are expected to enroll. Screening for this study will begin at the Recurrence Visit of Study SERES-012.

Cohort 2 is an open-label program for subjects who were not part of SERES-012. Subjects 18 years of age or older who had one or more CDI recurrence and have responded to a course of antibiotic treatment will receive an oral dose of SER-109. The CDI recurrence must be confirmed by a positive C. difficile stool toxin or polymerase chain reaction (PCR) assay to confirm eligibility. A treatment regimen of SER-109 is defined as an oral dose of SER-109 (4 capsules once daily) for 3 consecutive days.

Approximately 200 eligible subjects with recurrent CDI disease are expected to enroll.

Conditions

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Clostridioides Difficile Infection

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SER-109

Received oral dose of SER-109

Group Type EXPERIMENTAL

SER-109

Intervention Type BIOLOGICAL

SER-109, an oral, biologically derived, live microbiome therapeutic that comprises purified bacterial spores

Interventions

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SER-109

SER-109, an oral, biologically derived, live microbiome therapeutic that comprises purified bacterial spores

Intervention Type BIOLOGICAL

Other Intervention Names

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Firmicutes spores

Eligibility Criteria

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Inclusion Criteria

1. Previously enrolled in Study SERES-012, had CDI recurrence within 8 weeks after receipt of a treatment regimen of SER-109 or placebo
2. Signed informed consent prior to initiation of any study-specific procedure or treatment. The subject, or their legally authorized representative, must be able to provide written informed consent and understand the potential risks and benefits from study enrollment and treatment.
3. The CDI recurrence in Study SERES-012 must have met the protocol definition of ≥ 3 unformed stools per day over 2 consecutive days, a positive C. difficile stool toxin assay, and the requirement of CDI SOC antibiotic therapy, and an adequate clinical response following antibiotic therapy (\<3 unformed stools in 24 hours for 2 or more consecutive days).


1. Subjects 18 years of age or older who had one or more CDI recurrence (as confirmed by a C. difficile stool toxin or PCR test) and have responded to a course of antibiotic treatment.
2. Signed informed consent prior to initiation of any study-specific procedure or treatment. The subject, or their legally authorized representative, must be able to provide written informed consent and understand the potential risks and benefits from study enrollment and treatment.

Exclusion Criteria

1. Female subjects who are pregnant, breastfeeding, lactating, or planning to become pregnant during the study.
2. Known or suspected toxic megacolon and/or known small bowel ileus.
3. Admitted to or expected to be admitted to an intensive care unit for medical reasons (not just boarding). Note: nursing homes, rehabilitation, assisted living centers and acute care hospitals are acceptable.
4. Absolute neutrophil count of \<500 cells/mm\^3.
5. Major gastrointestinal surgery (e.g. significant bowel resection or diversion) within 3 months before enrollment (this does not include appendectomy or cholecystectomy), or any history of total colectomy or bariatric surgery (bariatric surgery which does not disrupt the gastrointestinal lumen, i.e., restrictive procedures such as banding, are permitted).
6. History of active inflammatory bowel disease (ulcerative colitis, Crohn's disease, microscopic colitis) with diarrhea believed to be caused by active inflammatory bowel disease in the past 3 months.
7. Concurrent intensive induction chemotherapy, radiotherapy, or biologic treatment for active malignancy (subjects on maintenance chemotherapy may only be enrolled after consultation with the study medical monitor).
8. Any history of fecal microbiota transplantation (FMT) in the past 3 months.



9\. Previously enrolled in a Seres Therapeutics clinical study. An exception is made for subjects who screened in SERES-012 who did not receive SER-109 and did not previously roll-over to SERES-013.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seres Therapeutics, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elaine Wang, MD

Role: STUDY_DIRECTOR

Seres Therapeutics, Inc.

Locations

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Dothan, Alabama, United States

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Sun City West, Arizona, United States

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Mather, California, United States

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Mountain View, California, United States

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Murrieta, California, United States

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Northridge, California, United States

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Sacramento, California, United States

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San Bernardino, California, United States

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San Diego, California, United States

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San Dimas, California, United States

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Simi Valley, California, United States

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Thousand Oaks, California, United States

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Clearwater, Florida, United States

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Clearwater, Florida, United States

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DeLand, Florida, United States

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Hialeah, Florida, United States

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Homestead, Florida, United States

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Jacksonville, Florida, United States

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Miami, Florida, United States

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Miami, Florida, United States

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Miami, Florida, United States

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Miami, Florida, United States

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Miami, Florida, United States

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Miami, Florida, United States

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Miami Lakes, Florida, United States

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Naples, Florida, United States

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Orlando, Florida, United States

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Pembroke Pines, Florida, United States

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Pembroke Pines, Florida, United States

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Port Orange, Florida, United States

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Athens, Georgia, United States

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Atlanta, Georgia, United States

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Decatur, Georgia, United States

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Marietta, Georgia, United States

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Morrow, Georgia, United States

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Boise, Idaho, United States

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Idaho Falls, Idaho, United States

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Chicago, Illinois, United States

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Oak Lawn, Illinois, United States

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Springfield, Illinois, United States

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Evansville, Indiana, United States

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Iowa City, Iowa, United States

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Kansas City, Kansas, United States

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New Orleans, Louisiana, United States

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Annapolis, Maryland, United States

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Chevy Chase, Maryland, United States

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Glen Burnie, Maryland, United States

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Boston, Massachusetts, United States

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Framingham, Massachusetts, United States

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North Dartmouth, Massachusetts, United States

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Weymouth, Massachusetts, United States

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Worcester, Massachusetts, United States

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Chesterfield, Michigan, United States

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Detroit, Michigan, United States

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Flint, Michigan, United States

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Royal Oak, Michigan, United States

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Wyoming, Michigan, United States

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Rochester, Minnesota, United States

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Chesterfield, Missouri, United States

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Butte, Montana, United States

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Morristown, New Jersey, United States

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Neptune City, New Jersey, United States

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Buffalo, New York, United States

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New York, New York, United States

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Charlotte, North Carolina, United States

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Greenville, North Carolina, United States

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Jacksonville, North Carolina, United States

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Kinston, North Carolina, United States

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Akron, Ohio, United States

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Centerville, Ohio, United States

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Cincinnati, Ohio, United States

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Cleveland, Ohio, United States

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Mentor, Ohio, United States

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Toledo, Ohio, United States

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Camp Hill, Pennsylvania, United States

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Harrisburg, Pennsylvania, United States

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Sayre, Pennsylvania, United States

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Providence, Rhode Island, United States

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Union City, Tennessee, United States

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Cypress, Texas, United States

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Garland, Texas, United States

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McKinney, Texas, United States

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Pasadena, Texas, United States

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San Antonio, Texas, United States

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Southlake, Texas, United States

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Spring, Texas, United States

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Ogden, Utah, United States

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Riverton, Utah, United States

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Salt Lake City, Utah, United States

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Spokane, Washington, United States

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Tacoma, Washington, United States

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Milwaukee, Wisconsin, United States

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Calgary, Alberta, Canada

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Vancouver, British Columbia, Canada

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Victoria, British Columbia, Canada

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St. John's, Newfoundland and Labrador, Canada

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London, Ontario, Canada

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North Bay, Ontario, Canada

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Scarborough Village, Ontario, Canada

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Chicoutimi, Quebec, Canada

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Québec, Quebec, Canada

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Sainte-Foy, Quebec, Canada

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Countries

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United States Canada

References

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Kraft CS, Sims M, Silverman M, Louie TJ, Feuerstadt P, Huang ES, Khanna S, Berenson CS, Wang EEL, Cohen SH, Korman L, Lee C, Kelly CR, Odio A, Cook PP, Lashner B, Ramesh M, Kumar P, De A, Memisoglu A, Lombardi DA, Hasson BR, McGovern BH, von Moltke L, Pardi DS; ECOSPOR III and ECOSPOR IV investigators. Integrated Safety and Efficacy Analyses of Phase 3 Trials of a Microbiome Therapeutic for Recurrent CDI. Infect Dis Ther. 2024 Oct;13(10):2105-2121. doi: 10.1007/s40121-024-01007-z. Epub 2024 Jun 28.

Reference Type DERIVED
PMID: 38941068 (View on PubMed)

Sims MD, Khanna S, Feuerstadt P, Louie TJ, Kelly CR, Huang ES, Hohmann EL, Wang EEL, Oneto C, Cohen SH, Berenson CS, Korman L, Lee C, Lashner B, Kraft CS, Ramesh M, Silverman M, Pardi DS, De A, Memisoglu A, Lombardi DA, Hasson BR, McGovern BH, von Moltke L; ECOSPOR IV Investigators. Safety and Tolerability of SER-109 as an Investigational Microbiome Therapeutic in Adults With Recurrent Clostridioides difficile Infection: A Phase 3, Open-Label, Single-Arm Trial. JAMA Netw Open. 2023 Feb 1;6(2):e2255758. doi: 10.1001/jamanetworkopen.2022.55758.

Reference Type DERIVED
PMID: 36780159 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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SERES-013

Identifier Type: -

Identifier Source: org_study_id

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