Rifaximin for the Secondary Prevention of Recurrent Pouchitis

NCT ID: NCT06312683

Last Updated: 2025-07-11

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE4
• Total Enrollment: 16 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-07-01
• Study Completion Date: 2026-07-31

Brief Summary

Although many people will develop recurrent pouchitis (inflammation of the ileal pouch-anal anastomosis or J-pouch after colectomy for ulcerative colitis) after an initial episode of pouchitis, there are currently no effective treatments to prevent recurrent pouchitis. The goal of this study is to evaluate the potential for rifaximin, an antibiotic, to prevent recurrent pouchitis after treatment for an initial episode of pouchitis. In this study, all patients will be given daily rifaximin for one year after being treated for an initial episode of pouchitis. This study will examine whether people are willing to take rifaximin for one year with the goal of preventing recurrent pouchitis. Additionally, this study will examine whether patients experience any unexpected side effects of rifaximin therapy. The information gained through this study will potentially be helpful in improving the ability to prevent recurrent pouchitis in patients who have a colectomy for ulcerative colitis.

Conditions

Pouchitis

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

All Participants

550 mg Rifaximin (Xifaxan) twice a day x 365 days

Group Type: EXPERIMENTAL

Rifaximin 550 MG Oral Tablet [XIFAXAN]

Intervention Type: DRUG

Rifaximin 550 MG Oral Tablet \[XIFAXAN\] Taken twice a day for up to 365 days

Interventions

Rifaximin 550 MG Oral Tablet [XIFAXAN]

Rifaximin 550 MG Oral Tablet \[XIFAXAN\] Taken twice a day for up to 365 days

Intervention Type: DRUG

Other Intervention Names

Xifaxan

Eligibility Criteria

Inclusion Criteria

• Informed consent will be obtained before any study-related procedures
• Age > 18 and <75 years
• Participants with a proven history of ulcerative colitis and history of 1,2, modified -2 or 3 stage Ileal pouch anal anastomosis (IPAA) and ileostomy takedown
• Diagnosis of initial episode of pouchitis within the first 12 months after ileostomy takedown/final stage of IPAA surgery

Exclusion Criteria

• Known hypersensitivity to rifaximin or its metabolites
• Known Crohn's disease
• History of perianal fistula
• Known incontinence due to anal sphincter dysfunction
• Known irritable pouch syndrome
• Active ongoing pelvic infection/sepsis at baseline visit
• New onset of high bowel frequency in the setting of acute pouchitis in the first 4 weeks after IPAA
• Known Clostridoides difficile infection
• Need for antibiotic long-term therapy (e.g. doxycycline for acne)
• Known active Hepatitis B, C, HIV
• Clinically significant liver disease (Primary Sclerosing Cholangitis with LFT's <1.5 upper limit of normal can be included)
• Severe hepatic impairment, defined as Child-Pugh Class C
• Concomitant use of p-glycoprotein (P-gp) inhibitors (e.g. cyclosporine)
• Known decreased kidney function with a glomerular filtration rate <60 ml/min/1.732
• Fecal microbiota transplantation within 16 weeks before ileostomy takedown
• History of malignancy, except for basal cell carcinoma, non-metastatic squamous cell carcinoma of the skin, or prior malignancy with curative therapy completed at least 5 years prior to Screening and no recurrence.
• Clinically significant laboratory results at screening or baseline, as judged by the Investigator from local testing.
• Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using a highly effective contraceptive method. Women of child-bearing potential must have a negative urine pregnancy test prior to drug being dispensed.
• Participation in any clinical trial of an approved or non-approved investigational medicinal product within 30 days before screening.
• Any disorder, which in the investigator's opinion might jeopardize participant's safety or compliance with the protocol.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 74 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Bausch Health Americas, Inc.

INDUSTRY

Sponsor Role: collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Edward Barnes, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina

Locations

NYU IBD Center

New York, New York, United States

Site Status: RECRUITING

University of North Carolina

Chapel Hill, North Carolina, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Mikki Sandridge

Role: CONTACT

mikki_sandridge@med.unc.edu

(919) 843-3873

Facility Contacts

Nathasha Melukkaran

Role: primary

Nathasha.melukkaran@nyulangone.org

646-754-3417

Mikki Sandridge

Role: primary

mikki_sandridge@med.unc.edu

919-843-3873

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Other Identifiers

23-2111

Identifier Type: -

Identifier Source: org_study_id