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Phase 3 Completed N=267 Randomized Triple-blind Treatment

Microbiota Restoration Therapy for Recurrent Clostridium Difficile Infection (PUNCHCD3)

Clostridium Difficile Infection (CDI)
Source: ClinicalTrials.gov NCT03244644 ↗
Enrolled (actual)
267
Serious AEs
7.2%
Results posted
Aug 2023
Primary outcomePrimary: Efficacy of RBX2660 Compared to Placebo Through 8 Weeks — 57.5; 70.6 Model-estimated percent of participants
◆ Published Evidence
Emerging
13citations · ~13 / year
Microbiome and Metabolome Restoration After Administration of Fecal Microbiota, Live-jslm (REBYOTA) for Preventing Recurrent Clostridioides difficile Infection.
The Journal of infectious diseases · 2025 · Open access · Likely link

Summary

This is a prospective, multicenter, randomized, double-blinded, placebo-controlled Phase 3 study of a microbiota suspension of intestinal microbes. Patients who have had at least one recurrence after a primary episode and have completed at least one round of standard-of-care oral antibiotic therapy or have had at least two episodes of severe Clostridioides difficile infection (CDI) resulting in hospitalization within the last year may be eligible for the study. Subjects who are deemed failures following the blinded treatment per the pre-specified treatment failure definition may elect to receive an unblinded dose of RBX2660.

Linked Publications (5)

  • Microbiome and Metabolome Restoration After Administration of Fecal Microbiota, Live-jslm (REBYOTA) for Preventing Recurrent Clostridioides difficile Infection.
    The Journal of infectious diseases · 2025 · 13 citations · Open access · Likely link
  • Microbiome compositional changes and clonal engraftment in a phase 3 trial of fecal microbiota, live-jslm for recurrent <i>Clostridioides difficile</i> infection.
    Gut microbes · 2025 · 8 citations · Open access · Likely link
  • Microbiome and metabolome changes after fecal microbiota, live-jslm, administration are associated with health-related quality of life improvements.
    Anaerobe · 2025 · 3 citations · Likely link
  • Integrated analysis of the safety of fecal microbiota, live-jslm in adults with recurrent <i>Clostridioides difficile</i> infection from five prospective clinical trials: an update.
    Therapeutic advances in gastroenterology · 2025 · 1 citation · Open access · Likely link
  • Decreased Antimicrobial Resistance Gene Richness Following Fecal Microbiota, Live-jslm (REBYOTA®) Administration: Post Hoc Analysis of PUNCH CD3.
    Open Forum Infectious Diseases · 2025 · 0 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Efficacy of RBX2660 Compared to Placebo Through 8 Weeks
57.5; 70.6
SECONDARY
Sustained Clinical Response Through 6 Months After Blinded Treatment
48; 116; 48; 116 0.156

Eligibility Criteria

Inclusion Criteria

  • ≥ 18 years old.
  • Medical record documentation of recurrent CDI per the study definition, that includes either: a) at least one recurrence after a primary episode and has completed at least one round of standard-of-care oral antibiotic therapy or b) has had at least two episodes of severe CDI resulting in hospitalization within the last year.
  • A positive stool test for the presence of toxigenic C. difficile within 30 days prior to or on the date of enrollment.
  • Is currently taking or was just prescribed antibiotics to control CDI related diarrhea at the time of enrollment.

[Note: Subject's CDI diarrhea must be controlled (<3 unformed/loose stools/day) while taking this course of antibiotics]

Exclusion Criteria

  • Currently has continued CDI diarrhea despite being on antibiotics prescribed for CDI treatment.
  • Previous fecal transplant
  • History of inflammatory bowel disease (IBD), e.g., ulcerative colitis, Crohn's disease, or microscopic colitis.
  • Diagnosis of irritable bowel syndrome (IBS) as determined by Rome III criteria.
  • Compromised immune system (e.g. immunosuppressed due to a medical condition or medication; current or recent (< 90 days) treatment with chemotherapy)
  • An absolute neutrophil count of <1000 cells/µL during screening.
  • Pregnant, breastfeeding, or intends to become pregnant during study participation.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03244644) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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