Evidence map›Paper›PMID 29538686›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018

Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection in Patients at Increased Risk for Recurrence.

Dale N Gerding, Ciaran P Kelly, Galia Rahav, Christine Lee, Erik R Dubberke, Princy N Kumar, Bruce Yacyshyn, Dina Kao, Karen Eves, Misoo C Ellison and 3 more

3 registry-linked trialsOpen access · hybridAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 97 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 1 pooled it
12.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01241552 phase3completednot on this map

A Phase III, Randomized, Double-Blind, Placebo-Controlled, Adaptive Design Study of the Efficacy, Safety, and Tolerability of a Single Infusion of MK-3415 (Human Monoclonal Antibody to Clostridium Difficile Toxin A), MK-6072 (Human Monoclonal Antibody to Clostridium Difficile Toxin B), and MK-3415A (Human Monoclonal Antibodies to Clostridium Difficile Toxin A and Toxin B) in Patients Receiving Antibiotic Therapy for Clostridium Difficile Infection (MODIFY I)

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2011 to 2014Enrolled1,452ConditionsClostridium Difficile InfectionArmsMK-3415, MK-6072, MK-3415A, Placebo, SOC
NCT01513239 phase3completednot on this map

A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of the Efficacy, Safety and Tolerability of a Single Infusion of MK-6072 (Human Monoclonal Antibody to Clostridium Difficile Toxin B), and MK-3415A (Human Monoclonal Antibodies to Clostridium Difficile Toxin A and B) in Patients Receiving Antibiotic Therapy for Clostridium Difficile Infection (MODIFY II)

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2012 to 2015Enrolled1,203ConditionsClostridium Difficile InfectionArmsMK-6072, MK-3415A, Placebo, SOC
NCT05192148 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Seroprevalence of Antibodies to Surface Antigens and Toxins of Clostridioides Difficile

TypeinterventionalSponsorFondation Hôpital Saint-JosephRan2021 to 2024Enrolled840ConditionsClostridium Difficile InfectionArmsPatients
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 1 synthesis or guideline pooled it, 202 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Predictors of RecurrentDiagnostics (Basel, Switzerland) · 2026
    Article
  10. Development of a high-throughput screening platform forAntimicrobial agents and chemotherapy · 2026
    Article
  11. Article
  12. Review
  13. Gastro hep advances · 2026
    Article
  14. Biomedicines · 2025
    Review
  15. De novo design of potent inhibitors of clostridial family toxins.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  16. Article
  17. Management ofEClinicalMedicine · 2025
    Review
  18. Post-transplant diarrhea in pediatric kidney transplant recipients.Pediatric nephrology (Berlin, Germany) · 2025
    Review
  19. The evolving landscape of live biotherapeutics in the treatment of Clostridioides difficile infection.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Review
  20. Article

37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 3 countries.

Dale N GerdingDepartment of Veterans Affairs, Edward Hines Jr Veterans Affairs Hospital, Illinois.
Ciaran P KellyGastroenterology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
Galia RahavInfectious Diseases, Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel-Aviv University, Israel.
Christine LeeDepartment of Pathology and Laboratory Medicine, University of British Columbia, Vancouver.
Erik R DubberkeDivision of Infectious Diseases, Washington University School of Medicine, St Louis, Missouri.
Princy N KumarDivision of Infectious Diseases and Travel Medicine, Georgetown University School of Medicine, Washington, D.C.
Bruce YacyshynDivision of Digestive Diseases, University of Cincinnati, Ohio.
Dina KaoDepartment of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Canada.
Karen EvesClinical Research, Infectious Diseases, Kenilworth, New Jersey.
Misoo C EllisonLate Development Statistics, Biostatistics, Kenilworth, New Jersey.
Mary E HansonGlobal Scientific and Medical Publications, Infectious Diseases, Merck & Co, Inc, Kenilworth, New Jersey.
Dalya GurisClinical Research, Infectious Diseases, Kenilworth, New Jersey.
Mary Beth DorrClinical Research, Infectious Diseases, Kenilworth, New Jersey.
Beth Israel Deaconess Medical Center · USEdward Hines, Jr. VA Hospital · USGeorgetown University · USMerck & Co., Inc., Rahway, NJ, USA (United States) · USTel Aviv University · ILUniversity of Alberta · CAUniversity of British Columbia · CAUniversity of Cincinnati · USWashington University in St. Louis · US

Funding

Stem Cell/Organoid and Genome Editing CoreP30DK078392 · NIDDK · CINCINNATI CHILDRENS HOSP MED CTR · PI Alexander Miethke · 2007 to 2026
$24.4M
NIDDK NIH HHS P30 DK078392
6 · The paper itself

Abstract

Background: Bezlotoxumab is a human monoclonal antibody against Clostridium difficile toxin B indicated to prevent C. difficile infection (CDI) recurrence (rCDI) in adults at high risk for rCDI. This post hoc analysis of pooled monocolonal antibodies for C.difficile therapy (MODIFY) I/II data assessed bezlotoxumab efficacy in participants with characteristics associated with increased risk for rCDI. Methods: The analysis population was the modified intent-to-treat population who received bezlotoxumab or placebo (n = 1554) by risk factors for rCDI that were prespecified in the statistical analysis plan: age ≥65 years, history of CDI, compromised immunity, severe CDI, and ribotype 027/078/244. The proportion of participants with rCDI in 12 weeks, fecal microbiota transplant procedures, 30-day all cause and CDI-associated hospital readmissions, and mortality at 30 and 90 days after randomization were presented. Results: The majority of enrolled participants (75.6%) had ≥1 risk factor; these participants were older and a higher proportion had comorbidities compared with participants with no risk factors. The proportion of placebo participants who experienced rCDI exceeded 30% for each risk factor compared with 20.9% among those without a risk factor, and the rCDI rate increased with the number of risk factors (1 risk factor: 31.3%; ≥3 risk factors: 46.1%). Bezlotoxumab reduced rCDI, fecal microbiota transplants, and CDI-associated 30-day readmissions in participants with risk factors for rCDI. Conclusions: The risk factors prespecified in the MODIFY statistical analysis plan are appropriate to identify patients at high risk for rCDI. While participants with ≥3 risk factors had the greatest reduction of rCDI with bezlotoxumab, those with 1 or 2 risk factors may also benefit. Clinical Trials Registration: NCT01241552 (MODIFY I) and NCT01513239 (MODIFY II).

Indexed as

Secondary PreventionAdolescentAdultAgedAged, 80 and overAge FactorsAnti-Bacterial AgentsAntibodies, MonoclonalAntibodies, NeutralizingBroadly Neutralizing AntibodiesClostridioides difficileClostridium InfectionsFecal Microbiota TransplantationFemaleFidaxomicinHumansAnti-Bacterial AgentsAntibodies, MonoclonalAntibodies, NeutralizingbezlotoxumabBroadly Neutralizing AntibodiesFidaxomicinMetronidazoleVancomycin

Identifiers

PMID29538686
PMCPMC6093994
OpenAlexW2792237904

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.