Evidence map›Paper›PMID 37389891›Full record

Trial reportJournal of the Pediatric Infectious Diseases Society2023

Double-Blind, Placebo-Controlled Study of Bezlotoxumab in Children Receiving Antibacterial Treatment for Clostridioides difficile Infection (MODIFY III).

Thomas J Sferra, Tomas Merta, Michael Neely, Claudia Murta de Oliveira, Alvaro Lassaletta, Claudia Fortuny Guasch, Mary Beth Dorr, Gregory Winchell, Feng-Hsiu Su, Sarah Perko and 3 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of the Pediatric Infectious Diseases Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03182907 (A Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of a Single Infusion of Bezlotoxumab), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

NCT03182907 phase3completednot on this map

A Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of a Single Infusion of Bezlotoxumab (MK-6072, Human Monoclonal Antibody to C. Difficile Toxin B) in Children Aged 1 to <18 Years Receiving Antibacterial Drug Treatment for C. Difficile Infection (MODIFY III)

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2018 to 2022Enrolled148ConditionsClostridium Difficile InfectionArmsBezlotoxumab, Placebo, Antibacterial drug treatment (ABD)
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Frontiers in pediatrics · 2025
    Review
  2. Clinical microbiology reviews · 2024
    Review
  3. Guideline for the management ofEClinicalMedicine · 2024
    Review
  4. Journal of medical microbiology · 2024
    Review
  5. Review
  6. Clostridioides difficile Infections: Prevention and Treatment Strategies.Advances in experimental medicine and biology · 2024
    Review
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.

Thomas J SferraDepartment of Pediatrics, UH Rainbow Babies & Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Tomas MertaDepartment of Pediatric Oncology, University Hospital Brno, Brno, Czech Republic.
Michael NeelyDivision of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA.ORCID 0000-0002-1675-8276
Claudia Murta de OliveiraSanta Casa de Misericórdia, Belo Horizonte, Brazil.
Alvaro LassalettaPediatric Hematology-Oncology Department, Hospital Niño Jesus, Madrid, Spain.
Claudia Fortuny Guasch
Mary Beth DorrPPDM QP2, Merck & Co., Inc., Rahway, New Jersey, USA.
Gregory WinchellBiostatistics, Merck & Co., Inc., Rahway, New Jersey, USA.
Feng-Hsiu SuClinical Operations, Merck & Co., Inc., Rahway, New Jersey, USA.
Sarah PerkoClinical Research, MSD UK, London, UK.
Doreen FernslerClinical Research, MSD UK, London, UK.
Hetty WaskinPPDM QP2, Merck & Co., Inc., Rahway, New Jersey, USA.
Stephen R HoldenClinical Research, MSD UK, London, UK.

Funding

Merck Sharp & Dohme
6 · The paper itself

Abstract

backgroundTherapies to prevent recurrence of Clostridioides difficile infection (CDI) in pediatric patients are needed. Bezlotoxumab is a fully human monoclonal antibody approved for prevention of recurrent CDI in adults. We assessed the pharmacokinetics, safety, tolerability, and efficacy of bezlotoxumab in pediatric patients.

methodsMODIFY III was a multicenter, double-blind, placebo-controlled study of bezlotoxumab in children (1 to <18 years) receiving antibacterial treatment for CDI. Participants were randomized 3:1 to receive a single infusion of bezlotoxumab (10 mg/kg) or placebo and were stratified by age at randomization (cohort 1: 12 to <18 years, cohort 2: 1 to <12 years). The primary objective was to characterize bezlotoxumab pharmacokinetics to support dose selection for pediatric patients; the primary endpoint was the area under the bezlotoxumab serum concentration-time curve (AUC0-inf). Safety, tolerability, and efficacy were monitored for 12 weeks post-infusion.

resultsA total of 148 participants were randomized and 143 were treated: 107 with bezlotoxumab and 36 with placebo (cohort 1 n = 60, cohort 2 n = 83; median age 9.0 years); 52.4% of participants were male and 80.4% were white. Geometric mean ratios (90% CI) for bezlotoxumab AUC0-inf were 1.06 (0.95, 1.18) and 0.82 (0.75, 0.89) h * μg/mL for cohorts 1 and 2, respectively. Bezlotoxumab 10 mg/kg was generally well-tolerated with an adverse event profile similar to placebo, including no treatment discontinuations due to adverse events. CDI recurrence was low and comparable for bezlotoxumab (11.2%) and placebo (14.7%).

conclusionsThe results of this study support the bezlotoxumab dose of 10 mg/kg for pediatric patients.

trial registrationNCT03182907 at ClinicalTrials.gov.

Indexed as

Anti-Bacterial AgentsClostridium InfectionsAdultAntibodies, MonoclonalBroadly Neutralizing AntibodiesChildDouble-Blind MethodFemaleHumansMaleAnti-Bacterial AgentsAntibodies, MonoclonalbezlotoxumabBroadly Neutralizing AntibodiesadolescentsbezlotoxumabchildrenClostridioides difficile infectionrecurrence

Identifiers

PMID37389891
PMCPMC10312293

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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.