Read the latest updates on irritable bowel disease, eosinophilic esophagitis, and C difficile infection presented at Digestive Disease Week (DDW), held from May 21 to 24, 2022, in San Diego, California, and virtually. Click on the links below for full news coverage.

Rifaximin Effective for IBS With Diarrhea

A 2-week course of rifaximin significantly improved multiple abdominal symptoms in patients with irritable bowel syndrome with diarrhea (IBS-D), according to an analysis of pooled data from 2 identically designed, phase 3, randomized, double-blind trials.

A total of 1258 patients (mean age, 45.9±14.5 years; 72.3% women) with IBS-D were included in the study. Participants were randomly assigned to receive rifaximin 550 mg 3 times per day or placebo for 2 weeks, followed by 4 weeks without treatment.


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Patients who received rifaximin were significantly more likely to report adequate relief of global IBS symptoms posttreatment compared with the placebo group (40.7% vs 31.7%; P <.001). Rifaximin was linked to a significantly greater response rate (defined 30% or 40% greater reduction in weekly mean abdominal pain or discomfort and bloating scores as well as the percentage of days with bowel movement urgency) compared with placebo.

Food Allergies May Weaken PPI Response in Eosinophilic Esophagitis

While food allergies may affect response to proton pump inhibitors (PPIs) in the treatment of eosinophilic esophagitis (EoE), environmental allergies do not, according to findings from a retrospective analysis.

Sixty-one patients with eosinophilic esophagitis underwent testing for environmental and food allergens at a tertiary care center. Food allergies were independently associated with decreased patient response to PPIs (odds ratio, 0.17; 95% CI, 0.04-0.65), after controlling for age, gender, and comorbid asthma. Study results also showed that 21.4% of patients with food allergies had PPI responsive disease compared with 63.2% of patients without food allergies (P =.003). Environmental allergies did not affect PPI response (P =.13).

Oral Microbiome Therapy Recurrent C difficile

Use of the investigational oral microbiome therapeutic CP101 for recurrent Clostridioides difficile infection was linked to a high cumulative cure rate, according to data from the PRISM3 placebo-controlled trial and the PRISM-EXT open-label extension trial of CP101.

The PRISM3 placebo-controlled trial found that patients with recurrent C difficile infection who received CP101 had a higher rate of sustained clinical cure compared with those who received placebo. For this post-hoc analysis, data from PRISM3 and the open-label extension PRISM-EXT were evaluated. Patients (N=214) received the one-time CP101 oral therapy following standard-of-care antibiotics. The primary endpoint was sustained clinical cure at 8 weeks, as defined by no recurrence of C difficile infection.

At week 8, the cumulative cure rate was 85.0%. Among the subset of patients who received CP101 in PRISM3, 20 received a second CP101 dose during the extension period. The cumulative cure rate at 8 weeks among the patients who received active treatment in CP101 was 88.2%, which was higher than what was observed in the original trial (74.5%). No treatment-related serious adverse events were reported through week 24.

More DDW 2022 Updates

Additional studies presented at DDW 2022 provide new insights into nonalcoholic fatty liver disease prevention, inflammatory bowel disease treatment, liver test abnormalities in patients with COVID-19, and predictors of postoperative recurrence of Crohn disease. Click on the following topics for more news:

Disclosure: The rifaximin trials were supported by Salix Pharmaceuticals. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References

Lacy BE, Sayuk GS, Karsan HA, Allen C, Heimanson Z, Brenner DM. A new trisymptom composite endpoint to evaluate the efficacy of rifaximin for the multiple symptoms of irritable bowel syndrome with diarrhea (IBS-D): a pooled analysis of two randomized, phase 3 trials. Presented at: DDW 2022; May 21-24, 2022; San Diego, CA. Abstract Mo1395.

Muftah M, Flanagan R, Redd WD, Jenkins A, Chan W. Food allergies are associated with PPI non-response in eosinophilic esophagitis. Presented at: DDW 2022; May 21-24, 2022; San Diego, CA. Abstract Su1180.

Allegretti JR, Kelly CR, Fischer M, Cohen T, Budree S, Khanna S. CP101, an investigational microbiome therapeutic for the prevention of recurrent C Difficile Infection: a combined analysis of the PRISM3 (randomized placebo-controlled) and PRISM-EXT (open-label) trials.Presented at: DDW 2022; May 21-24, 2022; San Diego, CA. Abstract Tu1519.