Journal
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
Volume 11, Issue 7, Pages 611-622Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17474124.2017.1344551
Keywords
Monoclonal antibodies; clostridium difficile; immunotherapy; recurrence; bezlototumab; antibiotic associated diarrhea; clostridium difficile infection
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Funding
- US Department of Health, National Institute of Health, National Institute of Allergy and Infectious Diseases [R01 AI116596, U19 AI-109,776]
- Institut Merieux
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Introduction: Clostridium difficile infection (CDI) is the most common nosocomial infection in the U.S. 25% of CDI patients go on to develop recurrent CDI (rCDI) following current standard of care (SOC) therapy, leading to morbidity, mortality and economic loss. The first passive immunotherapy drug targeting C.difficile toxin B (bezlotoxumab) has been approved recently by the FDA and EMA for prevention of rCDI.Areas covered: A body of key studies was selected and reviewed by the authors. The unmet needs in CDI care were ascertained with emphasis in rCDI, including the epidemiology, pathophysiology and current management. The current knowledge about the immune response to C. difficile toxins and how this knowledge led to the development and the clinical use of bezlotoxumab is described. Current and potential future competitors to the drug were examined.Expert commentary: A single 10mg/kg intravenous infusion of bezlotoxumab has been shown to decrease rCDI by similar to 40% (absolute reduction similar to 10%) in patients being treated for primary CDI or rCDI with SOC antibiotics. Targeting C.difficile toxins by passive immunotherapy is a novel mechanism for prevention of C.difficile infection. Bezlotoxumab will be a valuable adjunctive therapy to reduce the burden of CDI.
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