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SHR Neuro Cancer Cardio Lipid Metab Microb

Noviello, D; Chaparro, M; Viganò, C; Blesl, A; Barberio, B; Yanai, H; Orlando, A; Ferreiro-Iglesias, R; Bezzio, C; Zilli, A; Molnár, T; Gheorghe, C; Conforti, F; Innocenti, T; Saibeni, S; Bossuyt, P; Oliveira, R; Carvalhas, Gabrielli, AM; Losco, A; Vieujean, S; Tettoni, E; Pirola, L; Calderone, S; Kornowski, Cohen, M; Dragoni, G; Rath, T; Barreiro-de, Acosta, M; Savarino, EV; Gisbert, JP; Vecchi, M; Atreya, R; Caprioli, F.
Fidaxomicin for Clostridioides difficile infection in patients with inflammatory bowel disease: a multicenter retrospective cohort study.
J Crohns Colitis. 2025; 19(5): Doi: 10.1093/ecco-jcc/jjaf056 [OPEN ACCESS]
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Co-authors Med Uni Graz: Blesl Andreas
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Abstract:: BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) patients with Clostridioides difficile infection (CDI) are at increased risk of adverse outcomes. Data on fidaxomicin use in IBD remain scarce. We assessed the effectiveness and safety of fidaxomicin for CDI and its impact on IBD outcomes in a large international cohort. METHODS: Adult patients with ulcerative colitis (UC) or Crohn's disease (CD) treated with fidaxomicin for documented CDI were retrospectively included. The primary outcome was CDI recurrence rate within 8 weeks (C. difficile toxin detection and CDI-targeted therapy). Secondary outcomes included sustained response (no CDI-targeted therapy within 12 weeks), IBD therapy escalation, colectomy rate, and all-cause mortality within 30, 90, and 180 days. RESULTS: Ninety-six patients (57 UC and 39 CD) from 20 IBD centers were included. Most were on advanced IBD therapy. Half had a previous CDI episode, 15% a severe episode. CDI recurrence rate was 10% at week 8, and sustained response 82% at week 12. Compared with patients with previous CDI episode, patients at first episode tended to have a lower recurrence (4.3% vs 16%; P = .06) and higher sustained response (91% vs 75%; P = .04) rate. IBD therapy escalation was required in 48% with a numerically lower need for patients achieving vs not-achieving sustained response within 30 days (12% vs 20%; P = .42). Five UC patients underwent colectomy. One death unrelated to CDI or IBD occurred. One moderate and 5 mild adverse events were reported. CONCLUSIONS: Fidaxomicin was effective and safe in IBD patients with CDI, with greater effectiveness in CDI-naïve patients, potentially influencing short-term IBD outcomes.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Aged - administration & dosage; Female - administration & dosage; Humans - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; Anti-Bacterial Agents - therapeutic use, adverse effects; Clostridioides difficile - isolation & purification; Clostridium Infections - complications, diagnosis, drug therapy, microbiology; Colectomy - statistics & numerical data; Colitis, Ulcerative - complications; Crohn Disease - complications; Fidaxomicin - therapeutic use, adverse effects; Recurrence - administration & dosage; Retrospective Studies - administration & dosage; Treatment Outcome - administration & dosage
Find related publications in this database (Keywords): fidaxomicin; Clostridioides difficile; CDI; inflammatory bowel disease