Most Read Articles
Roshini Claire Anthony, 6 days ago

The addition of the glucagon-like peptide-1 analogue semaglutide to standard of care resulted in sustained reduction in weight and waist circumference in individuals with type 2 diabetes (T2D) with high cardiovascular risk, according to the phase III SUSTAIN 6* trial presented at EASD 2017.

Yesterday
Overall survival (OS) and head and neck cancer (HNC)-specific survival vary among HNC sites, according to a study. In particular, cigarette smoking is a prognostic factor of OS and HNC-specific survival in patients with cancer of the oral cavity and oropharynx, whereas alcohol consumption is a prognostic factor of both survival outcomes in patients with cancer of the larynx.
18 Sep 2017
The additional use of intermittent low-energy diet (LED) or daily meal replacements after a mean 10-percent weight loss and 1-year maintenance effectively maintains weight loss in obese patients with knee osteoarthritis for 3 years, according to a recent study.
Yesterday
Adiponectin, but not leptin, is significantly correlated with proteinuria and its severity in systemic lupus erythematosus (SLE) nephritis, reveals a new cross-sectional study.

Ridinilazole potentially effective for C. difficile infection

Audrey Abella
08 Sep 2017

The novel, targeted-spectrum antimicrobial ridinilazole showed potential in the treatment of initial Clostridium difficile (C. difficile) infection compared with vancomycin, a new study has found.

In a phase 2, double-blind trial, 100 C. difficile-positive patients were randomized to receive ridinilazole 200 mg/12 hours (n=50) or vancomycin 125 mg/6 hours for 10 days (n=50). A total of 69 patients (n=36 and 33 in the ridinilazole and vancomycin arms, respectively) were included in the modified intention-to-treat (ITT) population. [Lancet Infect Dis 2017;17:735-744]

Clinical response at test of cure in the ridinilazole and vancomycin arms had an estimated treatment difference (ETD) of 8.3 percent (90 percent confidence interval [CI], −9.3 to 25.8), translating to noninferiority of ridinilazole to vancomycin. In addition, sustained clinical response established superiority of ridinilazole over vancomycin (ETD, 21.1 percent, 90 percent CI 3.1–39.1; p=0.0004).

“The superiority of ridinilazole [over] vancomycin with regard to sustained clinical response was driven by a marked reduction in recurrent C. difficile infection, which is likely due to the highly selective activity of ridinilazole against C. difficile and the absence of collateral damage to the microbiota during therapy,” said the researchers.

On subgroup analysis, ridinilazole remained associated with more sustained clinical responses than vancomycin in patients >75 years (ETD, 42.7 percent), those with severe disease (ETD, 15.9 percent), and those with previous episodes of C. difficile infection (ETD, 19.9 percent).

“[These subgroups were evaluated as] all are at increased risk of infection and of disease recurrence following treatment,” said the researchers, adding that having faecal-toxin-positive subjects adds significance to their evaluation given the worse clinical outcomes associated with the presence of faecal toxins.

It is important to treat C. difficile infection as it entails a significant economic burden, noted the researchers. “[Furthermore, recurrence] places a substantial burden on patient welfare, is associated with increased morbidity and mortality, and is difficult to treat.”

Given the high recurrence rates associated with other antibiotics recommended for C. difficile, such as metronidazole and vancomycin, and the lack of improvement against other C. difficile strains (ie, BI/NAP1/027) with fidaxomicin, it is imperative to evaluate other drugs that could mitigate these outcomes, noted the researchers.

“[S]afe and effective alternatives that do not negatively affect the normal gut microbiota [may facilitate the] prevention of recurrent C. difficile infection … Ridinilazole has potential as a new treatment of C. difficile infection, owing to its good sustained clinical response rates … probably as a result of decreased disturbance of the normally protective intestinal microbiota,” they said.

Although the results are encouraging, the researchers called for larger studies with longer follow-up periods to further confirm the findings.

 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 6 days ago

The addition of the glucagon-like peptide-1 analogue semaglutide to standard of care resulted in sustained reduction in weight and waist circumference in individuals with type 2 diabetes (T2D) with high cardiovascular risk, according to the phase III SUSTAIN 6* trial presented at EASD 2017.

Yesterday
Overall survival (OS) and head and neck cancer (HNC)-specific survival vary among HNC sites, according to a study. In particular, cigarette smoking is a prognostic factor of OS and HNC-specific survival in patients with cancer of the oral cavity and oropharynx, whereas alcohol consumption is a prognostic factor of both survival outcomes in patients with cancer of the larynx.
18 Sep 2017
The additional use of intermittent low-energy diet (LED) or daily meal replacements after a mean 10-percent weight loss and 1-year maintenance effectively maintains weight loss in obese patients with knee osteoarthritis for 3 years, according to a recent study.
Yesterday
Adiponectin, but not leptin, is significantly correlated with proteinuria and its severity in systemic lupus erythematosus (SLE) nephritis, reveals a new cross-sectional study.