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NCT07513285PHASE2Recruiting

ACX-362E [Ibezapolstat] for Oral Treatment of Recurrent Clostridioides Difficile Infection

Acurx Pharmaceuticals Inc.

Start Date

8/6/2026

Completion Date

11/24/2027

Summary

Single-arm trial to evaluate the safety and efficacy of ACX-362E \[ibezapolstat\] in patients with recurrent C. difficile infection (CDI).

Detailed Description

Phase 2 multicenter, open-label, single-arm study is designed to evaluate the efficacy, safety, and tolerability of ibezapolstat in the treatment and reduction of recurrence of CDI in an adult patient population that has experienced ≥3 episodes of CDI within the past 12 months. Up to 20 participants will be treated with ibezapolstat 450 mg taken with food every 12 hours for 14 days (28 total doses) and followed for Clinical Cure (Day 16), Sustained Clinical Cure (Day 42), rate of CDI recurrence (Up to Week 24), and Extended Clinical Cure (ECC) (Up to Week 24).

Eligibility Criteria

Age Range: 18 years to 90 years

Inclusion Criteria: * Confirmed diagnosis of CDI as defined by 1) the presence of diarrhea, defined as passage of ≥ 3 UBMs within 24 hours before study Day 1, AND 2) a stool test result positive for the presence of C. difficile free toxins * Three or more CDI episodes in the past 12 months, including the current episode, with each episode defined as ≥ 3 unformed stools in 24 hours associated with positive C. difficile toxin test. * At least 1 of the protocol-qualifying prior CDI episodes, not including the current episode, has been treated with oral vancomycin or with fidaxomicin Exclusion Criteria: * Severe, complicated, or life-threatening fulminant CDI with evidence of hypotension (systolic blood pressure \< 90 mmHg), septic shock, peritoneal signs or ileus, or toxic megacolon * Received more than 24 hours of dosing with antibiotics for the current CDI episode: * Received a live biotherapeutic product (LBP) (Rebyota® or Vowst™) within the past 12 weeks * Received or current use of anti-C. difficile antibodies, eg, IV immunoglobulin \[IVIG\], bezlotoxumab * Active inflammatory bowel disease (Crohn's disease, ulcerative colitis) with chronic diarrhea within 12 weeks before Baseline, or with a history of symptoms \> 12 weeks before Baseline without evidence of mucosal healing on colonoscopy within the past year. * Active irritable bowel syndrome with chronic diarrhea in the past 12 weeks. * Active gastroenteritis because of Salmonella, Shigella, Escherichia coli 0157H7, Yersinia or Campylobacter, other bacteria, a parasite, or a virus within the past 2 weeks * Major GI surgery (eg, significant bowel resection) within 3 months of enrollment (does not include appendectomy or cholecystectomy). * Known current history of a severely compromised immune system

Interventions

DRUG

Ibezapolstat

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Conditions

Clostridium Difficile Infection Recurrence

Locations

UC Davis Medical Center

Sacramento, California 95817

United States

Gastroenterolgy Center of Conneticut

Hamden, Connecticut 06518

United States

Florida International Medical Research

Coral Gables, Florida 33134

United States

L&A Morales Healthcare, Inc

Hialeah, Florida 33012

United States

San Marcus Research Clinc, Inc

Miami Lakes, Florida 33014

United States

Belis Delgado, MD PA

Miami Springs, Florida 33166

United States

Infectious Disease Consultants of Georgia

Athens, Georgia 30606

United States

Snake River Research PLLC

Idaho Falls, Idaho 83404

United States

Endevour Health

Skokie, Illinois 60077

United States

Newton-Wellesley Hospital

Newton, Massachusetts 02462

United States

University of Massachusetts Memorial Healthcare

Worcester, Massachusetts 01655

United States

Henry Ford Hospital

Detroit, Michigan 48202

United States

DiGiovanna Institute for Medical Education and Research

Massapequa, New York 11758

United States

Romano, Pontzer & Associated

Pittsburgh, Pennsylvania 15215

United States

University of Utah

Salt Lake City, Utah 84115

United States