P3424 - Long-Term Safety of Fecal Microbiota, Live-jslm Administered via Colonoscopy to Adults With Recurrent Clostridioides difficile Infection: 6-Month Safety Data From CDI-SCOPE, a Single-Arm, Phase 3b Trial

Sahil Khanna, MBBS, MD, MS¹, Paul Feuerstadt, MD, FACG², Tahany Awad, ³, Beth Guthmueller, AS⁴, Daniel Armandi, ³, Brian Clark, ³
1Mayo Clinic Rochester, Rochester, MN; 2Yale University School of Medicine and PACT-Gastroenterology Center, Hamden, CT; 3Ferring Pharmaceuticals A/S, Kastrup, Hovedstaden, Denmark; 4Ferring Pharmaceuticals, Inc, Parsippany, NJ

Introduction: Fecal microbiota, live-jslm (RBL) is a microbiota-based product to prevent recurrent Clostridioides difficile infection (rCDI) in adults after standard-of-care antibiotic treatment. In CDI-SCOPE (NCT05831189), a multicenter, single-arm, phase 3b trial assessing the safety and efficacy of RBL when administered by colonoscopy to adults with rCDI, interim results through 8 weeks showed 9.8% of participants had RBL-related treatment-emergent adverse events (TEAEs) and 95.1% experienced treatment success (no CDI recurrence) (Khanna S et al. Therap Adv Gastroenterol. 2025:18:17562848251339697). This analysis presents long-term safety and efficacy through 6 months of follow-up in CDI-SCOPE.

Methods: Adults with documented rCDI who had completed standard-of-care antibiotics were eligible to participate in the trial. Participants received 1 dose of RBL by colonoscopy after a 24- to 72-hour antibiotic washout period and bowel preparation. Secondary endpoints included safety up to 6 months after RBL administration and assessment of CDI recurrence.

Results: Of the 41 participants, 39 completed follow-up through 6 months. From 8 weeks through 6 months after RBL administration, 36 additional TEAEs in 15 participants (36.6%) were reported, 1 of which (irritable bowel syndrome) was RBL-related. During this period, most TEAEs (97.2%) were of mild or moderate severity, and 1 serious, potentially life-threatening TEAE (worsening abdominal pain) unrelated to RBL was observed. Over the full trial period, 6 RBL-related TEAEs occurred in 4 participants (9.8%), all of which were mild in severity and gastrointestinal in nature. Overall, 23 participants (56.1%) experienced 69 TEAEs; 94.2% were of mild or moderate severity. Serious TEAEs occurred in 3 participants (7.3%), none of which were related to RBL or its administration. TEAEs of special interest were reported in 2 participants (4.9%) and were not related to RBL. During the full trial period, 38 participants (92.7%) did not experience CDI recurrence, 1 (2.4%) did between 8 weeks and 6 months, and 2 (4.9%) had an indeterminate outcome due to study withdrawal before 8 weeks.

Discussion: RBL administered via colonoscopy was safe and effective for the prevention of CDI recurrence in adults with rCDI in CDI-SCOPE. Long-term safety findings through 6 months were consistent with results from previous RBL trials.

Disclosures:
Sahil Khanna: Ferring Pharmaceuticals – Advisor or Review Panel Member. Finch Therapeutics – Grant/Research Support. Immuron Limited – Consultant. Jetson Probiotics – Stock Options. Niche Pharmaceuticals – Consultant. Rebiotix – Grant/Research Support. Seres Therapeutics – Grant/Research Support. Vedanta BioSciences – Grant/Research Support.
Paul Feuerstadt: Ferring Pharmaceuticals – Advisor or Review Panel Member, Honoraria. Rebiotix, Inc. – Consultant. Seres Therapeutics – Advisor or Review Panel Member, Honoraria. Takeda Pharmaceuticals – Advisor or Review Panel Member, Consultant, Honoraria.
Tahany Awad: Ferring Pharmaceutical – Employee.
Beth Guthmueller: Ferring Pharmaceutical – Employee.
Daniel Armandi: Ferring Pharmaceutical – Employee.
Brian Clark: Ferring Pharmaceutical – Employee.

Sahil Khanna, MBBS, MD, MS¹, Paul Feuerstadt, MD, FACG², Tahany Awad, ³, Beth Guthmueller, AS⁴, Daniel Armandi, ³, Brian Clark, ³. P3424 - Long-Term Safety of Fecal Microbiota, Live-jslm Administered via Colonoscopy to Adults With Recurrent <i>Clostridioides difficile</i> Infection: 6-Month Safety Data From CDI-SCOPE, a Single-Arm, Phase 3b Trial, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.