Patients with diverticulitis experience a prolonged course of the disease and report a variety of physical, psychological and social symptoms, which highly impacts in their quality of life. Although antibiotic therapy has been the preferred treatment option for acute diverticulitis, it does not control the disease in 40 percent of the patients with complicated diverticulitis and 13 to 23 percent of the patients with non-complicated diverticulitis, which results in chronic and recurrent episodes of diverticulitis. As the episodes repeat, the outpatient conservative treatment has worse success rates and the incidence of complicated diverticulitis with abscess increases up to five times. Therefore, it is of great importance to establish new treatments in order to avoid the recurrences of the disease. As of today, there is not enough evidence of the efficacy of current treatment options to prevent recurrences in patients with diverticulitis, but recent approaches suggest the modification of intestinal microbiota as a preventive strategy. Microbial imbalance (dysbiosis) has been proposed as a mechanism involved in the transition from diverticulosis to diverticulitis, inflammation and some of the symptoms of the disease. In this way, fecal microbiota transplantation (FMT) could have an important role in the prevention of new episodes, as it can modify the composition of the intestinal microbiota in a less invasive and more physiological way. Until now the efficacy of FMT in patients with recurrent diverticulitis has not been assessed; however, its benefits and safety have been demonstrated in studies for inflammatory bowel disease (IBD), a pathology with similarities to diverticulitis in its symptoms and underlying inflammation. The objective of the present clinical trial is to assess the efficacy of MBK-01 (heterologous lyophilized intestinal microbiota oral capsules) in reducing the frequency of episodes in recurrent diverticulitis, its safety and tolerability and to determine the optimal dosing regimen.
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Number of new episodes of acute diverticulitis during the trial
Timeframe: Up to 1 year after the start of the treatment
Time to first episode of acute diverticulitis
Timeframe: Up to 1 year after the start of the treatment
Time to successive episodes of acute diverticulitis (other than the first episode)
Timeframe: Up to 1 year after the start of the treatment
Time between episodes of acute diverticulitis
Timeframe: Up to 1 year after the start of the treatment
Number of hospitalizations due to acute diverticulitis in the trial
Timeframe: Up to 1 year after the start of the treatment
Number courses of systemic antibiotic treatment used in the trial for the episodes of acute diverticulitis
Timeframe: Up to 1 year after the start of the treatment
Need for surgery for acute diverticulitis during the trial
Timeframe: Up to 1 year after the start of the treatment
Occurrence of Adverse Events (AES)
Timeframe: Up to 1 year after the start of the treatment
Occurrence of Serious Adverse Events (SAES)
Timeframe: Up to 1 year after the start of the treatment
Occurrence of AES that result in discontinuation of study treatment
Timeframe: Up to 1 year after the start of the treatment
Occurrence of AES of special interest (AESI)
Timeframe: Up to 1 year after the start of the treatment
Occurrence of diverticulitis-related AES
Timeframe: Up to 1 year after the start of the treatment
Changes in vital signs
Timeframe: Up to 1 year after the start of the treatment
Changes in laboratory values
Timeframe: Up to 1 year after the start of the treatment
Number of new episodes of acute diverticulitis in the trial between the two MBK-01 regimens
Timeframe: Up to 1 year after the start of the treatment
Occurrence of treatment-related AES between the two MBK-01 regimens during the trial
Timeframe: Up to 1 year after the start of the treatment