Actoxumab + bezlotoxumab combination: what promise for Clostridium difficile treatment?

Brunella Posteraro, Federico Pea, Luca Masucci, Patrizia Posteraro, Maurizio Sanguinetti

Research output: Contribution to journalArticle

Abstract

Introduction: Clostridium difficile infection (CDI) is the most common healthcare-associated infection worldwide. As standard CDI antibiotic therapies can result in unacceptably high recurrence rates, novel therapeutic strategies for CDI are necessary. A recently emerged immunological therapy is a monoclonal antibody against C. difficile toxin B. Areas covered: In this review, the authors summarize the available pharmacological, preclinical, and clinical data for the CDI treatment based on anti-toxin A (actoxumab) and anti-toxin B (bezlotoxumab) human monoclonal antibodies (HuMabs), and discuss about the potentiality of a therapy that includes HuMab combined administration for CDI. Expert opinion: Although only bezlotoxumab is indicated to reduce recurrence of CDI, experimental studies using a combination of HuMabs actoxumab and bezlotoxumab have shown that bolstering the host immune response against both the C. difficile toxins may be effective in primary and secondary CDI prevention. Besides neutralizing both the key virulence factors, combination of two HuMabs could potentially offer an advantage for a yet to emerge C. difficile strain, which is a steady threat for patients at high risk of CDI. However, as actoxumab development was halted, passive immunotherapy with actoxumab/bezlotoxumab is actually impracticable. Future research will be needed to assess HuMab combination as a therapeutic strategy in clinical and microbiological cure of CDI.

Original languageEnglish
Pages (from-to)469-476
Number of pages8
JournalExpert Opinion on Biological Therapy
Volume18
Issue number4
DOIs
Publication statusPublished - Apr 3 2018

Keywords

  • Actoxumab
  • bezlotoxumab
  • Clostridium difficile
  • monoclonal antibody
  • pharmacotherapy
  • recurrence
  • targeted treatment

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery
  • Clinical Biochemistry

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