Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial.

@article{Moayyedi2015FecalMT,
  title={Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial.},
  author={Paul Moayyedi and Michael G. Surette and Peter T. Kim and Josie Libertucci and Melanie Wolfe and Catherine Onischi and David Armstrong and John K. Marshall and Zain A Kassam and Walter Reinisch and Christine H. Lee},
  journal={Gastroenterology},
  year={2015},
  volume={149 1},
  pages={
          102-109.e6
        }
}
BACKGROUND & AIMS Ulcerative colitis (UC) is difficult to treat, and standard therapy does not always induce remission. Fecal microbiota transplantation (FMT) is an alternative approach that induced remission in small series of patients with active UC. We investigated its safety and efficacy in a placebo-controlled randomized trial. METHODS We performed a parallel study of patients with active UC without infectious diarrhea. Participants were examined by flexible sigmoidoscopy when the study… 

Figures and Tables from this paper

Specific Bacteria and Metabolites Associated With Response to Fecal Microbiota Transplantation in Patients With Ulcerative Colitis.

FMT increased microbial diversity and altered composition, based on analyses of colon and fecal samples collected before vs after FMT, and associated specific bacteria and metabolic pathways with induction of remission.

Effect of Fecal Microbiota Transplantation on 8-Week Remission in Patients With Ulcerative Colitis: A Randomized Clinical Trial

In this preliminary study of adults with mild to moderate UC, 1-week treatment with anaerobically prepared donor FMT compared with autologous FMT resulted in a higher likelihood of remission at 8 weeks.

Fecal microbiota transplantation to maintain remission in Crohn’s disease: a pilot randomized controlled study

Higher colonization by donor microbiota was associated with maintenance of remission and no safety signal was identified in this pilot study in adults with colonic or ileo-colonic CD.

Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis

A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal.

Fecal microbiota transplantation in ulcerative colitis.

FMT seems to be a promising and safe therapy in the management of UC, and further research will be needed to confirm this and to determine the optimal FMT procedure.

Fecal Microbiota Transplantation as Therapy for Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis

FMT shows a promising perspective with comparable safety and favorable clinical efficacy for the treatment of active UC in the short term, however, further larger, more rigorously conducted RCTs of FMT in UC are still needed in order to resolve the controversial questions.

Fecal Microbiota Transplantation as a Novel Therapy for Ulcerative Colitis

FMT is potentially useful in UC disease management but better-designed RCTs are still required to confirm the findings before wide adoption is suggested and basic guidelines are needed imminently to identify the right patient population and to standardize the process of FMT.

Is there a potential role of fecal microbiota transplantation in the treatment of inflammatory bowel disease?

  • C. Eun
  • Medicine, Biology
    Intestinal research
  • 2017
Several human and animal studies have shown that dysbiosis, an altered intestinal microbial profile, is associated with IBD, and that the intestinal microbiota seems to play a crucial role in the development of this disease.

Systematic Review and Meta-analysis: Fecal Microbiota Transplantation for Treatment of Active Ulcerative Colitis.

Among randomized controlled trials, short-term use of FMT shows promise as a treatment to induce remission in active UC based on the efficacy and safety observed, but there remain many unanswered questions that require further research before FMT can be considered for use in clinical practice.
...

References

SHOWING 1-10 OF 37 REFERENCES

Antibiotic Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Antibiotic therapy may induce remission in active CD and UC, although the diverse number of antibiotics tested means the data are difficult to interpret.

Temporal Bacterial Community Dynamics Vary Among Ulcerative Colitis Patients After Fecal Microbiota Transplantation

This study highlights the value of characterizing temporally resolved microbiota dynamics for a better understanding of FMT efficacy and provides potentially useful diagnostic indicators for monitoring FMT success in the treatment of ulcerative colitis.

Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab.

Patients with moderately to severely active ulcerative colitis treated with infliximab were less likely to undergo colectomy through 54 weeks than those receiving placebo.

Alterations in the gut microbiome of children with severe ulcerative colitis

Richness, evenness, and biodiversity of the gut microbiome were remarkably reduced in children with UC compared with healthy controls and children who did not respond to steroids harbored a microbiome that was even less rich than steroid responders.

Phylogenetic Analysis of Dysbiosis in Ulcerative Colitis During Remission

Dysbiosis in UC is stable in time and shared between patients from different geographic locations, and the microbial alterations offer a mechanistic insight into the pathogenesis of the disease.

Vedolizumab as induction and maintenance therapy for ulcerative colitis.

Vedolizumab was more effective than placebo as induction and maintenance therapy for ulcerative colitis and the frequency of adverse events was similar in the vedolIZumab and placebo groups.

Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection.

This preliminary study among patients with relapsing C. difficile infection provides data on adverse events and rates of resolution of diarrhea following administration of FMT using frozen encapsulated inoculum from unrelated donors.

Standardized Frozen Preparation for Transplantation of Fecal Microbiota for Recurrent Clostridium difficile Infection

Standardization of material preparation significantly simplified the practical aspects of FMT without loss of apparent efficacy in clearing recurrent CDI in patients failing antibiotic therapy.

New therapeutic avenues in ulcerative colitis: thinking out of the box

It is important that a better understanding of the clinical particularities of the disease, an improved knowledge of the host-microbiome negative interactions and of the environmental factors beyond disease development is achieved to obtain the final and desired outcome: to provide better treatment and quality of life for patients with this disabling disease.

Duodenal infusion of donor feces for recurrent Clostridium difficile.

The infusion of donor feces was significantly more effective for the treatment of recurrent C. difficile infection than the use of vancomycin and patients showed increased fecal bacterial diversity, similar to that in healthy donors, with an increase in Bacteroidetes species and clostridium clusters IV and XIVa and a decrease in Proteobacteria species.