All Boards >> Irritable Bowel Syndrome Research Library

View all threads Posts     Flat     Threaded

Fecal transplant induces remission in active ulcerative colitis
      07/16/15 04:39 PM
HeatherAdministrator

Reged: 12/09/02
Posts: 7790
Loc: Seattle, WA

FMT induces remission in active ulcerative colitis

Moayyedi P, et al. Gastroenterology. 2015;doi:10.1053/j.gastro.2015.04.001.
Grinspan AM, Kelly CR. Gastroenterology. 2015;doi:10.1053/j.gastro.2015.05.030.
June 29, 2015



Aiming to evaluate the safety and efficacy of FMT for treatment of active UC, Paul Moayyedi, MD, from McMaster University in Ontario, and colleagues performed a placebo-controlled, double-blind, randomized, parallel study. Adult participants were randomly assigned to receive 50-mL FMT from healthy anonymous donors (n = 38) or placebo (50 mL water; n = 37) via retention enema once a week for 6 weeks. Stool samples were collected weekly prior to enema for microbiome analysis, flexible sigmoidoscopy was performed at baseline and week 7, and the primary study outcome was remission at week 7.

The trial was stopped early for futility, but patients already enrolled were allowed to complete the trial. Of the 70 patients who completed the trial, 24% of the FMT group compared with 5% of the placebo group were in remission at week 7 (17% difference; 95% CI, 2%-33%) with comparable adverse events. Of the nine patients in remission after FMT, seven received FMT from a single donor. Of the four patients with UC for 1 year or less, three achieved remission, and of the 34 patients with UC for more than 1 year, six achieved remission (P = .04). Patients in the FMT group had greater diversity in their stool microbial composition vs. baseline compared with patients in the placebo group (P = .02).

"This is the first randomized, placebo-controlled trial, to evaluate the efficacy of FMT in active UC and suggests that this approach induces remission in a statistically significant proportion of cases," the authors wrote. "FMT may be more efficacious in patients with a recent diagnosis of UC, and this is biologically plausible, as a perturbation in the microbiome might be more easily restored early in the course of the disease. The efficacy of this approach may also be donor dependent and this may explain why some case series have shown promise, and other have had disappointing results."

Colleen R. Kelly

In a related editorial, Ari M. Grinspan, MD, from Icahn School of Medicine at Mount Sinai in New York, and Colleen R. Kelly, MD, from Brown University, explored the reasons why another recent randomized controlled trial of FMT for UC (Rossen, et al) was negative while this one was positive. First, Moayyedi and colleagues administered a higher number of FMTs per patient and via the lower rather than upper gastrointestinal route. "The upper GI route might render the active constituent of FMT ineffective by the time it reaches the diseased colon. It is also possible that there is a dose response or a threshold required for engraftment to be attained to alter effectively the gut microbiome and the downstream inflammatory cascade," they wrote. Moayyedi's study also permitted anti-tumor necrosis factor treatment, "and those subjects on immunosuppression did better, raising the question as to whether immune factors may have a role in successful FMT induction. These uncertainties make our ignorance clear; we still do not understand the active component of FMT."

Grinspan and Kelly concluded that for IBD, "based on the current data, FMT should remain in clinical trials and not clinical practice." – by Adam Leitenberger

Disclosure: Moayyedi reports he is a chair partly funded by an unrestricted donation given to McMaster University by AstraZeneca, and he has received honoraria for speaking and/or serving on the advisory board for AstraZeneca, Actavis and Shire. Grinspan reports he received research support from the Sinai Ulcerative Colitis Clinical, Experimental and System Studies. Kelly reports she has served as a consultant and site investigator for Seres Health and received research support from Assembly Biosciences.

http://www.healio.com/gastroenterology/inflammatory-bowel-disease/news/online/%7B9917554a-9c2a-4b0e-8ada-ded4a9028707%7D/fmt-induces-remission-in-active-ulcerative-colitis?utm_source=maestro&utm_medium=email&utm_campaign=gastroenterology%20news

--------------------
Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

Print     Remind Me     Notify Moderator    

Entire thread
* Inflammatory Bowel Disease
HeatherAdministrator
07/14/03 01:51 PM
* Why cannabis relieves IBD symptoms
HeatherAdministrator
08/22/18 02:39 PM
* Dietary fiber associated with reduced Crohn's disease flares
HeatherAdministrator
01/27/16 02:58 PM
* Probiotics not superior for maintaining ulcerative colitis remission
HeatherAdministrator
12/29/15 10:12 AM
* Fecal transplant induces remission in active ulcerative colitis
HeatherAdministrator
07/16/15 04:39 PM
* 7 recent developments in Crohn's disease
HeatherAdministrator
04/02/15 03:16 PM
* Hormonal contraception improved menstrual-related IBD symptoms
HeatherAdministrator
09/15/14 12:43 PM
* Fecal lactoferrin differentiated IBD from IBS
HeatherAdministrator
07/29/14 01:50 PM
* Vitamin D and Cancer Risk in IBD
HeatherAdministrator
07/15/14 02:53 PM
* Self-assessment scale developed for patients with IBD-fatigue
HeatherAdministrator
06/17/14 10:44 AM
* Stool test distinguishes between IBD and IBS
HeatherAdministrator
04/07/14 01:40 PM
* Breathing exercises, meditation improved inflammatory markers, quality of life in IBD patients
HeatherAdministrator
10/23/13 04:20 PM
* Inflammatory Bowel Disease: Heat Waves Linked to Flares
HeatherAdministrator
08/16/13 12:58 PM
* Dietary changes may reduce effects of IBD
HeatherAdministrator
06/27/13 05:43 PM
* Genetic Clues May Help Unravel Cause of Crohn's
HeatherAdministrator
11/02/12 12:59 PM
* Inflammatory bowel, ulcerative colitis linked to intestinal fungi
HeatherAdministrator
06/15/12 01:23 PM
* Smoking makes Crohn's disease worse
HeatherAdministrator
05/09/12 01:33 PM
* Kids With Crohn’s Disease, Colitis Often Struggle at School
HeatherAdministrator
04/23/12 01:22 PM
* As Nations Develop, So May Bowel Disease
HeatherAdministrator
01/09/12 12:01 PM
* Loneliness Triggers Inflammatory Illnesses
HeatherAdministrator
02/10/11 10:05 AM
* Infants' antibiotic use tied to IBD risk
HeatherAdministrator
11/03/10 01:42 PM
* Olive Oil May Protect Against Ulcerative Colitis
HeatherAdministrator
05/05/10 10:32 AM
* Accutane may cause ulcerative colitis
HeatherAdministrator
04/09/10 01:38 PM
* Red meat may raise odds for ulcerative colitis, but oily fish could be protective
HeatherAdministrator
03/11/10 01:22 PM
* Inflammatory Bowel Disease and Irritable Bowel Syndrome: Separate or Unified?
HeatherAdministrator
01/05/10 12:03 PM
* Novel Compound Targets Mucosal Healing in Crohn's
HeatherAdministrator
05/29/06 02:19 PM
* Viagra May Help Crohn's Disease
HeatherAdministrator
03/04/06 12:50 PM
* Carbon Monoxide Eases Ulcerative Colitis
HeatherAdministrator
01/18/06 04:12 PM
* Colonoscopic Surveillance in Inflammatory Bowel Disease
HeatherAdministrator
10/11/05 01:33 PM
* Oral Contraceptives and HRT a Risk Factor for Inflammatory Bowel Disease
HeatherAdministrator
09/13/05 01:22 PM
* Cannabinoids Show Promise for Inflammatory Bowel Disease
HeatherAdministrator
09/01/05 11:23 AM
* Differentiation of Inflammatory Bowel Disease and Irritable Bowel Syndrome
HeatherAdministrator
09/01/05 11:13 AM
* The Clinical Epidemiology of Inflammatory Bowel Disease
HeatherAdministrator
08/22/05 04:45 PM
* IBD Patients May Benefit From Folic Acid Supplementation
HeatherAdministrator
05/22/05 07:02 PM
* Fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis
HeatherAdministrator
04/24/05 03:33 PM
* Biotic Therapy Cuts Inflammation in Ulcerative Colitis
HeatherAdministrator
02/19/05 05:59 PM
* Calming Crohn's Disease with Fish Oil and Antioxidants
HeatherAdministrator
01/07/05 04:55 PM
* Probiotics Prove Just As Effective As a Popular Prescription Drug for Ulcerative Colitis
HeatherAdministrator
12/20/04 01:37 PM
* Increased Incidence of Inflammatory Bowel Disease: The Price of the Decline of Infectious Burden?
HeatherAdministrator
11/28/04 02:58 PM
* Diet May Influence Relapse in Ulcerative Colitis
HeatherAdministrator
10/24/04 07:50 PM
* Parasite Therapy for Crohn's and Colitis?
HeatherAdministrator
08/08/04 03:00 PM
* Pipeline Treatments, Novel Procedures Offer New Options for GI Diseases
HeatherAdministrator
06/04/04 06:41 PM
* Faulty Gene for Crohn's Disease Found
HeatherAdministrator
04/13/04 03:19 PM
* Data links Crohn's disease and antibiotics
HeatherAdministrator
02/24/04 02:07 PM
* Elan Reports Successful Results of Antegren Trial for Crohn's Disease
HeatherAdministrator
02/10/04 01:30 PM
* 5-ASA Therapy for Inflammatory Bowel Disease No Bar to Colon Cancer
HeatherAdministrator
02/10/04 01:29 PM
* Once-Daily Probiotic Treatment Maintains Remission in Ulcerative Colitis patients with Pouchitis
HeatherAdministrator
01/26/04 03:33 PM
* Bone Disease and Intestinal Problems May Share a Common Cause
HeatherAdministrator
01/07/04 11:47 AM
* Increased Anal Resting Pressure and Rectal Sensitivity in Crohn's Disease
HeatherAdministrator
12/16/03 11:59 AM
* Environmental Factors May Play a Role in the Pathogenesis of IBD
HeatherAdministrator
12/01/03 05:56 PM
* Colonoscopy Prep
HeatherAdministrator
10/17/03 12:05 PM
* Detection of Pulmonary Involvement in Inflammatory Bowel Disease
HeatherAdministrator
09/30/03 01:20 PM
* Indeterminate Colitis
HeatherAdministrator
09/16/03 03:33 PM
* Familial Occurrence of Inflammatory Bowel Disease in Celiac Disease
HeatherAdministrator
09/16/03 03:30 PM
* Bacteria in Milk Linked to Crohn's Disease and Possibly IBS
HeatherAdministrator
08/12/03 11:55 AM
* Inflammatory Bowel Disease During Pregnancy.
HeatherAdministrator
07/15/03 06:20 PM
* A study of the menopause, smoking, and contraception in women with Crohn's disease.
HeatherAdministrator
07/15/03 06:05 PM
* Hormone replacement therapy prevents bone loss in patients with IBD
HeatherAdministrator
07/15/03 06:02 PM
* Chemo Drug Improves Crohn's Symptoms
HeatherAdministrator
07/14/03 04:09 PM

Extra information
0 registered and 94 anonymous users are browsing this forum.

Moderator:  Heather 



Permissions
      You cannot post until you login
      You cannot reply until you login
      HTML is enabled
      UBBCode is enabled

Thread views: 257918

Jump to

| Privacy statement Help for IBS Home

*
UBB.threads™ 6.2


McAfee SECURE sites help keep you safe from identity theft, credit card fraud, spyware, spam, viruses and online scams

HelpForIBS.com BBB Business Review