A recent prospective open-label study (Suskind DL, et al. Inflamm Bowel Dis 2015; 21: 556-63) adds a bit more information on fecal microbial transplantation (FMT) for individuals with Crohn’s disease (CD). This study included 9 patients, ages 12-19, and 11 authors.
- Pretreated with rifaximin 200 mg TID x 3 days and Miralax 17 gm TID x 2 days prior, and omeprazole day before and morning of procedure
- Patients continued on prior treatment: 4 on methotrexate, 2 on thiopurine, and 3 on mesalamine (1 mesalamine patient was receiving methotrexate also)
- Stool donor was a screened parent
- Stool administered via NG
- Stool DNA studied –>metagenomic sequencing
- FMT engraftment was demonstrated in 7 of 9 patients
- Mean PCDAI improved –baseline 19.7 –>6.4 at 2 weeks–>8.6 at 6 weeks
- 5 of 9 patients who did not receive additional medical therapy were in remission at 6 and 12 weeks.
One particular advance with this study was the correlation between microbial species before and after FMT. One speculation from the authors was that “the more divergent a Crohn’s patient is from his donor the more the potential benefit of transplantation.” Thus, this same study with unrelated donor stool (eg. OpenBiome) would be of interest as well.
My Take: While this study offers encouragement for bigger studies, we will not know if FMT is effective (& how to administer optimally) until we have studies with more patients than authors.
Related blog posts:
- Clostridium difficile/Fecal Microbiota Transplantation Video …
- Early Results of FMT for IBD -Any Efficacy? | gutsandgrowth
- Something New with FMT | gutsandgrowth
- Consensus Guidelines on FMT | gutsandgrowth
- FMT -not quite the new Laser | gutsandgrowth