Xiao Ding1,2, Qianqian Li1, Pan Li1,3, Ting Zhang1, Bota Cui1,3, Guozhong Ji1,3, Xiang Lu4, Faming Zhang5,6. 1. Medical Center for Digestive Diseases, The Second Affiliated Hospital, Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, 210011, China. 2. Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Ave, Nanjing, 211166, China. 3. Key Laboratory of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, 210011, China. 4. Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, 109 Longmian Ave, Nanjing, 211166, China. luxiang66@njmu.edu.cn. 5. Medical Center for Digestive Diseases, The Second Affiliated Hospital, Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing, 210011, China. fzhang@njmu.edu.cn. 6. Key Laboratory of Holistic Integrative Enterology, Nanjing Medical University, Nanjing, 210011, China. fzhang@njmu.edu.cn.
Abstract
INTRODUCTION AND OBJECTIVE: The therapeutic role of fecal microbiota transplantation in ulcerative colitis varies across different reports. This study aims to evaluate the long-term safety and efficacy of a strategy called step-up fecal microbiota transplantation for ulcerative colitis. METHODS: Two clinical trials (NCT01790061, NCT02560727) for moderate-to-severe ulcerative colitis (Mayo score range 6-12) were performed from November 2012 to July 2017. Both studies were pooled for analysis on the safety and efficacy of fecal microbiota transplantation in patients with ulcerative colitis over a 1-year follow-up. The step-up fecal microbiota transplantation strategy included step 1: single fecal microbiota transplantation; step 2: two or more fecal microbiota transplantations; and step 3: fecal microbiota transplantations followed by immunosuppressants. Long-term clinical efficacy and adverse events were assessed, and multiple factors related to fecal microbiota transplantation were evaluated. RESULTS: Of 134 eligible patients in this real-word study, 81.3% (109/134) were included for analysis. The follow-up ranged from 1 to 5 years. Fecal microbiota transplantation-related adverse events were observed in 17.4% (43/247) of fecal microbiota transplantation procedures including one serious adverse event (myasthenia gravis) and 56 non-serious adverse events. Multivariable logistic regression analysis showed that both the method of preparation of microbiota from stool using the automatic system and the delivery method of colonic transendoscopic enteral tubing were associated with a lower rate of fecal microbiota transplantation-related adverse events (p = 0.023, p = 0.017, respectively). In total, 74.3% (81/109) and 51.4% (56/109) of patients achieved clinical response at 1 month and 3 months after step-up fecal microbiota transplantation, respectively. CONCLUSIONS: Fecal microbiota transplantation should be a safe and promising therapy for ulcerative colitis. The improved fecal microbiota preparation and colonic transendoscopic enteral tubing might reduce the rate of adverse events in ulcerative colitis. TRIAL REGISTRATION: ClinicalTrials.gov NCT01790061, NCT02560727.
INTRODUCTION AND OBJECTIVE: The therapeutic role of fecal microbiota transplantation in ulcerative colitis varies across different reports. This study aims to evaluate the long-term safety and efficacy of a strategy called step-up fecal microbiota transplantation for ulcerative colitis. METHODS: Two clinical trials (NCT01790061, NCT02560727) for moderate-to-severe ulcerative colitis (Mayo score range 6-12) were performed from November 2012 to July 2017. Both studies were pooled for analysis on the safety and efficacy of fecal microbiota transplantation in patients with ulcerative colitis over a 1-year follow-up. The step-up fecal microbiota transplantation strategy included step 1: single fecal microbiota transplantation; step 2: two or more fecal microbiota transplantations; and step 3: fecal microbiota transplantations followed by immunosuppressants. Long-term clinical efficacy and adverse events were assessed, and multiple factors related to fecal microbiota transplantation were evaluated. RESULTS: Of 134 eligible patients in this real-word study, 81.3% (109/134) were included for analysis. The follow-up ranged from 1 to 5 years. Fecal microbiota transplantation-related adverse events were observed in 17.4% (43/247) of fecal microbiota transplantation procedures including one serious adverse event (myasthenia gravis) and 56 non-serious adverse events. Multivariable logistic regression analysis showed that both the method of preparation of microbiota from stool using the automatic system and the delivery method of colonic transendoscopic enteral tubing were associated with a lower rate of fecal microbiota transplantation-related adverse events (p = 0.023, p = 0.017, respectively). In total, 74.3% (81/109) and 51.4% (56/109) of patients achieved clinical response at 1 month and 3 months after step-up fecal microbiota transplantation, respectively. CONCLUSIONS: Fecal microbiota transplantation should be a safe and promising therapy for ulcerative colitis. The improved fecal microbiota preparation and colonic transendoscopic enteral tubing might reduce the rate of adverse events in ulcerative colitis. TRIAL REGISTRATION: ClinicalTrials.gov NCT01790061, NCT02560727.
Authors: Severine Vermeire; Marie Joossens; Kristin Verbeke; Jun Wang; Kathleen Machiels; João Sabino; Marc Ferrante; Gert Van Assche; Paul Rutgeerts; Jeroen Raes Journal: J Crohns Colitis Date: 2015-10-29 Impact factor: 9.071
Authors: Stephan J Ott; Georg H Waetzig; Ateequr Rehman; Jacqueline Moltzau-Anderson; Richa Bharti; Juris A Grasis; Liam Cassidy; Andreas Tholey; Helmut Fickenscher; Dirk Seegert; Philip Rosenstiel; Stefan Schreiber Journal: Gastroenterology Date: 2016-11-17 Impact factor: 22.682