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Fecal microbiota transplant improved symptoms in patients with Crohn's disease

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Fecal microbiota transplant induced early improvement of symptoms in patients with active Crohn’s disease, according to findings from a pilot study presented at the American Gastroenterological Association’s James W. Freston Conference.

In a prospective, open-label trial, Byron P. Vaughn, MD, of the Beth-Israel Deaconess Medical Center, and colleagues evaluated the safety and efficacy of fecal microbiota transplant (FMT) in 11 patients with active Crohn’s disease (CD).

Byron P. Vaughn

“FMT is currently not ready to be offered as a treatment for patients with inflammatory bowel disease (IBD),” Vaughn told Healio.com/Gastroenterology. “It is still unknown if the dysbiosis causes inflammation or is an effect of inflammation, or has components of both. Yet we are starting to see a signal that improving the dysbiosis through manipulating the intestinal flora may improve symptoms related to Crohn’s disease for some patients.”

After FMT, patients’ symptoms improved as indicated by Harvey-Bradshaw Index scores (P<.0001) and the short IBD questionnaire (P=.0002). After 4 weeks of follow-up, 55% had clinical response; 36% were in clinical remission. Microbial composition analysis of a single donor-recipient pair showed 99.5% of the donor microbiome was found in 56% of the recipients while just 10% of the pre-FMT microbiome remained.

“The preliminary results of our uncontrolled observation trial demonstrate that FMT for active CD induces early symptomatic improvement, although no changes were seen in inflammatory parameters,” Vaughn said. “Patients who had a symptomatic response tended to have a change in their flora toward donor stool samples, which had less disease-associated taxa.”

Although these results are preliminary, Vaughn said, given the lack of control group, not accounting for variables like diet, and the administration of only a single FMT, “our results are provocative and warrant continued research. We have currently completed enrollment and expect follow-up and data analysis to be complete later this year.” – by Adam Leitenberger

Disclosure: The trial was funded by a grant to the Harvard Institute of Translational Immunology from the Leona and Harry Helmsley Charitable Trust. The researchers report no other relevant financial disclosures.