DDW Expert Perspective: Top 5 FMT, microbiome takeaways

In this first-hand account, Colleen R. Kelly, MD, FACG, Assistant Professor of Medicine at The Alpert Medical School of Brown University, gives her insight into the latest in Digestive Disease Week research.

CHICAGO — We’re only 2 days into DDW 2017 and I am already excited about new research coming out of this year’s meeting. Here are my top five takeaways about fecal microbiota transplantation and the microbiome, based on research presented here so far:

1. New insights into the best way to perform FMT will be extremely useful to clinicians — and patients. Researchers presented results from a multicenter randomized trial comparing colonoscopic FMT with encapsulated delivery. These methods were shown to be equivalent in efficacy — 96% for both — but encapsulated FMT was rated more tolerable by patients and was also less expensive to administer.

Colleen R. Kelly, MD

2. Viable options are becoming available for patients who do not respond to or who have adverse events associated with FMT — and this will be critical to helping all patients suffering from GI issues. New research still recommends repeated FMT for non-responsive patients, and highlights the need to consider alternative diagnoses in patients presenting with atypical symptoms.

3. Research into the safety and efficacy of FMT will provide important insights on its long-term impact, which could have huge implications on the future of patient care. A new national FMT registry will help us understand the real-world successes and possible risks of disease or other side-effects for patients with altered gut microbiota.

4. The interaction between bacterial and non-bacterial microbes in the human gut may provide important new insights. Recent studies are showing that non-bacterial components of the microbiome, such as viruses, may be involved with intestinal inflammation or with the transfer of genes between gut bacteria, affecting their functional capabilities. This may be associated with diseases like inflammatory bowel disease and even asthma.

5. IBD has increased rapidly in Asia over the past decade, and this trend may be key in understanding the role of gut microbiota in the development of digestive diseases.New research is focusing on how environmental factors, such as diet, impact gut microbiota and the pathogenesis of IBD and other immune-mediated inflammatory disease.

This research has the potential to transform care delivery for patients who suffer from digestive diseases, and I am intrigued to see how it plays out in the clinical setting.

References:

Kelly CR. Session 3105. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Fischer M. Sp297. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Loren L. Sp299. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Wu G. Sp349. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Ng S. Sp457. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosures: Kelly reports a financial relationship with Summit Therapeutics. For specific disclosures on presentations, please refer to DDW.org.