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Sibling donation of FMT linked to long-term UC remission

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AUSTIN, Texas — The use of sibling donation for fecal microbiota transplant led to long-term remission of ulcerative colitis more often than donation from a parent, according to a presenter at the Crohn’s and Colitis Congress. Additionally, when donor and recipient were close in age – less than 10 years difference – researchers saw greater success.

“FMT between brother and sister has a significantly higher non-relapse rate than transplantation between spouses and children,” Koki Okahara, MD, of the Juntendo University Hospital, Bunkyoku, Tokyo, Japan, said during his presentation. “The over 11 years older group has a significantly lower non-relapse rate than the less than 10 years group.”

In this prospective, non-randomized, controlled study, Okahara and colleagues aimed to compare triple-antibiotic therapy of amoxicillin, fosfomycin and metronidazole (AFM) used alone with the use of AFM prior to FMT. In the FMT group, patients received donations from their spouses or family relatives who passed Amsterdam protocol for FMT.

At 4 weeks, Okahara reported that the FMT group (n = 47) showed 65.9% clinical response and 40.4% clinical remission while the AFM monotherapy group (n = 32) saw 56.2% with clinical response and 18.7% with clinical remission. At 12 months, clinical response remained in favor of FMT treatment (P = .046).

At 24 months, 22.2% of the AFM monotherapy group maintained no relapse while 33.3% of the FMT group maintained long-term success (P = .034 for comparison).

Perhaps more importantly, Okahara showed that when the donor-recipient relationship was one of siblings, there was a higher rate of maintenance (P = .006) than when the donor and recipient were parent and child. And when the donor and recipient had an age difference less than 10 years, the maintenance rate was higher (P = .003).

“In my opinion, the gut microbiota of siblings may reflect microbiota before the development of UC, so a healthy microbiota for the patient,” Okahara said. – by Katrina Altersitz

Reference: Okahara K, et al. Abstract 25. Presented at: Crohn’s and Colitis Congress; Jan. 23-25, 2020; Austin, Texas.

Disclosures: Okahara reports joint research expenses from Kyowa Hakkou Kirin Co Ltd. and Kirin Bio Co. Ltd.