#VisualAbstract: Effect of Fecal Microbiota Transplantation on 8-Week Remission in Patients With Ulcerative Colitis

1. In this randomized controlled trial, patients who received a donor fecal microbiota transplant (FMT) had a higher rate of steroid-free remission at 8-weeks than those who a received autologous FMT.

2. Donor FMT was also associated with better clinical response and clinical remission.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Ulcerative colitis (UC) is a chronic inflammatory bowel condition that is treated with anti-inflammatory medications but often results in breakthrough symptoms, increased colorectal cancer risk, and sometimes necessitates colectomy. Though some studies have implicated colonic bacteria as being tied to UC pathogenesis, it is unclear if Fecal Microbiota Transplant (FMT) would be a suitable treatment. In this randomized controlled trial, a 3-dose, 1-week induction course of donor FMT was more likely to induce steroid-free, clinical and endoscopic remission in patients with active UC at 8 weeks versus autologous FMT. Patients who underwent donor FMT also had improved clinical remission and response.

This study utilized an anaerobic method for processing donor FMTs, which may have contributed to the similar clinical effects to other studies using higher intensity regimens. However, limitations including small study size and only 8 weeks of follow up suggest that further investigation would be necessary to endorse FMT as an effective and safe treatment for UC.

Click to read the study in JAMA

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