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Clinical Trial
. 2020 May;13(3):760-769.
doi: 10.1111/1751-7915.13536. Epub 2020 Jan 20.

Efficacy of faecal microbiota transplantation in Crohn's disease: a new target treatment?

Liyuan Xiang  1   2 , Xiao Ding  1   2 , Qianqian Li  1   2 , Xia Wu  1   2 , Min Dai  1   2 , Chuyan Long  1   2 , Zhi He  1   2 , Bota Cui  1   2 , Faming Zhang  1   2   3   4
Affiliations
Clinical Trial

Efficacy of faecal microbiota transplantation in Crohn's disease: a new target treatment?

Liyuan Xiang et al. Microb Biotechnol. 2020 May.

Abstract

The efficacy of faecal microbiota transplantation (FMT) in Crohn's disease (CD) remains unclear due to lack of data. This study aimed to assess the value of FMT in treating CD-related clinical targets. The use of FMT for CD as a registered trial (NCT01793831) was performed between October 2012 and December 2017. Seven therapeutic targets included abdominal pain, diarrhoea, hematochezia, fever, steroid-dependence, enterocutaneous fistula and active perianal fistula. Each target was recorded as 1 (yes) or 0 (no) during the long-term follow-up for each patient. The primary outcome was the rate of improvement in each therapeutic target. Overall, 174 patients completed the follow-up. The median follow-up duration was 43 (interquartile range, 28-59) months. The median score of the total targets was 2 (range, 1-4) before FMT, and it decreased significantly at 1, 3, 6, 12, 24 and 36 months after FMT (P < 0.001 respectively). At 1 month after FMT, 72.7% (101/139), 61.6% (90/146), 76% (19/25) and 70.6% (12/17) of patients achieved improvement in abdominal pain, diarrhoea, hematochezia and fever respectively. Furthermore, 50% (10/20) of steroid-dependent patients achieved steroid-free remission after FMT. The present findings indicate that it is important to understand the efficacy of FMT in CD as a targeted therapy, especially for abdominal pain, hematochezia, fever and diarrhoea.

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Conflict of interest statement

Faming Zhang invented the concept of GenFMTer and transendoscopic enteral tubing and devices related to it. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Outcomes of step‐up FMT strategy in CD patients.
Figure 2
Figure 2
Improvement of each target at serial assessment time point post‐FMT. Percentage of patients who achieved improvement in abdominal pain, diarrhoea, hematochezia, fever at 1, 3, 6, 12, 24, 36 months post‐FMT and steroid‐dependence at 6, 12, 24, 36 months post‐FMT. The original data were shown as the table below, including specific number and percentage of patients who achieved improvement in each target, number of patients with follow‐up data at serial assessment time point.
Figure 3
Figure 3
Improvement in each target in two groups divided by whether patients underwent step 3. EEN, exclusive enteral nutrition. Percentage of patients who achieved improvement in abdominal pain (A), diarrhoea (B), hematochezia (C), fever (D) and steroid‐dependence (E) in two groups divided by whether they received steroids, immunomodulators or EEN (step 3) based on single or multiple FMTs (step 1/2).
See this image and copyright information in PMC

References

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