Randomised clinical trial: faecal microbiota transplantation versus autologous placebo administered via colonoscopy in irritable bowel syndrome

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Lahtinen , P , Jalanka , J , Hartikainen , A , Mattila , E , Hillilä , M , Punkkinen , J , Koskenpato , J , Anttila , V-J , Tillonen , J , Satokari , R & Arkkila , P 2020 , ' Randomised clinical trial: faecal microbiota transplantation versus autologous placebo administered via colonoscopy in irritable bowel syndrome ' , Alimentary Pharmacology & Therapeutics , vol. 51 , no. 12 , pp. 1321-1331 . https://doi.org/10.1111/apt.15740

Title: Randomised clinical trial: faecal microbiota transplantation versus autologous placebo administered via colonoscopy in irritable bowel syndrome
Author: Lahtinen, Perttu; Jalanka, Jonna; Hartikainen, Anna; Mattila, Eero; Hillilä, Markku; Punkkinen, Jari; Koskenpato, Jari; Anttila, Veli-Jukka; Tillonen, Jyrki; Satokari, Reetta; Arkkila, Perttu
Contributor: University of Helsinki, Päijät-Häme Welfare Consortium
University of Helsinki, HUMI - Human Microbiome Research
University of Helsinki, HUMI - Human Microbiome Research
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, Medical Centre Aava
University of Helsinki, HUS Inflammation Center
University of Helsinki, HYKS erva
University of Helsinki, HUMI - Human Microbiome Research
University of Helsinki, HUS Abdominal Center
Date: 2020-06
Language: eng
Number of pages: 11
Belongs to series: Alimentary Pharmacology & Therapeutics
ISSN: 0269-2813
URI: http://hdl.handle.net/10138/329448
Abstract: Summary Background Irritable bowel syndrome (IBS) has been associated with microbial dysbiosis. Aim To investigate the efficacy of faecal microbiota transplantation (FMT) in the treatment of IBS. Methods Forty-nine IBS patients were randomised to receive autologous or allogenic FMT via colonoscopy. The primary endpoint was a sustained, minimum of 50-point, reduction in the IBS Symptom Severity Score. The secondary outcomes were levels of anxiety and depression, changes in quality of life, gut microbiota and faecal water content as assessed with validated questionnaires, intestinal microbiota composition and stool dry weight. Results The primary endpoint was not achieved in either group. However, there was a transient reduction in the mean IBS Symptom Severity Score in the FMT group at 12 weeks after treatment as compared to baseline (P = 0.01). The groups did not differ in the number of patients achieving clinical response at 12 weeks. In the FMT-treated patients, microbial composition had changed to resemble that of the donor and the stool water content decreased significantly compared to baseline. The depression score decreased in patients with a reduction in IBS symptoms after FMT, but not in those placebo-treated patients who experienced a reduction in IBS symptoms. Conclusions FMT provided only a transient relief of symptoms, although it induced a sustained alteration in the microbiota of IBS patients. Therefore, FMT delivered by a single infusion via colonoscopy cannot be recommended as a treatment for IBS in clinical practice. ClinicalTrials.Org, Trial registration number: NCT03561519.
Subject: 3111 Biomedicine
3121 General medicine, internal medicine and other clinical medicine
ACTIVE ULCERATIVE-COLITIS
RECURRENT
EFFICACY
VALIDATION
REMISSION
BACTERIAL
SEVERITY
SYMPTOMS
ANXIETY
IBS
317 Pharmacy
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