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

Titel: Randomised clinical trial: faecal microbiota transplantation versus autologous placebo administered via colonoscopy in irritable bowel syndrome
Författare: Lahtinen, Perttu; Jalanka, Jonna; Hartikainen, Anna; Mattila, Eero; Hillilä, Markku; Punkkinen, Jari; Koskenpato, Jari; Anttila, Veli-Jukka; Tillonen, Jyrki; Satokari, Reetta; Arkkila, Perttu
Upphovmannens organisation: Päijät-Häme Welfare Consortium
HYKS erva
Faculty of Medicine
University of Helsinki
HUMI - Human Microbiome Research
Research Programs Unit
HUS Internal Medicine and Rehabilitation
Infektiosairauksien yksikkö
Department of Medicine
Helsinki University Hospital Area
HUS Abdominal Center
Gastroenterologian yksikkö
Clinicum
HUS Inflammation Center
Datum: 2020-06
Språk: eng
Sidantal: 11
Tillhör serie: Alimentary Pharmacology & Therapeutics
ISSN: 0269-2813
DOI: https://doi.org/10.1111/apt.15740
Permanenta länken (URI): http://hdl.handle.net/10138/329448
Abstrakt: 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
Referentgranskad: Ja
Användningsbegränsning: openAccess
Parallelpublicerad version: acceptedVersion


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