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Effectiveness of Fecal Microbiota Transplantation as add-on Therapy in Mild-to-moderate Ulcerative Colitis

Not Applicable
Completed
Conditions
Ulcerative Colitis Chronic Mild
Inflammatory Bowel Diseases
Interventions
Biological: Fecal transplantation
Registration Number
NCT05538026
Lead Sponsor
Bogomolets National Medical University
Brief Summary

Ulcerative colitis (UC) is a chronic immune-mediated inflammatory bowel disease (IBD) that almost always affects the rectum and often extends to the more proximal colon. UC usually begins at a young age (15-30 years), most patients (\~ 85%) have a mild or moderate activity, characterized by periods of exacerbation and remission. Considering the important pathogenetic role of gut dysbiosis, recently, as an additional method of treating UC, it is considered a modification of altered gut microbiota using various drug and non-drug methods. One such method is fecal microbiota transplantation (FMT), consisting of the simultaneous replacement of the gut microbiota of a sick recipient with fecal material from a healthy donor. Even though so far the only officially approved indication for FMT is recurrent Clostridium difficile infection, however, the effectiveness of FMT is currently being studied in the treatment of other gastrointestinal and non-gastrointestinal pathologies, including UC. To date, several controlled and uncontrolled studies have been conducted to study the effectiveness of FMT in UC, showing encouraging results. This study aimed to assess the clinical and microbiological efficacy, tolerability, and safety of FMT as add-on therapy to basic therapy, in patients with mild-to-moderate UC.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
53
Inclusion Criteria
  • Age 18-60;
  • Endoscopically and morphologically confirmed UC;
  • Negative results of stool culture for the presence of pathogenic bacteria (Shigella spp., Salmonella spp., Campylobacter spp., Yersinia spp.) and toxin-producing Clostridioides difficile;
  • partial Mayo score of 4-6;
  • Mayo endoscopic subscore ≥1;
  • Fecal calprotectin > 150 mcg/g
  • Treatment with mesalazine at a daily dose of 3 g during the last 4 weeks
Exclusion Criteria
  • Pregnancy, planning pregnancy or breastfeeding;
  • Postponed operations on the abdominal cavity;
  • Severe mental disorders, alcohol or drug abuse;
  • Use of systemic corticosteroids, biological agents, and probiotics within 8 weeks before study
  • Any condition or circumstance that would, in the opinion of the investigator, prevent completion of the study or interfere with analysis of study results.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
standard care groupMesalazinemesalazine (Pentasa) at a daily dose of 3 g (2 g orally + 1 g rectally)
Fecal transplantationFecal transplantationFecal transplantation of fresh prepared feces from healthy donor. Application by colonoscope in proximal half of colon.
Primary Outcome Measures
NameTimeMethod
Change in partial Mayo score > 2 points8 weeks

Partial Mayo score composed of four parts: rectal bleeding, stool frequency, physician assessment, and endoscopy appearance. Each part is rated from 0 to 3, giving a total score of 0 to 12. Partial Mayo score (eliminates endoscopy) and of 2 to 4 points indicates mildly active disease, a score of 5 to 6 points indicates moderately active disease, and a score of 7 to 9 points indicates severely active disease

Changes in fecal calprotectin8 weeks

expressed in µg/g

Secondary Outcome Measures
NameTimeMethod
Microbiome profile change4 weeks

Characterization of fecal microbiome by metagenomic analysis before and after intervention Characterization of fecal microbiome by metagenomic analysis before and after intervention

Trial Locations

Locations (2)

Bogomolets National Medical University

🇺🇦

Kyiv, Ukraine

Ukrainian Research and Practical Centre of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine

🇺🇦

Kyiv, Ukraine

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