Effects of Faecal Microbiota Transplantation in Patients With Irritable Bowel Syndrome: A Randomised, Double-blind Placebo-controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 164
- 试验地点
- 2
- 主要终点
- Quality of life as assessed by Short form of Nepean Dyspepsia Index (SF-NDI) questionnaires
研究概览
简要总结
Irritable bowel syndrom (IBS) is a common chronic gastrointestinal disorder that affects 10-20% of the world population. The prevalence of IBS in Norway is between 8% and 25%. The pathophysiology of IBS is incompletely understood, and there is no effective treatment for this condition. Imbalance (dysbiosis) of the gut microbiome has been found in patients with IBS. In the absence of effective method to restore the dysbiosis, transplantation of a microbiome from healthy individuals with well-functioning gut (FMT) to those with IBS has been performed. Two randomized double blind placebo-controlled (RCT) studies have been published recently. Whereas it was reported in one study that FMT reduced symptom and improved quality of life in patients with IBS, FMT had no effect in the other study. In order to clarify these contradictory results, a new RCT study that enrolled larger number of patients is required. In this study, the investigators intend to recruit 170 IBS patients from those attending outdoor clinic at Stord hospital in a randomized, double blind placebo trial. A single healthy donor with well-characterized microbiome is going to be used. The effects on symptoms, quality of life, fatigue as well as dysbiosis before and after FMT are going to be investigated. The possible mechanisms behind the effects if any of FMT such as changes in intestinal stem cells, enteroendocrine cells and local immune defense shall be also investigated. The patients are going to be randomized either to placebo (own faces), 30 g or 60 g of the donor faces in ratio 1:1:1.
详细描述
Study design Patients One hundred and seventy patients who fulfill the following inclusion criteria and lack the exclusion criteria shall be included. In addition, the patients are examined physically, and blood tests are taken to exclude inflammation, and liver, kidney and thyroid diseases. They undergo further gastroscopy with duodenal biopsies to exclude coeliac disease. They undergo also colonoscopy to exclude malignity, or inflammatory bowel disease (IBD). Microscopic colitis is excluded by examining tissue obtained by colonoscopy with segmental biopsy sampling.
Donor selection and screening:
A single donor shall be selected and screened according to the European and international guidelines. The donor should not be a first-degree relative to any of the patients, as the intestinal microbiota is affected by the genetic composition, and similarity between the donor and recipient in the fecal microbiota may occur.
Protocol
Feces collection, preparation and administration:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
A research nurse, not involved in the trial, create the allocation sequence using a website. This was done in blocks of 21 patients.
入排标准
- 年龄范围
- 18 Years 至 85 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients between who fulfill Rome IV criteria for the diagnosis of IBS.
- •Patients with moderate to severe IBS symptoms (IBS-SSS ≥ 175).
排除标准
- •Pregnant, planning pregnancy or lactating women.
- •The use of antibiotics or probiotics within 1 month prior to FMT.
- •Patients who had undergone any abdominal surgery, with the exception of appendectomy, cholecystectomy, Caesarean section or hysterectomy.
结局指标
主要结局
Quality of life as assessed by Short form of Nepean Dyspepsia Index (SF-NDI) questionnaires
时间窗: 3 months
SF-NDI is a five-point Likert scale ranging from 0 to 5. Lower scores indicate improvement.
Global improvement in IBS symptoms as assessed by IBS Symptom Severity Scale (IBS-SSS)
时间窗: 3 months.
IBS-SSS is a visual assessment scale (VAS) rating from 0 to 100, with total scores ranging from 0 to 500. Lower scores indicate improvement.
Quality of life as assessed by IBS quality of life (IBSQoL) questionnaire
时间窗: 3 months
IBSQoL consist of 34- questions measured on a five-point Likert scale ranging from 0 to 5. Higher scores indicate improvement.
Global improvement in IBS symptoms as assessed by Birmingham Symptom scale questionnaire
时间窗: 3 months.
This questionnaire consists of 11 question. measured on a six-point Likert scale ranging from 0 to 5. Lower scores indicate improvement.
Fatigue as assessed by: Fatigue Assessment Scale (FAS) questionnaire
时间窗: 3 months
FAS is a five-point Likert scale ranging from 0 to 5. Lower scores indicate improvement.
次要结局
- Stool microbiota changes as assessed by the Dysbiosis index (DI)(3 months.)
研究者
Magdy El-Salhy, MD, PhD
Professor/Consultant gatroenterologist
Helse Fonna
