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Standardized Fecal Microbiota Transplantation for Crohn's Diseases

Not Applicable
Recruiting
Conditions
Inflammatory Bowel Disease
Crohn's Disease (CD)
Interventions
Procedure: FMT
Registration Number
NCT01793831
Lead Sponsor
The Second Hospital of Nanjing Medical University
Brief Summary

The gut microbiota is considered to constitute a "microbial organ" which has pivotal roles in the intestinal diseases and body's metabolism. Evidence from animal and human studies strongly supports the link between intestinal bacteria and inflammatory bowel diseases (IBD). Dozens of studies reported its efficacy in treatment of severe Clostridium difficile colitis. Preliminary studies using fecal microbiota transplantation (FMT) for Ulcerative Colitis (UC), Crohn's diseases (CD), irritable bowel syndrome (IBS) and constipation have also met with some success. However, the results on CD is very limited. This marks the initial step in exploring the potential efficacy of fecal bacteriotherapy for CD. The investigators aim to evaluate the effectiveness, durability, and safety of FMT in a cohort of at least 500 patients with CD over a ten-year period

Detailed Description

The present clinical trial aims to re-establish a gut functionality state of intestinal flora through FMT as a therapy for CD (all age range,HBI\>4). We established a standard microbiota isolation from donated fresh stool in lab. The microbiota is then transplanted into the intestine via endoscopy or other established methods, such as mid-gut or colonic transendoscopic enteral tubing. Patients from multi-clinical centers in this study will be assigned to receive FMT or traditional treatments according to associated guidelines and follow-up for at least one year. Blood tests, imaging, endoscopy and questionnaire will be used to assess participants at study start and at study completion.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
800
Inclusion Criteria

Clinical diagnosis of Crohn's disease, with the diagnosis remaining unchanged after at least three months of follow-up.

Willingness to undergo FMT (Fecal Microbiota Transplantation).

Exclusion Criteria

Presence of serious conditions that made them unsuitable for inclusion (e.g., malignant neoplasms, cardiopulmonary failure, serious liver or kidney disease).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fecal microbiota transplantationFMTStandard fecal microbiota transplantation, which has been defined as washed microbiota transplantation since 2019.
Primary Outcome Measures
NameTimeMethod
Clinical remissionUp to one year

Clinical remission defined as HBI score ≦ 4. For patients with complications such as intestinal obstruction, Clinical remission can be defined as obstruction improvement. The endpoint of follow-up is the time of clinical recurrence.

Secondary Outcome Measures
NameTimeMethod
CostsUp to one year

Social and medical costs

Symptomatic stricturebefore FMT, 1 month after FMT, 12 weeks after FMT

evaluated by Crohn's Disease Obstruction Score (CDOS), with a score range of 0 to 6. Higher scores indicate greater severity of obstructive symptoms.

Sleep qualitybefore FMT, 1 month after FMT, 12 weeks after FMT

evaluated by Pittsburgh Sleep Quality Index (PSQI), with a score range of 0 to 21. Higher PSQI score indicates poorer sleep quality. Insomnia Severity Index (ISI), with a score range of 0 to 28. Higher ISI score indicates more severe insomnia.

Adverse eventsDuring FMT and ten years after FMT

All possible adverse events:fever,abdominal pain,infectious diseases and others

Fatiguebefore FMT, 1 month after FMT, 12 weeks after FMT

evaluated by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), with a score range of 0 to 52. Higher FACIT-F score indicates lower levels of fatigue and better quality of life.

Anxiety and depressionbefore FMT, 1 month after FMT, 12 weeks after FMT

evaluated by Hospital Anxiety and Depression Scale (HADS), with a score range of 0 to 42. Higher scores indicate greater severity of anxiety and depression symptoms.

Trial Locations

Locations (2)

The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University

🇨🇳

Huai'an, Jiangsu, China

Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University

🇨🇳

Nanjing, Jiangsu, China

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