Recalibrating Intestinal Microflora in IBS by Fecal Transplantation
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 90
- 试验地点
- 2
- 主要终点
- Change in subjective symptom score
研究概览
简要总结
Fecal Microbial Transplantation in Treatment of Irritable Bowel Syndrome; a Double Blinded Placebo Controlled Trial - the REFIT project
Irritable bowel syndrome (IBS) is a condition characterized by variable complaints like diarrhoea, bloating and abdominal pain, and may result in considerably reduced quality of life and increased sickness absence. The prevalence of IBS in the general population may be as high as 15 per cent depending on the diagnostic criteria used. The pathophysiology of IBS is poorly understood and theories of visceral hypersensitivity, micro-inflammation and other less well founded theories have been stated. So far, no measurement or test can affirm diagnosis, but exclusion of organic diseases in combination with a typical symptom pattern according to the Rome classification can set the diagnosis.
Earlier non-controlled case reports have shown a convincing effect of fecal microbial transplantation (FMT) in IBS patients. However, no placebo controlled trial has been performed in this condition. Changes in the gut microbiome may be an important factor in IBS pathogenesis. Microbiome analysis has revealed changes in microbiome composition that may trigger changes in visceral sensibility and pain perception.
The fecal microbial transplantation (FMT) procedure has been used primarily to treat clostridium difficile infections. Few minor side effects have been reported.
Hypothesis: IBS is caused by an imbalance of the gut microbiome that may be reset by transplanting a microbiome sample from a healthy donor.
Aim of study:
- To test the clinical effect of FMT in patients with IBS
- To describe the fecal microbiome in IBS patients
- To describe changes in the fecal microbiome of IBS patients following FMT
The REFIT study will perform a randomized placebo-controlled double blinded trial of FMT on IBS according to the Rome 3 criteria. A study group of 60 IBS (diarrhoea variant) patients will recruited from general practice and allocated to active (30) or placebo (30) by block randomization. Donors will be 15 healthy volunteers with no risk behaviour and a pre-screening for communicable diseases will be performed.
Outcome measures will be clinical assessment by IBS-severity scoring system (IBS-SSS) at 0, 1, 3, 6, and 12 months. Microbiome analysis will be performed by metagenomic sequencing (University of Tromsø) at 0, 3, and 12 months for patients, and at inclusion for donors.
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
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •for patients:
- •Patients with IBS-D according to Roma 3 criteria
排除标准
- •for patients:
- •Immunomodulating medication
- •Nocturnal abdominal pain
- •Constant abdominal pain
- •Alarm symptoms like rectal bleeding, weight loss, nightsweats
- •Symptomatic heart/vascular/lung disease
- •Renal failure
- •Known food allergy
- •Microscopic/collagenous colitis
- •non-compliant
- •Inclusion criteria for donors:
- •healthy volunteers
- •Exclusion criteria for donors
- •Tattoos, imprisoning or piercing last 3 months
- •Any history of chronic diarrhoea, constipation, inflammatory bowel disease, irritable bowel disease, colorectal polyps or cancer, immunosuppression, morbid obesity, metabolic syndrome, atopica, or fatigue
- •positive test for hepatitis B, C, HIV, treponema pallidum
- •sexual high risk habits
- •antibiotic treatment in the past 3 months
结局指标
主要结局
Change in subjective symptom score
时间窗: at 0 and 3 months
Comparison of Irritable bowel syndrome severity scoring system (IBS-SSS) grade assessment before and after fecal transplantation
次要结局
- Microbiome profile change(at 0, 3 and 12 months)
- Long term effects of fecal transplantation(at 12 months)
- Safety of fecal transplantation in IBS(during study period (0-12 months))