Transplantation of Faeces in Ulcerative Colitis; Restoring Nature's Homeostasis
- Conditions
- Ulcerative Colitis
- Interventions
- Other: treatment with faecal transplantation (own faeces)Other: treatment with faecal transplantation (donor faeces)
- Registration Number
- NCT01650038
- Brief Summary
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) of the colon. Complaints such as abdominal pain, cramps and bloody diarrhoea usually start in early adulthood and lead to life-long substantial morbidity. There is no medical treatment available that meets the desired criteria of high efficacy versus low adverse effects. The current prevailing hypothesis regarding the cause of UC states that the pathogenesis involves an inappropriate and ongoing activation of the mucosal immune system driven by the intestinal microbiota in a genetically predisposed individual. Systematic investigation into the effect of correcting the dysbiosis in ulcerative colitis patients has never been performed. The most radical way to restore the presumably disturbed natural homeostasis in UC is to perform faecal transplantation from a healthy donor. In this trial the potential beneficial effects of restoring microbial homeostasis by faecal transplantation through a duodenal tube will be studied in a phase II randomised placebo controlled design.
Endpoints are clinical remission and reduction of endoscopic inflammation after 12 weeks (primary), as well as time to recurrence, intra individual changes in faecal samples and mucosal biopsies. Follow up is 12 months.
- Detailed Description
treatment with faecal transplantation from a healthy donor in active ulcerative colitis patients. In this trial the potential beneficial effects of restoring microbial homeostasis by faecal transplantation through a duodenal tube will be studied in a phase II randomised placebo controlled design.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 50
- Age ≥ 18
- Ability to give informed consent
- Established ulcerative colitis with known involvement of the left colon according to the Lennard-Jones criteria
- SCCAI of 4 > < 11
- Endoscopic Mayo score of > 1
- Stable dose of thiopurines in preceding 8 weeks
- Stable dose of corticosteroids and 5-ASA in preceding 2 weeks
- Condition leading to profound immunosuppression
- Anti-TNF treatment in preceding 2 months
- Cyclosporine treatment in preceding 4 weeks
- Use of Methotrexate in preceding 2 months
- Prednisolone dose > 10 mg
- Life expectancy < 12 months
- Use of systemic antibiotics in preceding 6 weeks
- Use of probiotic treatment in preceding 6 weeks
- Positive stool cultures for common enteric pathogens (Salmonella, Shigella, Yersinia, Campylobacter, enteropathogenic e coli)
- Positive faecal PCR-test (positive PCR means: > 1 of the following viruses is present) for: Rotavirus, Norovirus, Enterovirus, Parechovirus Sapovirus, Adenovirus 40/41/52. Astrovirus.
- Pregnancy or women who give breastfeeding
- Vasopressive medication, icu stay
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description faecal transplantation; placebo treatment with faecal transplantation (own faeces) 2 times treatment with (own) faecal transplantation: faeces from the patient processed for duodenal tube infusion. after bowel lavage with macrogol. faecal transplantation; donor faeces treatment with faecal transplantation (donor faeces) 2 times treatment with faecal transplantation: faeces from a healthy donor processed for duodenal tube infusion. after bowel lavage with macrogol.
- Primary Outcome Measures
Name Time Method co-primary endpoint of clinical remission, as well as reduction of Mayo endoscopic inflammation score at 12 weeks after treatment. * clinical remission = questionnaire: SCCAI 2 or lower
* reduction of Mayo endoscopic inflammation score= decrement of 1 or more as assessed by sigmoidoscopy
- Secondary Outcome Measures
Name Time Method Time to recurrence from timepoint 12 weeks after treatment up to 12 months Simple clinical colitis activity index (SCCAI) score reduction time: 6 weeks after treatment Frequency of bowel movements start at baseline up to 6 weeks after treatment
Trial Locations
- Locations (1)
Academic_Medical_Center
🇳🇱Amsterdam, Netherlands