Acceptability, tolerability, and safety of fecal microbiota transplantation in patients with active ulcerative colitis (AT&S Study)

Abstract

Background and Aim Fecal microbiota transplantation (FMT) targets gut microbiome dysbiosis and is an emerging therapy for ulcerative colitis (UC). Although initial results with FMT in patients with active UC are encouraging, data regarding its acceptability, tolerability, and safety are scant. Methods A retrospective analysis of patients with active UC (Mayo clinic score ≥ 4), who received multisession FMT (at weeks 0, 2, 6, 10, 14, 18, and 22) via colonoscopy between June 2016 and June 2018, was performed. Patient acceptability, tolerability, and immediate and long‐term safety of the therapy were assessed. Results Of the 129 patients with active UC who were offered FMT, 101 patients consented, giving acceptability of 78.3%. Fecal slurry retention time improved with each session (3.27 ± 1.06 h for the first session vs 5.12 ± 0.5 h for the seventh session). Abdominal discomfort, flatulence, abdominal distension, borborygmi, and low‐grade fever (30.8%, 15.9%, 9.8%, 7.9%, and 7.6%, respectively) were the most common post‐procedural short‐term adverse events. Long‐term adverse events included new‐onset urticaria (n = 2, 4.3%), arthritis/arthralgia (n = 3, 6.5%), depression (n = 1, 2.2%), partial sensorineural hearing loss (n = 1, 2.2%), and allergic bronchitis (n = 1, 2.2%). Thirteen (12.9%) patients dropped out because of adverse events. Conclusion Fecal microbiota transplantation appears to be a safe and well‐tolerated procedure, with good acceptability in patients with active UC.

Fecal Microbiota Transplant in Two Ulcerative Colitis Pediatric Cases: Gut Microbiota and Clinical Course Correlations

“…The role of FMT in the treatment of pediatric UC is still debated, although the safety and tolerability of this clinical practice have already been assessed [ 16 , 17 , 28 ]. Recent reviews examined the current state of knowledge on FMT in IBD, and concluded that translational research on FMT is important in order to transfer its potential to real clinical management [ 15 , 37 ].…”

“…The success of FMT for the treatment of Clostridium difficile infection has been proven [ 8 , 9 ]. However, several articles have already reported on FMT’s potential therapeutic use in GI and GI-related diseases, including IBD [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Allicin‐induced host‐gut microbe interactions improves energy homeostasis

“…15,39 In recent years, GM transplantation (GMT) has been considered to be a highly promising safe and effective treatment for a variety of diseases. 40,41 A growing number of studies indicate that GTM is a potential preventive and curative treatment for obesity and related metabolic diseases. [42][43][44] F I G U R E 5 AGMT induces BAT activity in HFD mice.…”

Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

“…These should, however, not be attributed to co-incident COVID-19. Lastly, however, the isolation of the virus from fecal samples has implications for fecal microbiota transplants [45,46]. Although presently undocumented, COVID-19 might potentially spread during fecal microbiota transplants, and hence, it might be prudent to demonstrate negative viral RT-PCR multiple times in donor samples before accepting fecal samples for transplant.…”