Amsterdam researchers recently published an investigation of fecal microbiota transplantation (FMT) for the treatment of ulcerative colitis (UC). The TURN trial — Transplantation of feces in Ulcerative colitis; Returning Nature’s homeostasis — was a double-blind randomized trial with 48 subjects who had mild to moderatively active UC.
Participants received either a healthy donor’s feces or their own feces (i.e. autologous FMT) via naso-duodenal tube.
No significant difference was observed between groups. In the per protocol analysis, 41.2% of patients in the donor group and 25% of controls achieved the primary endpoint, which was clinical remission of UC. Serious adverse events occurred in 4 patients but these were not considered related to the FMT.
Patients who responded to FMT donor treatment showed a shift toward a donor-like microbiota composition. The microbiota of responders had distinct features from that of nonresponders after FMT.
This study contrasts with a recent study from Canada (covered here on GMFH) in which 24% of the FMT group and 5% of the placebo group achieved remission.
In the Canadian study, the placebo group received a water treatment, while in the Dutch study the placebo group received autologous FMT. Mode of administration was also different — enema and naso-duodenal tube, respectively. Also, while the Canadian study showed a possible donor effect, this was not assessed in the Dutch study because of low numbers in each subgroup.
Rossen NG, et al. (2015) Findings from a Randomized Controlled Trial of Fecal Transplantation for Patients with Ulcerative Colitis. Gastroenterology DOI: http://dx.doi.org/10.1053/j.gastro.2015.03.045