Oral treatment of Fecal Microbiota Transplant (FMT) via capsules has similar effects to colonoscopic FMT administration when treating recurrent Clostridiodes difficile infection (rCDI). The corresponding study was published in Clinical Gastroenterology and Hepatology.
Each year in the US, around 200,000 people develop CDI, typically following antibiotic use. the condition is typically treated with antibiotics, which further damage intestinal microbiota. Symptoms of the condition range from diarrhea to life-threatening damage to the colon.
In the current study, researchers investigated the efficacy of two standardized FMT preparations for treating rCDI: capsule-based FMT and colonoscopy FMT. FMT preparations are composed of intestinal microbes that can restore healthy intestinal microbiota and, in doing so, repair damage caused by antibiotics, ultimately providing resistance to CDI.
For the study, the researchers recruited 269 patients from six sites. They performed 301 FMTs on the patients, two-thirds of which were capsule-based FMT. The rCDI 'cure' rate was assessed at 1 and 2 months, and safety data were collected within the first 72 hours and at one and two months.
After one month of treatment, 86% of patients no longer had rCDI. The percentage of ‘cured’ patients, however, fell to 81% at two months. The researchers noted no difference in outcome between those who received FMT via capsules of colonoscopy.
They wrote, however, that patients who were older and receiving hemodialysis were more likely to experience FMT failure after two months. Nevertheless, both preparations were generally safe. Although they reported one serious adverse event from colonoscopy- aspiration pneumonia- they identified no other safety signals.
The researchers concluded that while successful overall, patient selection is key for optimizing FMT success. They also noted that further research should identify patients for whom FMT was not successful, so they may understand why they did not respond to the therapy.