Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease
Background: Patients with inflammatory bowel disease (IBD) are at an increased risk of developing Clostridioides difficile infection (CDI). Treatment of CDI in patients with IBD is challenging due to higher failure rates and concomitant IBD activity. Objectives: We performed a multicentre cohort stu...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
|
| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848231156285 |
| _version_ | 1811158095053717504 |
|---|---|
| author | Emilie (E.) van Lingen Simon (S. M. D.) Baunwall Simone (S. C.) Lieberknecht Nicolas (N.) Benech Gianluca (G.) Ianiro Harry (H.) Sokol Alessandro (A.) Gasbarrini Giovanni (G.) Cammarota Marcel (M. K.) Eriksen Andrea (A. E.) van der Meulen-de Jong Elizabeth (E. M.) Terveer Hein (H. W.) Verspaget Maria (M.) Vehreschild Christian (C. L.) Hvas Josbert (J. J.) Keller |
| author_facet | Emilie (E.) van Lingen Simon (S. M. D.) Baunwall Simone (S. C.) Lieberknecht Nicolas (N.) Benech Gianluca (G.) Ianiro Harry (H.) Sokol Alessandro (A.) Gasbarrini Giovanni (G.) Cammarota Marcel (M. K.) Eriksen Andrea (A. E.) van der Meulen-de Jong Elizabeth (E. M.) Terveer Hein (H. W.) Verspaget Maria (M.) Vehreschild Christian (C. L.) Hvas Josbert (J. J.) Keller |
| author_sort | Emilie (E.) van Lingen |
| collection | DOAJ |
| description | Background: Patients with inflammatory bowel disease (IBD) are at an increased risk of developing Clostridioides difficile infection (CDI). Treatment of CDI in patients with IBD is challenging due to higher failure rates and concomitant IBD activity. Objectives: We performed a multicentre cohort study in patients with IBD who received fecal microbiota transplantation (FMT) for recurrent CDI (rCDI), to further investigate factors that influence the clinical outcome and course of both rCDI and IBD. Design: This is a multicentre cohort study conducted in five European FMT centres. Methods: Adult IBD patients treated with FMT for rCDI were studied. Cure was defined as clinical resolution of diarrhoea or diarrhoea with a negative C. difficile test. The definition of an IBD flare was record based. Long-term follow-up data were collected including new episodes of CDI, IBD flares, infections, hospital admissions, and death. Results: In total, 113 IBD patients underwent FMT because of rCDI. Mean age of the patients was 48 years; 64% had ulcerative colitis. Concomitant rCDI was associated with an IBD flare in 54%, of whom 63% had received IBD remission-induction therapy prior to FMT. All FMT procedures were preceded by vancomycin treatment, 40% of patients received FMT via colonoscopy. CDI cure rate was 71%. Long-term follow-up data were available in 90 patients with a median follow-up of 784 days (402–1251). IBD activity decreased in 39% of patients who had active IBD at baseline, whereas an IBD flare occurred in only 5%. During follow-up of up to 2 years, 27% of the patients had infections, 39% were hospitalized, 5% underwent colectomy, and 10% died (median age of these latter patients: 72 years). Conclusion: FMT for rCDI in IBD patients is safe and effective, and IBD exacerbation after FMT is infrequent. Further studies should investigate the effects on IBD course following FMT. |
| first_indexed | 2024-04-10T05:17:26Z |
| format | Article |
| id | doaj.art-d1e5885c4fe14d608dda3e4027daaf28 |
| institution | Directory Open Access Journal |
| issn | 1756-2848 |
| language | English |
| last_indexed | 2024-04-10T05:17:26Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj.art-d1e5885c4fe14d608dda3e4027daaf282023-03-08T17:03:29ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482023-03-011610.1177/17562848231156285Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel diseaseEmilie (E.) van LingenSimon (S. M. D.) BaunwallSimone (S. C.) LieberknechtNicolas (N.) BenechGianluca (G.) IaniroHarry (H.) SokolAlessandro (A.) GasbarriniGiovanni (G.) CammarotaMarcel (M. K.) EriksenAndrea (A. E.) van der Meulen-de JongElizabeth (E. M.) TerveerHein (H. W.) VerspagetMaria (M.) VehreschildChristian (C. L.) HvasJosbert (J. J.) KellerBackground: Patients with inflammatory bowel disease (IBD) are at an increased risk of developing Clostridioides difficile infection (CDI). Treatment of CDI in patients with IBD is challenging due to higher failure rates and concomitant IBD activity. Objectives: We performed a multicentre cohort study in patients with IBD who received fecal microbiota transplantation (FMT) for recurrent CDI (rCDI), to further investigate factors that influence the clinical outcome and course of both rCDI and IBD. Design: This is a multicentre cohort study conducted in five European FMT centres. Methods: Adult IBD patients treated with FMT for rCDI were studied. Cure was defined as clinical resolution of diarrhoea or diarrhoea with a negative C. difficile test. The definition of an IBD flare was record based. Long-term follow-up data were collected including new episodes of CDI, IBD flares, infections, hospital admissions, and death. Results: In total, 113 IBD patients underwent FMT because of rCDI. Mean age of the patients was 48 years; 64% had ulcerative colitis. Concomitant rCDI was associated with an IBD flare in 54%, of whom 63% had received IBD remission-induction therapy prior to FMT. All FMT procedures were preceded by vancomycin treatment, 40% of patients received FMT via colonoscopy. CDI cure rate was 71%. Long-term follow-up data were available in 90 patients with a median follow-up of 784 days (402–1251). IBD activity decreased in 39% of patients who had active IBD at baseline, whereas an IBD flare occurred in only 5%. During follow-up of up to 2 years, 27% of the patients had infections, 39% were hospitalized, 5% underwent colectomy, and 10% died (median age of these latter patients: 72 years). Conclusion: FMT for rCDI in IBD patients is safe and effective, and IBD exacerbation after FMT is infrequent. Further studies should investigate the effects on IBD course following FMT.https://doi.org/10.1177/17562848231156285 |
| spellingShingle | Emilie (E.) van Lingen Simon (S. M. D.) Baunwall Simone (S. C.) Lieberknecht Nicolas (N.) Benech Gianluca (G.) Ianiro Harry (H.) Sokol Alessandro (A.) Gasbarrini Giovanni (G.) Cammarota Marcel (M. K.) Eriksen Andrea (A. E.) van der Meulen-de Jong Elizabeth (E. M.) Terveer Hein (H. W.) Verspaget Maria (M.) Vehreschild Christian (C. L.) Hvas Josbert (J. J.) Keller Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease Therapeutic Advances in Gastroenterology |
| title | Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| title_full | Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| title_fullStr | Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| title_full_unstemmed | Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| title_short | Short- and long-term follow-up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| title_sort | short and long term follow up after fecal microbiota transplantation as treatment for recurrent infection in patients with inflammatory bowel disease |
| url | https://doi.org/10.1177/17562848231156285 |
| work_keys_str_mv | AT emilieevanlingen shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT simonsmdbaunwall shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT simonesclieberknecht shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT nicolasnbenech shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT gianlucagianiro shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT harryhsokol shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT alessandroagasbarrini shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT giovannigcammarota shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT marcelmkeriksen shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT andreaaevandermeulendejong shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT elizabethemterveer shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT heinhwverspaget shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT mariamvehreschild shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT christianclhvas shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease AT josbertjjkeller shortandlongtermfollowupafterfecalmicrobiotatransplantationastreatmentforrecurrentinfectioninpatientswithinflammatoryboweldisease |