Capsule delivery of fecal microbiota transplant has similar effectiveness to transplant by colonoscopy

Every year in the United States, approximately 500,000 people develop CDI — which is typically a complication of antibiotics. Antibiotics are also used to treat CDI, which further damage the intestinal microbiota. The U of M research team developed standardized FMT preparations — which are composed of intestinal microbes that can restore a healthy intestinal microbiota. This strategy repairs the damage caused by antibiotics and restores resistance against CDI.

“Capsule FMT can avoid complications of colonoscopy and facilitate access to this potentially life-saving therapy,” said Byron Vaughn, MD, MS, associate professor in the Medical School and gastroenterologist at M Health Fairview.

In this multicentered, national prospective study, 301 FMTs were performed in 269 patients. Two-thirds of the procedures were capsule FMT. CDI cure rates were 86% at one month and 81% at two months. There was no difference in the one-month or two-month cure rate between capsule and colonoscopic FMT.

While highly effective overall, the research team says patient selection is a key factor to optimizing FMT success. Older age, hemodialysis and post-FMT antibiotics were associated with lower cure rates. Further research is suggested to identify patients that do not have a successful FMT and understand why they don’t respond to the therapy.

This work was supported by Achieving Cures Together, a nonprofit organization dedicated to advancing microbiome-based research.

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