Capsule delivery of fecal microbiota transplant has similar effectiveness to transplant by colonoscopy
Recent work published in Clinical Gastroenterology and Hepatology by researchers from the University of Minnesota Medical School found that fecal microbiota transplant (FMT) using capsules containing freeze-dried microbes taken orally has similar safety and effectiveness to colonoscopic administration of liquid FMT for treating recurrent Clostridioides difficile infection (CDI).
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.
More information: Byron P. Vaughn et al, Effectiveness and safety of colonic and capsule fecal microbiota transplantation for recurrent Clostridioides difficile infection, Clinical Gastroenterology and Hepatology (2022). DOI: 10.1016/j.cgh.2022.09.008