Fecal Bacteriotherapy for Ulcerative Colitis; Patients Are Ready, Are We?

Kahn, Stacy A.; Gorawara-Bhat, Rita; Rubin, David T.

doi:10.1016/s0016-5085(11)62456-6

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…How FMT should be regulated remains contentious—particularly whether the feces should be considered a therapeutic “drug,” a biologic product or tissue . Patients have stated that they would be willing to receive FMT for recurrent CDI if it is recommended by their treating physician . Given this willingness and the other benefits of FMT compared with antibiotic therapy, the inclusion of FMT as standard care for recurrent CDI is justified.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of fecal microbiota transplantation for the treatment of recurrentClostridium difficileinfection in Australia

Merlo

Graves

Brain

et al. 2016

J of Gastro and Hepatol

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Background and Aim Clostridium difficile is the most common cause of hospital‐acquired diarrhea in Australia. In 2013, a randomized controlled trial demonstrated the effectiveness of fecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this study is to evaluate the cost‐effectiveness of fecal microbiota transplantation—via either nasoduodenal or colorectal delivery—compared with vancomycin for the treatment of recurrent CDI in Australia. Methods A Markov model was developed to compare the cost‐effectiveness of fecal microbiota transplantation compared with standard antibiotic therapy. A literature review of clinical evidence informed the structure of the model and the choice of parameter values. Clinical effectiveness was measured in terms of quality‐adjusted life years. Uncertainty in the model was explored using probabilistic sensitivity analysis. Results Both nasoduodenal and colorectal FMT resulted in improved quality of life and reduced cost compared with vancomycin. The incremental effectiveness of either FMT delivery compared with vancomycin was 1.2 (95% CI: 0.1, 2.3) quality‐adjusted life years, or 1.4 (95% CI: 0.4, 2.4) life years saved. Treatment with vancomycin resulted in an increased cost of AU$4094 (95% CI: AU$26, AU$8161) compared with nasoduodenal delivery of FMT and AU$4045 (95% CI: −AU$33, AU$8124) compared with colorectal delivery. The mean difference in cost between colorectal and nasoduodenal FMT was not significant. Conclusions If FMT, rather than vancomycin, became standard care for recurrent CDI in Australia, the estimated national healthcare savings would be over AU$4000 per treated person, with a substantial increase in quality of life.

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Section: Discussionmentioning

confidence: 99%

Economic evaluation of fecal microbiota transplantation for the treatment of recurrentClostridium difficileinfection in Australia

Merlo

Graves

Brain

et al. 2016

J of Gastro and Hepatol

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“…Two recent studies suggested that patients would actually be very interested in performing FMT in a hospital setting as a treatment for their IBD [37,38]. Here, we aimed to assess the view of a broad number of IBD patients with respect to FMT as a potential treatment option.…”

Section: Introductionmentioning

confidence: 99%

Patients’ views on fecal microbiota transplantation: an acceptable therapeutic option in inflammatory bowel disease?

Zeitz

Bissig

Barthel

et al. 2017

European Journal of Gastroenterology &Amp; Hepatology

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FMT represents a therapeutic procedure that is of interest for IBD patients. As FMT has been receiving increasing interest as an alternative treatment in IBD and more studies on FMT in IBD are being carried out, it is important to learn about the knowledge, attitude, and preferences of patients to provide better education to patients on this topic. However, there are reservations because of the fact that data on the benefits of FMT in IBD are controversial and several limitations exist on the use of FMT in IBD.

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“…In a survey of 73 physicians, 25 (34%) indicated they would be unwilling to perform the procedure with the most common concerns being patient acceptance and tolerability (71%) followed by safety (60%) and efficacy (57%) . In contrast, in a recent qualitative study exploring readiness for FMT in patients with UC, the majority of patients wished the procedure was already available and most viewed it as being safer than current available therapies, especially steroids or biological therapies . In a quantitative extension of this study, the majority of UC patients were interested or willing to consider FMT despite reporting disease control with IBD medications .…”

Section: Discussionmentioning

confidence: 86%

Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease

Anderson

Edney

Whelan

2012

Aliment Pharmacol Ther

281

208

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Summary Background The intestinal microbiota is involved in the pathogenesis of inflammatory bowel disease (IBD). Faecal microbiota transplantation (FMT) has been used for the management of IBD as well as infectious diarrhoea. Aim To undertake a systematic review of FMT in patients with IBD. Methods The systematic review followed Cochrane and PRISMA recommendations. Nine electronic databases were searched in addition to hand searching and contacting experts. Inclusion criteria were reports (RCT, nonrandomised trials, case series and case reports) of FMT in patients with IBD. Results Of the 5320 articles identified, 17 fulfilled the inclusion criteria, none of which were controlled trials. There were nine case series/case reports of patients receiving FMT for management of their IBD, and eight where FMT was for the treatment of infectious diarrhoea in IBD. These 17 articles reported on 41 patients with IBD (27 UC, 12 Crohn's, 2 unclassified) with a follow‐up period of between 2 weeks and 13 years. Where reported, FMT was administered via colonoscopy/enema (26/33) or via enteral tube (7/33). In patients treated for their IBD, the majority experienced a reduction of symptoms (19/25), cessation of IBD medications (13/17) and disease remission (15/24). There was resolution of C. difficile infection in all those treated for such (15/15). Conclusions Whilst the available evidence is limited and weak, it suggests that faecal microbiota transplantation has the potential to be an effective and safe treatment for IBD, at least when standard treatments have failed. Well‐designed randomised controlled trials are required to investigate these findings.

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Fecal Bacteriotherapy for Ulcerative Colitis; Patients Are Ready, Are We?

Cited by 11 publications

References 15 publications

Economic evaluation of fecal microbiota transplantation for the treatment of recurrentClostridium difficileinfection in Australia

Economic evaluation of fecal microbiota transplantation for the treatment of recurrentClostridium difficileinfection in Australia

Patients’ views on fecal microbiota transplantation: an acceptable therapeutic option in inflammatory bowel disease?

Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease

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