Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry.

Autor:	Kelly CR; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: colleen_r_kelly@brown.edu., Yen EF; Division of Gastroenterology, NorthShore University HealthSystem, Evanston, Illinois., Grinspan AM; Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York., Kahn SA; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts., Atreja A; Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York., Lewis JD; Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Moore TA; Infectious Disease Consultants, Wichita, Kansas., Rubin DT; Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, Illinois., Kim AM; American Gastroenterological Association, Bethesda, Maryland., Serra S; American Gastroenterological Association, Bethesda, Maryland., Nersesova Y; American Gastroenterological Association, Bethesda, Maryland., Fredell L; American Gastroenterological Association, Bethesda, Maryland., Hunsicker D; OpenBiome, Cambridge, Massachusetts., McDonald D; Department of Pediatrics, University of California San Diego, La Jolla, California., Knight R; Department of Pediatrics, University of California San Diego, La Jolla, California; Center for Microbiome Innovation, University of California San Diego, La Jolla, California; Department of Computer Science and Engineering, University of California San Diego, La Jolla, California; Department of Bioengineering, University of California San Diego, La Jolla, California., Allegretti JR; Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts., Pekow J; Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, Illinois., Absah I; Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Hsu R; Sutter Health, Sutter Institute for Medical Research and Division of Gastroenterology, School of Medicine, University of California, Davis, California., Vincent J; Division of Gastroenterology, Baylor Scott and White Research Institute, Temple, Texas., Khanna S; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota., Tangen L; Carle Foundation Hospital, Urbana, Illinois., Crawford CV; Division of Gastroenterology, Weill Cornell Medicine, New York, New York., Mattar MC; Division of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia., Chen LA; Division of Gastroenterology and Hepatology, New York University Grossman School of Medicine, New York, New York., Fischer M; Division of Gastroenterology, Indiana University, Indianapolis, Indiana., Arsenescu RI; Atlantic Inflammatory Bowel Disease Center of Excellence, Atlantic Digestive Health Institute, Morristown, New Jersey., Feuerstadt P; Gastroenterology Center of Connecticut, Hamden, Connecticut., Goldstein J; Gastroenterology Group of Rochester, Rochester, New York., Kerman D; Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, Florida., Ehrlich AC; Section of Gastroenterology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania., Wu GD; Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Laine L; Yale School of Medicine, New Haven, Connecticut; Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	Gastroenterology [Gastroenterology] 2021 Jan; Vol. 160 (1), pp. 183-192.e3. Date of Electronic Publication: 2020 Oct 01.
DOI:	10.1053/j.gastro.2020.09.038
Abstrakt:	Background & Aims: Fecal microbiota transplantation (FMT) is used commonly for treatment of Clostridioides difficile infections (CDIs), although prospective safety data are limited and real-world FMT practice and outcomes are not well described. The FMT National Registry was designed to assess FMT methods and both safety and effectiveness outcomes from North American FMT providers. Methods: Patients undergoing FMT in clinical practices across North America were eligible. Participating investigators enter de-identified data into an online platform, including FMT protocol, baseline patient characteristics, CDI cure and recurrence, and short and long-term safety outcomes. Results: Of the first 259 participants enrolled at 20 sites, 222 had completed short-term follow-up at 1 month and 123 had follow-up to 6 months; 171 (66%) were female. All FMTs were done for CDI and 249 (96%) used an unknown donor (eg, stool bank). One-month cure occurred in 200 patients (90%); of these, 197 (98%) received only 1 FMT. Among 112 patients with initial cure who were followed to 6 months, 4 (4%) had CDI recurrence. Severe symptoms reported within 1-month of FMT included diarrhea (n = 5 [2%]) and abdominal pain (n = 4 [2%]); 3 patients (1%) had hospitalizations possibly related to FMT. At 6 months, new diagnoses of irritable bowel syndrome were made in 2 patients (1%) and inflammatory bowel disease in 2 patients (1%). Conclusions: This prospective real-world study demonstrated high effectiveness of FMT for CDI with a good safety profile. Assessment of new conditions at long-term follow-up is planned as this registry grows and will be important for determining the full safety profile of FMT. (Copyright © 2021. Published by Elsevier Inc.)
Databáze:	MEDLINE
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