Fecal Microbiota Transplantation Capsules with Targeted Colonic Versus Gastric Delivery in Recurrent Clostridium difficile Infection: A Comparative Cohort Analysis of High and Lose Dose
| Autor: | Abdul Basit, Amanda Gentile, Eva L. de la Serna, Rotem Gura Sadovsky, Monika Fischer, Zain Kassam, Sejal R. Ranmal, Hala M. Fadda, Ylaine Gerardin, Mark D. Smith, Shrish Budree, Sashidhar Sagi, Dean L. Glettig, Jessica R. Allegretti, Sonia Timberlake, Matthew Bohm |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Colon Physiology Capsules Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Transplant surgery Internal medicine Humans Medicine Microbiome Aged Aged 80 and over business.industry Remission Induction Stomach Low dose Fecal bacteriotherapy Fecal Microbiota Transplantation Hydrogen-Ion Concentration Middle Aged Clostridium difficile Hepatology Gastrointestinal Microbiome Treatment Outcome 030220 oncology & carcinogenesis Clostridium Infections Female 030211 gastroenterology & hepatology business Cohort study |
| Zdroj: | Digestive Diseases and Sciences. 64:1672-1678 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Fecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridium. difficile infection (rCDI). FMT capsules have emerged, and it is unknown if delivery location and dose impact efficacy.We compared two cohorts of patients receiving two capsule formulations: gastric release (FMTgr) and targeted colonic release (FMTcr) at two different sites. Cohort A received FMTgr at (1) high dose: 60 capsules and low dose: 30 capsules. Patients in Cohort B received FMTcr at (1) high dose: 30 capsules (2) low dose: 10 capsules. Clinical cure rates and adverse events were monitored through week 8. Paired t-tests were used to compare diversity pre- and post-FMT.51 rCDI patients were enrolled. Cohort A contained n = 20 and Cohort B contained n = 31. Overall cure at week 8 for FMTgr was 75% (15/20) compared to 80.6% for FMTcr, (25/31), p = 0.63. Both formulations were safe with no serious adverse events. FMTcr was superior at increasing gut microbial diversity.To our knowledge, this is the first study to compare targeted delivery of FMT capsules. While both capsules were safe and efficacious, microbial engraftment patterns were superior in FMTcr. |
| Databáze: | OpenAIRE |
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