Donor Versus Autologous Fecal Microbiota Transplantation for Irritable Bowel Syndrome

Summary

Many patients with irritable bowel syndrome (IBS) do not experience adequate symptom relief with current treatments. The pathophysiology of IBS is diverse, controversial and not completely understood. The next disruptive frontier would be to find a cure where the effect is predictable and lasting. The study groups phase 2 pilot trial was the first indication of a possible benefit from treating IBS with fecal microbiota transplantation (FMT) (Number needed to treat only five) (Fecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomized, placebo-controlled, parallel-group, single-centre trial he Lancet Gastroenterology and Hepatology 2018). Additional results from the same trial show that the treatment response may be predicted (unpublished data), and that the pathophysiologic mechanisms behind the treatment response also can be identified (Effects of fecal microbiota transplantation in subjects with irritable bowel syndrome are mirrored by changes in gut microbiome, Gut Microbes 2020). This study is the first phase 3 trial of FMT for IBS worldwide.

The hypothesis of the trial is that donor FMT is more effective than placebo FMT in treating IBS, with little adverse events or complications. Patients ≥18 years with IBS are enrolled at five Norwegian Hospitals in this double blind randomized, placebo controlled, parallell-group multi center trial. Participants are randomized to FMT from a healthy donor (intervention group), or their own feces (placebo group). The primary outcome is the proportion of patients with ≥75 points decrease in the Irritable bowel Symptom Severity score 90 days after treatment.

Conditions

• Irritable Bowel Syndrome

Interventions

BIOLOGICAL

Fecal microbiota transplantation (FMT)

Delivered by enema

Sponsors & Collaborators

• Oslo University Hospital

  collaborator OTHER

• Sorlandet Hospital HF

  collaborator OTHER_GOV

• Haukeland University Hospital

  collaborator OTHER

• Alesund Hospital

  collaborator OTHER

• University Hospital of North Norway

  lead OTHER

Principal Investigators

• Peter H Johnsen, MD PhD · Univeristy Hospital of North Norway

• Rasmus Goll, MD PhD · University Hospital of North Norway

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-05-05

Primary Completion

2023-09-01

Completion

2026-12-31

Countries

• Norway

Study Locations