Fecal Microbial Transplantation versus Mesalamine Enema for Treatment of Active Left-Sided Ulcerative Colitis-Results of a Randomized Controlled TrialOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
A randomized controlled trial compared fecal microbial transplantation (FMT) enemas against 5-aminosalicylic acid (mesalamine) enemas for active left-sided ulcerative colitis, Mayo score 4 to 10.
How was it studied?
Forty-five patients across multiple centers were randomized equally to FMT (n=23) or 5-ASA (n=22). FMT was given five times in week one then weekly for five more weeks; 5-ASA was given daily for two weeks then every other day. The primary endpoint was clinical remission (total Mayo score ≤2, no subscore >1) at week 12.
What did they find?
Twelve of 21 FMT patients (57%) and eight of 22 5-ASA patients reached remission, meeting the noninferiority margin of 10% (95% CI: -7.6%, 48.9%). Adverse events were similar between groups (57% FMT vs 59% 5-ASA), and increased microbial diversity in FMT recipients persisted three months after treatment.
Why it matters
FMT performed at least as well as standard mesalamine enemas for left-sided ulcerative colitis while durably reshaping the gut microbiome. The authors note that targeted microbiome modification and better donor and patient selection could further improve FMT efficacy.