1 / 19

FMT in IBD

FMT in IBD. Walter Reinisch Department of Medicine McMaster University Hamilton, ON. Grey’s Anatomy, November 2008. Willingness to Undergo FMT in Patients with UC. Kahn SA et al. Inflamm Bowel Dis 2013. C. Diff. Infection ≠ IBD. C. diff.= Acute Infection. IBD = Chronic Inflammation.

dylan
Download Presentation

FMT in IBD

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. FMT in IBD Walter Reinisch Department of Medicine McMaster University Hamilton, ON

  2. Grey’s Anatomy, November 2008

  3. Willingness to Undergo FMT in Patients with UC Kahn SA et al. Inflamm Bowel Dis 2013

  4. C. Diff. Infection ≠ IBD C. diff.= Acute Infection IBD = Chronic Inflammation Adapted from Shanahan F et al. Gastroenterology 2014

  5. Dysbiosis in IBD HC = healthy controls, ACD = acute CD, RCD = CD in remission, AUC = acute UC, RUC = UC in remission Wei W et al. JCM 2014

  6. Dysbiosis in IBD: CauseorConsequenceofInflammation

  7. Antibiotics for active UC Nine trials, 622 patients NNT = 7 (95% CI = 4 to 25) Khan KJ et al. AJG 2011

  8. Probiotics for Maintenance of Remission in UC Relapse rate within 1 year Per-Protocol-Analysis (N = 222) 100% 80% Equivalence significant with p = 0,003 60% 36,4% 33,9% 40% 20% 0% E. Coli Nissle MESALAZIN Kruis, W.,etal.Gut2004;

  9. FMT and IBD Management of IBD: 63% disease remission Anderson JL et al. Aliment Pharmacol Ther 2012

  10. Heterogeneity among Studies • UC > CD; (some with C.diff infection) • Disease characteristics incomplete (duration, location, disease activity, endoscopic picture, concomitant treatment) • Patient preparation (lavage, antibiotics, PPI) • Stool preparation (g/mL saline, volume instilled) • Route of administration (naso-gastric, -jejunal, colonoscopy, enema) • Number of administration (single, multiple) • Donor relationship (relatives, unrelated, one or multiple donors) • Outcomes (subjective, score-based) • Duration of follow-up

  11. Angelberger S et al. AJG 2013

  12. Feces Preparation and Transplantation 250 ml 60 gr 100 ml Angelberger S et al. AJG 2013

  13. Patient Characteristics Angelberger S et al. AJG 2013

  14. FMT design Angelberger S et al. AJG 2013

  15. Safety • no SAE • no „bacterial overgrowth“ (glucose breath test wks 4 and 12) • AEs: Angelberger S et al. AJG 2013

  16. CRP course Angelberger S et al. AJG 2013

  17. Efficacy Angelberger S et al. AJG 2013

  18. Dynamic change in microbiome Angelberger S et al. AJG 2013

More Related