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| Name | Class |
|---|---|
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
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The investigators intend to screen for new donors, given that there may a donor effect (PubMed ID: 25857665), with some donors not inducing remission in any patient whilst others inducing remission in 20-40% of cases. It is important to give UC patients participating in RCTs stool that has been demonstrated to be effective in some patients. We therefore propose to conduct an open label study in patients with active UC to ensure new donors are effective at inducing remission in some patients. Patients that have FMT will relapse within 18 months (PubMed ID: 25857665) although further FMT therapy induces remission so it is possible that maintenance FMT will result in long term remission, but this needs evaluation. We will therefore follow UC patients that have responded to FMT long term in this open label study.
This is an open label study with all UC patients receiving FMT. Up to 200 patients with active UC will be recruited to the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open label FMT therapy | Experimental | FMT from a related or unrelated healthy donor screened for known communicable disease |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fecal Microbiota transplant (FMT) | Other | Patients will come once a week for FMT for 8 weeks. FMT is the administration of the supernatant component of stool and water mixture from a healthy relative or an unrelated donor. The donor's stool and blood is rigorously screened to exclude known communicable diseases. Those that achieve remission with FMT will have the option of continuing FMT once per month for 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of FMT donors at inducing UC remission | Suitability of FMT donors at inducing remission in active UC (remission defined as a Mayo score (7) < 3 with an endoscopic Mayo score = 0 at the end of 8 weeks of FMT). | 9 weeks |
| Efficacy of FMT at maintaining remission in UC | Maintenance of remission of UC after three years in those who achieve initial remission with FMT. This is defined as no relapse over three years that requires any medical therapy other than more intense FMT therapy | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of FMT at in inducing histological remission in active UC | Histological remission with no active inflammation on rectal and sigmoid biopsies | 9 weeks |
| Efficacy of FMT at relieving PRO2 symptoms |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Melanie A Wolfe, CCRP | Contact | 9055212100 | 22060 | wolfe@hhsc.ca |
| Aida Fernandes, MBA | Contact | 289-921-6483 | fernaa19@mcmaster.ca |
| Name | Affiliation | Role |
|---|---|---|
| Paul Moayyedi, MD | HHSC/McMaster | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hamilton Health Sciences / McMaster University | Recruiting | Hamilton | Ontario | L8N 3Z5 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25857665 | Background | Moayyedi P, Surette MG, Kim PT, Libertucci J, Wolfe M, Onischi C, Armstrong D, Marshall JK, Kassam Z, Reinisch W, Lee CH. Fecal Microbiota Transplantation Induces Remission in Patients With Active Ulcerative Colitis in a Randomized Controlled Trial. Gastroenterology. 2015 Jul;149(1):102-109.e6. doi: 10.1053/j.gastro.2015.04.001. Epub 2015 Apr 7. |
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Approach investigator to ask for anonymized dataset
Data will be available after study completion - estimated 7 years
Any researcher evaluating the efficacy of FMT in ulcerative colitis
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| ID | Term |
|---|---|
| D000069467 | Fecal Microbiota Transplantation |
| ID | Term |
|---|---|
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
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This is an open label study with all UC patients receiving FMT.
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|
A score of zero on the first two questions of the Mayo Score
| 9 weeks |
| Efficacy of FMT at improving Quality of life | Improvement in quality of life from baseline measured by EQ5D | 9 weeks and 3 years |
| Adverse effects of FMT | Adverse effects associated with FMT therapy | 3 years |
| Stool microbiota predicting FMT success | Comparison of stool microbiota evaluated by 16s RNA and metagenomics in those achieving remission with FMT versus those that are not successful | 9 weeks |
| Mucosal microbiota predicting FMT success | Comparison of mucosal microbiota evaluated by 16s RNA and metagenomics in those achieving remission with FMT versus those that are not successful | 9 weeks |