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Letter
Response to faecal microbiota transplantation in ulcerative colitis is not sustained long term following induction therapy
  1. Craig Haifer1,2,
  2. Aiasha Saikal3,
  3. Ramesh Paramsothy4,
  4. Nadeem O Kaakoush5,
  5. Rupert W Leong1,2,
  6. Thomas J Borody6,
  7. Michael A Kamm7,
  8. Sudarshan Paramsothy1,2
  1. 1 Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
  2. 2 Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia
  3. 3 St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  4. 4 Department of Gastroenterology, Blacktown Hospital, Sydney, New South Wales, Australia
  5. 5 School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
  6. 6 Centre for Digestive Diseases, Sydney, New South Wales, Australia
  7. 7 Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Sudarshan Paramsothy, Department of Gastroenterology, Concord Repatriation General Hospital, Concord, 2139, NSW, Australia; sudarshan.paramsothy{at}sydney.edu.au

https://doi.org/10.1136/gutjnl-2020-323581

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    We read with interest the paper by Ng et al, 1 which discussed the need to optimise faecal microbiota transplantation (FMT) processes in order to increase its therapeutic potential, especially in inflammatory bowel disease (IBD). While there is randomised controlled trial evidence that FMT can be effective in the induction of remission in patients with ulcerative colitis (UC),2–5 the durability of therapeutic response following FMT cessation is unknown. Furthermore, there is limited long-term safety data following FMT, especially in patients with IBD. In the FOCUS study, FMT delivered via an initial colonoscopy infusion, followed by enema therapy for 8 weeks was effective in mild to moderate UC remission induction.2 Here, we report the long-term outcomes from the FOCUS study.

    Enrolled study participants who received FMT (2013–2015) were contacted to assess time to disease relapse for patients in clinical remission following FMT induction (defined as worsening symptoms requiring escalation of medical therapy or surgery), disease progression and the development of adverse events or new medical conditions.

    Long-term data were obtained from 87% (68/78) of participants who received FMT, with a median follow-up …

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    Footnotes

    • Twitter @NOKaakoush

    • Contributors CH, RP, NOK, RL, TB, MK and SP designed the study. CH and AS were responsible for data collection and analysis. CH and SP wrote the initial draft of the correspondence. All authors critically reviewed the correspondence and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests CH has received speaker fees and educational support from Janssen, Pfizer, Takeda, Ferring and Abbvie; and received a research grant through the Royal Australasian College of Physicians. AS has no disclosures. RP has received speaker fees or research support from Janssen, Aspen, Pfizer, Abbvie and Takeda. NOK has no disclosures. RL reports advisory board fees from AbbVie, Aspen, Celgene, Ferring, Gilead, Hospira, Janssen, MSD, Novartis, Pfizer, and Takeda; research fees from Gastrointestinal Society of Australia (GESA), Endochoice, Janssen, National Health and Medical Research Council of Australia, Shire, and Takeda; and speaker fees from Emerge Health, Ferring, Janssen, Shire, and Takeda. TB has interests in Redhill Biopharma, and Finch Therapeutics, as well as in the Centre for Digestive Diseases, where faecal microbiota transplantation (FMT) is a treatment option for patients. He has filed patents relating to FMT. MK has received speaker fees, research funding, educational support or honorarium for advisory board participation from Ferring, AbbVie, Janssen, Takeda and received research support from AbbVie. SP is a consultant for Finch Therapeutics; has received speaker fees from Ferring, Janssen and Takeda; and has received a National Health and Medical Research Council of Australia Investigator Grant.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.