Is fecal microbiota transplantation effective in corticosteroid-dependent ulcerative colitis?

Fecal microbiota transplantation for induction of remission, maintenance and rescue in patients with corticosteroid-dependent ulcerative colitis: a long-term follow-up real-world cohort study
Avnish Kumar Seth, Priti Jain. Intest Res. 2022;20(2):251-259

Dysbiosis may play a pivotal role in the pathogenesis of inflammatory bowel disease (IBD). Although fecal microbiota transplantation (FMT) is indicated for use in refractory C. difficile infection, the evidence for its effectiveness in induction in ulcerative colitis (UC) is still lacking.
In the present study, the authors reported the results of a 5-year follow-up prospective open-label single arm cohort study of UC patients who underwent FMT. They showed that induction (iFMT), maintenance (mFMT), and rescue FMT (rFMT) played a role in the treatment of selected patients with corticosteroid-dependent UC.

In this study, at week 12, corticosteroid-free clinical remission was achieved in 48% of patients (13 of 27) and clinical response in 3.7% of patients (1 or 27).
At week 24, corticosteroid and azathioprine-free clinical remission was achieved in 48% of patients (13 of 27) and ,of them, histological response in 76.9% (10 of 27).
The first relapse 10 out of 13 responders (76.9%) occurred a median 14.8 months (range, 6-34 months) after iFMT, but it was less frequent in patients who underwent mFMT, and rFMT using low-dose steroids.

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