The combination of FMT+ anti-inflammatory diet successfully induced and sustained remission of ulcerative colitis.
"Deep remission at 48 weeks was also significantly better in the FMT-AID arm, suggesting that the anti-inflammatory diet could sustain the FMT-AID–induced endoscopic and clinical remission," wrote Saurabh Kedia, MD, of the All India Institute of Medical Sciences in New Delhi, and colleagues."The adherence to modified diet was maintained until 48 weeks, suggesting the acceptability of this approach to patients.
The 35 patients randomized to the FMT-AID arm received seven weekly colonoscopic infusions of FMT from multiple donors, drawn from healthy rural adults aged 18-45, and were instructed to follow an anti-inflammatory diet.
Those with clinical response or remission at 8 weeks – 23 people in the FMT-AID arm and 11 in the standard therapy arm – were then followed for the next 40 weeks. During that period, participants in the FMT-AID arm continued their anti-inflammatory diet and medications while the standard medical care group took only their medications.
"The major strength of our study was a unique protocol combining two microbiome manipulation strategies: FMT and diet," the authors wrote."While both were used for induction of remission, the effect was maintained only with diet, which adds novelty to the study design.
Ashwin Ananthakrishnan, MBBS, MPH, an associate professor of medicine at Massachusetts General Hospital and director of the MGH Crohn's and Colitis center in Boston, found the study design"intriguing and practical."
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