Older patients benefit more from sequential courses of washed microbiota transplantation than younger population with ulcerative colitis

ObjectivesThe short-term efficacy of fecal microbiota transplantation (FMT) for ulcerative colitis (UC) has increasingly been evaluated. However, few studies have examined the long-term efficacy and its predictors. This study aimed to assess the clinical factors affecting the long-term efficacy of FMT for patients with UC.MethodsThis is a retrospective analysis of a prospective trial (NCT01790061) for patients with UC undergoing washed microbiota transplantation (WMT), which is the improved methodology of FMT. The long-term clinical efficacy of WMT and the factors affecting efficacy were analyzed.ResultsA total of 259 patients were included for analysis. Of 70.7% (183/259) of patients achieved a clinical response at 1 month after WMT and 29.7% (77/259) achieved steroid-free clinical remission 6 months after WMT. Total 44 patients maintained a clinical response for >= 24 months, and 33 (17.1%, 33/193) achieved steroid-free clinical remission for >= 24 months with WMT monotherapy. Patients with age at UC onset of >= 60 years, mild disease severity and undergoing >= 2 courses of WMT during the response within 6 months were more likely to achieve steroid-free clinical remission 6 months after WMT. Besides, independent factors associated with the long-term response of WMT for UC were age at onset of >= 60 years and >= 2 courses of WMT during the response.ConclusionsThis study indicated WMT could induce short-term steroid-free clinical remission and maintain long-term response in UC, especially for older patients and patients undergoing sequential courses.

Automated summary

This study aimed to assess the clinical factors affecting the long-term efficacy of FMT for patients with UC. The results showed that patients aged 60 years and older, with mild disease severity, and undergoing two or more courses of WMT were more likely to achieve steroid-free clinical remission after 6 months.