AzTrials
AzTrials

Irritable Bowel SyndromeNCT03125564

FMT for Patients With IBS With Fecal and Mucosal Microbiota Assessment

A study testing Fecal Microbiota Transplantation and Fecal and Mucosal Microbiota Assessment in people with Irritable Bowel Syndrome and Fecal Microbiota Transplantation, run by Chinese University of Hong Kong at 1 site in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Irritable bowel syndrome (IBS) is a common functional bowel disorder of the gastrointestinal tract affecting up to 20 percent of the adolescent and adult populations. It is characterised by abdominal pain, irregular bowel habits, altered stool consistencies and bloating, and is associated with impaired quality of… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Fecal Microbiota Transplantation and Fecal and Mucosal Microbiota Assessment
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
56 participants
Where
1 siteHong Kong
Study dates
12 Apr 2017to 16 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients are aged 18 or above
  • Patients have a diagnosis of IBS consistent with the Rome III criteria (13)
  • Patients did not have adequate relief of global IBS symptoms and of IBS-related bloating at both the time of screening and the time of randomization
  • Patients had undergone clinical investigations with colonoscopy within five years of recruitment
  • Patients with written informed consent form provided

Who cannot join

  • Patients have constipation predominant IBS (according to the definition of Rome III criteria)
  • Patients have a history of inflammatory bowel disease or gastrointestinal malignancy
  • Patients have previous abdominal surgery (other than cholecystectomy or appendectomy)
  • Patients have human immunodeficiency virus infection
  • Patients have renal disease manifested by 1.5 times the ULN of serum creatinine or blood urea nitrogen level
  • Patients have hepatic disease manifested by twice the upper limit of normal (ULN) for any of the following liver function tests: alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, or total bilirubin (except in isolated elevation of unconjugated bilirubin
Show all 15Show fewer
  • Patients have diabetes mellitus manifested by HbA1C > 6.5%
  • Patients have abnormal thyroid function manifested by values of serum Sensitive Thyroid Stimulating Hormone and serum free T4 fall outside the reference range which is not controlled by thyroid medications
  • Patients have a history of psychiatric illness (mania and schizophrenia)
  • Patients have depression defined by having a Patient Health Questionnaire-9 (PHQ-9) score > 15
  • Patients have anxiety defined by having a Generalized Anxiety Disorder 7 (GAD7) score > 10
  • Patients have active infection at the time of inclusion
  • Patients have used antibiotic therapy or anti-inflammatory drugs within the past 7 days
  • Patients have any other organic causes that can explain the symptoms of IBS
  • Current pregnancy

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • The Chinese University of Hong Kong

    Shatin, 000000

Other trials in Hong Kong

About this study

Official title: A Randomised, Placebo-controlled Study on Fecal Microbiota Transplantation for Patients With Irritable Bowel Syndrome With Fecal and Mucosal Microbiota Assessment

Irritable bowel syndrome (IBS) is a common functional bowel disorder of the gastrointestinal tract affecting up to 20 percent of the adolescent and adult populations. It is characterised by abdominal pain, irregular bowel habits, altered stool consistencies and bloating, and is associated with impaired quality of life. IBS can be categorised into diarrhoea predominant type (IBS-D), constipation predominant type (IBS-C), and mixed type (IBS-M). Fecal microbiota transplantation (FMT) defined as infusion of feces from healthy donors to affected subjects has shown impressive results with high cure rates in patients with recurrent clostridium difficile infections. The investigators propose a randomised, placebo-controlled trial of FMT in patients with IBS.

Read the detailed description

Irritable bowel syndrome (IBS) is a common functional bowel disorder of the gastrointestinal tract affecting up to 20 percent of the adolescent and adult populations. It is characterised by abdominal pain, irregular bowel habits, altered stool consistencies and bloating, and is associated with impaired quality of life. IBS can be categorised into diarrhoea predominant type (IBS-D), constipation predominant type (IBS-C), and mixed type (IBS-M). Until recently, the development of an effective therapy for this condition has been hampered by a poor understanding of the etiology of the disease. Traditionally the underlying pathogenesis of IBS has been centered on the brain-gut axis whereby stress and psychological conditions alter the perception of IBS symptoms. Emerging evidence however supports the observation that at least in a subgroup of patients with IBS, peripheral mechanisms within the intestine including low grade mucosal inflammation, abnormal immune activation and altered visceral sensitivity may be the main drivers of the manifestations in IBS.

Accumulating data suggest that the intestinal microbiota play an important role in the pathophysiology of IBS. This is derived from early observation that post-infectious IBS developed in a subgroup of patients following a bout of gastroenteritis. Several studies have shown that the fecal microbiota was altered in IBS and IBS symptoms can be improved by therapeutic interventions that target the microbiota including antibiotics, probiotics and prebiotics. Rifaximin, an oral, non-systemic broad spectrum antibiotics has also been shown to provide significant relief in IBS symptoms in a randomized controlled trial.

Fecal microbiota transplantation (FMT) defined as infusion of feces from healthy donors to affected subjects has shown impressive results with high cure rates in patients with recurrent clostridium difficile infections.The mechanism of FMT in IBS is not completely clear.

The investigators propose a randomised, placebo-controlled trial of FMT in patients with IBS.

Being tested
Fecal Microbiota Transplantation, Sham, Fecal and Mucosal Microbiota Assessment
Medical subject headings
Irritable Bowel Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fecal Microbiota TransplantationProcedure or surgery

    Fecal microbiota transplantation

  • ShamProcedure or surgery

    Infusion of sham

  • Fecal and Mucosal Microbiota AssessmentProcedure or surgery

    To assess the fecal and mucosal microbiota before and after Fecal Microbiota Transplantation

Study groups in NCT03125564
Study groupRoleWhat they receive
Fecal Microbiota TransplantationExperimentalFMT infusion and Fecal and Mucosal Microbiota Assessment
Receives: Procedure: Fecal Microbiota Transplantation; Procedure: Fecal and Mucosal Microbiota Assessment
Sham infusionSham comparatorInfusion with sham and Fecal and Mucosal Microbiota Assessment
Receives: Procedure: Sham; Procedure: Fecal and Mucosal Microbiota Assessment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. the proportion of responders

    Response means a symptom relief of more than 50 points assessed by IBS-SSS.

    Measured: 12 weeks

Secondary outcomes (15)
  1. The proportion of patients who had adequate relief of general IBS symptoms

    Adequate relief of general IBS symptoms

    Measured: 12 weeks

  2. Assess the onset and duration of relief of general IBS symptoms

    The onset and duration of relief of general IBS symptoms

    Measured: 12 weeks

  3. The proportion of patients who had improvement on abdominal bloating

    Proportion of patients who had improvement on abdominal bloating between the treatment arms.

    Measured: 12 weeks

  4. Assess the onset and duration of abdominal bloating relief

    The onset and duration of abdominal bloating relief were assessed by phone interview and follow-up visits.

    Measured: 12 weeks

  5. Assess the Abdominal pain between two groups

    Assess abdominal pain by symptoms diary between treatment and placebo arms. The symptoms diary assesses abdominal pain on a scale of 0-10 and higher scores mean severe abdominal pain

    Measured: 12 weeks

  6. Assess the Stool consistency between two groups

    Assess stool consistency by Bristol Stool Scale between treatment and placebo arms. The Bristol Stool Scale ranges from 1 to 7.

    Measured: 12 weeks

  7. Health-related quality of life in patients with irritable bowel syndrome

    Assess quality of life by Irritable Bowel Syndrome Quality of Life (IBS-QOL) scale between treatment and placebo arms. The IBS-QOL scale ranges from 0 to 100 scores with higher scores indicating better quality of life.

    Measured: 12 weeks

  8. Assess the level of anxiety between two groups

    Assess the Anxiety scale by General Anxiety Disorder-7 (GAD-7) between treatment and placebo arms. The total scores of GAD-7 range from 0 to 21 with higher scores indicating more severe level of anxiety.

    Measured: 12 weeks

  9. Assess the change of abdominal pain scores in patients who undergo open-label FMT

    After unblinding, patients in the placebo group will be given a choice to receive open-label FMT and follow up under the same schedule as the blinded phase. The abdominal pain scores will be assessed by symptoms diary on a scale of 0-10 and higher scores mean severe abdominal pain

    Measured: 12 weeks

  10. The proportion of patients who undergo open-label FMT and have abdominal bloating relief

    After unblinding, patients in the placebo group will be given a choice to receive open-label FMT and follow up under the same schedule as the blinded phase. The abdominal bloating relief was assessed by phone interview and follow-up visits.

    Measured: 12 weeks

  11. The IBS quality of life change in patients who undergo open-label FMT

    After unblinding, patients in the placebo group will be given a choice to receive open-label FMT and follow up under the same schedule as the blinded phase. Quality of life was assessed by Irritable Bowel Syndrome Quality of Life (IBS-QOL) scale which ranges from 0 to 100 scores with higher scores indicating better quality of life.

    Measured: 12 weeks

  12. The level of anxiety change in patients who undergo open-label FMT

    After unblinding, patients in the placebo group will be given a choice to receive open-label FMT and follow up under the same schedule as the blinded phase. Anxiety was assessed by General Anxiety Disorder-7 (GAD-7). The total scores of GAD-7 range from 0 to 21 with higher scores indicating more severe level of anxiety.

    Measured: 12 weeks

  13. The changes in diversity and richness of gut microbiota

    Evaluating the changes in the diversity (shannon index) and richness (number of observed species) of gut microbiota of patients receiving FMT or placebo

    Measured: 12 weeks

  14. The changes in gut microbiota at species and functional levels

    Assessing changes in gut microbiota at species and functional levels in patients receiving FMT or placebo

    Measured: 12 weeks

  15. The similarity of gut microbiota to donors

    Assessing the similarity of gut microbiota to donors in patients following FMT

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Apr 2017
  2. Study start12 Apr 2017
  3. Primary completion16 Sep 2022
  4. Study completion16 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
56 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03125564
Sponsor's protocol ID
FMT-IBS study
Status last verified
Aug 2024
First submitted
7 Apr 2017
Last updated
22 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wilson S, Roberts L, Roalfe A, Bridge P, Singh S. Prevalence of irritable bowel syndrome: a community survey. Br J Gen Pract. 2004 Jul;54(504):495-502.

    PubMed 15239910
  • Talley NJ, Spiller R. Irritable bowel syndrome: a little understood organic bowel disease? Lancet. 2002 Aug 17;360(9332):555-64. doi: 10.1016/S0140-6736(02)09712-X.

    PubMed 12241674
  • Collins SM. A role for the gut microbiota in IBS. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):497-505. doi: 10.1038/nrgastro.2014.40. Epub 2014 Apr 22.

    PubMed 24751910
  • Kassinen A, Krogius-Kurikka L, Makivuokko H, Rinttila T, Paulin L, Corander J, Malinen E, Apajalahti J, Palva A. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology. 2007 Jul;133(1):24-33. doi: 10.1053/j.gastro.2007.04.005. Epub 2007 Apr 14.

    PubMed 17631127
  • Ng SC, Lam EF, Lam TT, Chan Y, Law W, Tse PC, Kamm MA, Sung JJ, Chan FK, Wu JC. Effect of probiotic bacteria on the intestinal microbiota in irritable bowel syndrome. J Gastroenterol Hepatol. 2013 Oct;28(10):1624-31. doi: 10.1111/jgh.12306.

    PubMed 23800182
  • Gwee KA, Graham JC, McKendrick MW, Collins SM, Marshall JS, Walters SJ, Read NW. Psychometric scores and persistence of irritable bowel after infectious diarrhoea. Lancet. 1996 Jan 20;347(8995):150-3. doi: 10.1016/s0140-6736(96)90341-4.

    PubMed 8544549
  • Spiller R, Campbell E. Post-infectious irritable bowel syndrome. Curr Opin Gastroenterol. 2006 Jan;22(1):13-7. doi: 10.1097/01.mog.0000194792.36466.5c.

    PubMed 16319671
  • Parkes GC, Sanderson JD, Whelan K. Treating irritable bowel syndrome with probiotics: the evidence. Proc Nutr Soc. 2010 May;69(2):187-94. doi: 10.1017/S002966511000011X. Epub 2010 Mar 18.

    PubMed 20236566
  • Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, Mareya SM, Shaw AL, Bortey E, Forbes WP; TARGET Study Group. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011 Jan 6;364(1):22-32. doi: 10.1056/NEJMoa1004409.

    PubMed 21208106
  • van Nood E, Dijkgraaf MG, Keller JJ. Duodenal infusion of feces for recurrent Clostridium difficile. N Engl J Med. 2013 May 30;368(22):2145. doi: 10.1056/NEJMc1303919. No abstract available.

    PubMed 23718168
  • Yau YK, Su Q, Xu Z, Tang W, Ching JYL, Mak JWY, Cheung CP, Fung M, Ip M, Chan PKS, Wu JCY, Chan FKL, Ng SC. Randomised clinical trial: Faecal microbiota transplantation for irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2023 Oct;58(8):795-804. doi: 10.1111/apt.17703. Epub 2023 Sep 5.

    PubMed 37667968

Questions about this trial

What is this clinical trial studying?

A study testing Fecal Microbiota Transplantation and Fecal and Mucosal Microbiota Assessment in people with Irritable Bowel Syndrome and Fecal Microbiota Transplantation, run by Chinese University of Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

the proportion of responders (time frame: 12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03125564, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Aug 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in