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Ulcerative ColitisPhase 3REBALANCE-UCNCT03483246

Impact of Fecal Microbiota Transplantation in Ulcerative Colitis

A Phase 3 study testing Fecal Microbiota Transplantation (FMT) in people with Ulcerative Colitis, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. UC pathogenesis remains poorly understood but involves an inappropriate immune response toward an unbalanced gut microbiota (called dysbiosis) in predisposed hosts. Read more about this study

Who is it for?
Ages 18 to 74 yearsHealthy volunteers can take part
Conditions the study is for
Ulcerative Colitis
What is being tested?
Fecal Microbiota Transplantation (FMT)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
150 participants
Where
1 siteFrance
Study dates
17 Sep 2018to 27 Mar 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 to 74 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years and < 75 years
  • Ulcerative colitis (according to the Lennard Jones criteria) diagnosed for at least 3 months and :
  • Currently active (PMC > 1) and planned to be treated by systemic corticosteroids (minimum 40mg prednisone equivalent daily) Or
  • Currently treated by systemic corticosteroid (minimum 40 mg prednisone equivalent daily) within max 3 weeks Or
  • Steroid dependent patients (at least one unsuccessful attempt to discontinue steroid within the last 6 months before inclusion)
  • Patient with health insurance (AME excepted)
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  • Informed written consent
  • Female of child-bearing age with an active contraception and this during at least period of treatment until the end of active follow-up period (week 24)
  • Age ≥ 18 years and < 50 years
  • 17 kg/m² < body mass index < 30 kg/m²
  • Regular bowel movement defined as at least 1 stool every other day and maximum 2 stools per day
  • Subject with health insurance (AME excepted)
  • Informed Written consent

Who cannot join

  • UC complication requiring surgical treatment
  • Patient treated with high dose corticosteroid more than three weeks before inclusion (≥ 40 mg prednisone equivalent daily) except in case of steroid-dependence
  • Contraindication to colonoscopy or anesthesia
  • Pregnancy or breastfeeding during the study
  • Treatment preceding the colonoscopy with:
  • intravenous infliximab and/or vedolizumab and/or ustekinumab (< 6 weeks before the planned date of the colonoscopy) and/or subcutaneous infliximab (<2 weeks before the planned date of the colonoscopy), and /or adalimumab (<2 weeks before the planned date of the colonoscopy) and/or golimumab and/or tofacitinib (<4 weeks before the planned date of the colonoscopy)
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  • immunosuppressant (thiopurine, methotrexate, tacrolimus or other classical immunosuppressant) started or stopped < 3 months before the planned date of the colonoscopy
  • Antibiotics, antifungic or probiotics treatment < 4 weeks before the planned date of the colonoscopy
  • participation in any other interventional study
  • patient under legal protection
  • For details, please see protocol.

Trial locations and contacts

1 site in 1 country.

France1 site
  • Service de Gastroentérologie et Nutrition Hôpital Saint Antoine

    Paris, Paris, 75012

Other trials in France

About this study

Official title: Impact of Fecal Microbiota Transplantation in Ulcerative Colitis: a Randomized, Sham Controlled Trial

Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. UC pathogenesis remains poorly understood but involves an inappropriate immune response toward an unbalanced gut microbiota (called dysbiosis) in predisposed hosts.

The purpose of this study is to determine the effect of the fecal microbiota transplantation on UC.

Read the detailed description

Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease affecting approximately 90 000 patients in France, mostly at young age, and altering their quality of life.

Conventional Immunosuppressive treatment (ie azathioprine, anti-TNF (tumor necrosis factor ), vedolizumab) used in UC are expensive and associated with potentially severe complications such as infections and cancers.

UC pathogenesis remains poorly understood but involves an inappropriate immune response toward an unbalanced gut microbiota (called dysbiosis) in predisposed hosts.

Fecal microbiota transplantation (FMT) is now recommended in guidelines for treating recurrent Clostridium difficile infection. Although the pathogenesis involved in UC is different, FMT is a potential therapeutic strategy as transferring a healthy microbiota in an UC patient could restore the appropriate host-microbiota crosstalk.

As the gut microbiota is dramatically altered by intestinal inflammation, transferring a massive amount of microbial organisms in an inflamed gut with epithelial barrier disruption might be a suboptimal strategy and could even have detrimental effects by allowing bacterial translocation.

Thus, it's possible that performing FMT in UC patients who achieved remission after conventional treatment might be associated with better clinical outcome than in patients with active disease.

Being tested
Fecal Microbiota Transplantation (FMT), Sham-transplantation Placebo
Keywords
Ulcerative colitis, Inflammatory bowel disease, Fecal microbiota transplantation
Medical subject headings
Colitis, Ulcerative, Inflammatory Bowel Diseases

What participants receive

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

  • Fecal Microbiota Transplantation (FMT)Drug

    The colonoscopy for FMT will be planned as soon as possible and never more than 5 weeks after inclusion visit.

    After colon cleansing using Polyethylen glycol, the patient will have a colonoscopy under general anesthesia.

    The patient will then receive either FMT (frozen preparation of 50g of stools in 300ml of physio, see donor section for details) or sham transplantation (FMT vehicle) in the cecum.

  • Sham-transplantation PlaceboDrug

    The sham-transplantation will be planned as soon as possible and never more than 5 weeks after inclusion visit.

    After colon cleansing using Polyethylen glycol, the patient will have a colonoscopy under general anesthesia.

    The patient will then sham transplantation (FMT vehicle) in the cecum.

Study groups in NCT03483246
Study groupRoleWhat they receive
Group B - fecal microbiota transplantationExperimentalPatients receiving the fecal microbiota transplantation (FMT) in 3 times after inclusion and randomisation
Receives: Drug: Fecal Microbiota Transplantation (FMT)
Group A- Sham-transplantationPlacebo comparatorPatients receiving the sham-transplantation in 3 times after inclusion and randomisation
Receives: Drug: Sham-transplantation Placebo

What is being measured

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

  1. Steroid-free clinical and endoscopic remission

    Steroid-free clinical and endoscopic remission defined as a total Mayo score of 2 or lower and no subscore higher than 1 and mucosal healing defined as an endoscopic subscore of 0 or 1 (Sigmoidoscopy).

    Measured: 12 weeks after FMT or sham-transplantation

Secondary outcomes (11)
  1. Steroid-free clinical remission

    Steroid-free clinical remission defined as a Partial Mayo Clinic score of 0 or 1

    Measured: 12 weeks after FMT or sham-transplantation

  2. Steroid-free clinical remission

    Steroid-free clinical remission defined as a Partial Mayo Clinic score of 0 or 1

    Measured: 24 weeks after FMT or sham-transplantation

  3. Steroid-free endoscopic response

    Steroid-free endoscopic response defined as a Mayo endoscopy subscore of 1 or less, with a reduction of at least 1 point from baseline

    Measured: 12 weeks after FMTor sham-transplantation

  4. Steroid-free endoscopic remission

    Steroid-free endoscopic remission defined as an Endoscopic Mayo Clinic score of 0

    Measured: 12 weeks after FMT or sham-transplantation

  5. Microbiota composition and diversity

    Microbiota composition and diversity assessed by 16s sequencing compared to baseline and to donor's microbiota.

    Measured: 12 and 24 weeks after FMT or sham-transplantation

  6. Proportion of adverse events in each group

    abdominal pain, nausea, vomiting, fever, modified intestinal transit and episode of infection

    Measured: Through study completion, up to 25 months and one week

  7. Inflammatory biological parameter 1

    CRP

    Measured: up to 24 weeks

  8. Inflammatory biological parameter 2

    fecal calprotectin

    Measured: up to 24 weeks

  9. Inflammatory biological parameter 3

    platelet number

    Measured: up to 24 weeks

  10. Endoscopic lesions

    Endoscopic lesions at coloscopy and sigmoidoscopy by endoscopic Mayo score

    Measured: 12 weeks after FMT or sham-transplantation

  11. Endoscopic lesions

    Endoscopic lesions at coloscopy (baseline) and sigmoidoscopy by UCEIS score

    Measured: 12 weeks after FMT or sham-transplantation

Timeline

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

  1. First posted30 Mar 2018
  2. Study start17 Sep 2018
  3. Primary completion16 Sep 2025
  4. Study completion27 Mar 2027 (estimated)

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03483246
Sponsor's protocol ID
P 160931J
Other IDs
2017-003802-42, 2017
Acronym
REBALANCE-UC
Status last verified
Jan 2026
First submitted
26 Feb 2018
Last updated
15 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol. 2015 Apr;12(4):205-17. doi: 10.1038/nrgastro.2015.34. Epub 2015 Mar 3.

    PubMed 25732745
  • Angelberger S, Reinisch W, Makristathis A, Lichtenberger C, Dejaco C, Papay P, Novacek G, Trauner M, Loy A, Berry D. Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation. Am J Gastroenterol. 2013 Oct;108(10):1620-30. doi: 10.1038/ajg.2013.257. Epub 2013 Sep 24.

    PubMed 24060759
  • Beaugerie L, Itzkowitz SH. Cancers Complicating Inflammatory Bowel Disease. N Engl J Med. 2015 Jul 9;373(2):195. doi: 10.1056/NEJMc1505689. No abstract available.

    PubMed 26154801
  • Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439-44.

    PubMed 1248701
  • Borody T, Fischer M, Mitchell S, Campbell J. Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead. Expert Rev Gastroenterol Hepatol. 2015;9(11):1379-91. doi: 10.1586/17474124.2015.1086267. Epub 2015 Sep 28.

    PubMed 26414076
  • Colman RJ, Rubin DT. Fecal microbiota transplantation as therapy for inflammatory bowel disease: a systematic review and meta-analysis. J Crohns Colitis. 2014 Dec;8(12):1569-81. doi: 10.1016/j.crohns.2014.08.006. Epub 2014 Sep 13.

    PubMed 25223604
  • Cui B, Li P, Xu L, Zhao Y, Wang H, Peng Z, Xu H, Xiang J, He Z, Zhang T, Nie Y, Wu K, Fan D, Ji G, Zhang F. Step-up fecal microbiota transplantation strategy: a pilot study for steroid-dependent ulcerative colitis. J Transl Med. 2015 Sep 12;13:298. doi: 10.1186/s12967-015-0646-2.

    PubMed 26363929
  • D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, Lemann M, Marteau P, Rutgeerts P, Scholmerich J, Sutherland LR. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology. 2007 Feb;132(2):763-86. doi: 10.1053/j.gastro.2006.12.038. Epub 2006 Dec 20. No abstract available.

    PubMed 17258735
  • Debast SB, Bauer MP, Kuijper EJ; European Society of Clinical Microbiology and Infectious Diseases. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect. 2014 Mar;20 Suppl 2:1-26. doi: 10.1111/1469-0691.12418.

    PubMed 24118601
  • Grinspan AM, Kelly CR. Fecal Microbiota Transplantation for Ulcerative Colitis: Not Just Yet. Gastroenterology. 2015 Jul;149(1):15-8. doi: 10.1053/j.gastro.2015.05.030. Epub 2015 May 27. No abstract available.

    PubMed 26021232
  • Kelly CR, Ihunnah C, Fischer M, Khoruts A, Surawicz C, Afzali A, Aroniadis O, Barto A, Borody T, Giovanelli A, Gordon S, Gluck M, Hohmann EL, Kao D, Kao JY, McQuillen DP, Mellow M, Rank KM, Rao K, Ray A, Schwartz MA, Singh N, Stollman N, Suskind DL, Vindigni SM, Youngster I, Brandt L. Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. Am J Gastroenterol. 2014 Jul;109(7):1065-71. doi: 10.1038/ajg.2014.133. Epub 2014 Jun 3.

    PubMed 24890442
  • Kelly CR, Kahn S, Kashyap P, Laine L, Rubin D, Atreja A, Moore T, Wu G. Update on Fecal Microbiota Transplantation 2015: Indications, Methodologies, Mechanisms, and Outlook. Gastroenterology. 2015 Jul;149(1):223-37. doi: 10.1053/j.gastro.2015.05.008. Epub 2015 May 15.

    PubMed 25982290
  • Khor B, Gardet A, Xavier RJ. Genetics and pathogenesis of inflammatory bowel disease. Nature. 2011 Jun 15;474(7351):307-17. doi: 10.1038/nature10209.

    PubMed 21677747
  • Lamas B, Richard ML, Leducq V, Pham HP, Michel ML, Da Costa G, Bridonneau C, Jegou S, Hoffmann TW, Natividad JM, Brot L, Taleb S, Couturier-Maillard A, Nion-Larmurier I, Merabtene F, Seksik P, Bourrier A, Cosnes J, Ryffel B, Beaugerie L, Launay JM, Langella P, Xavier RJ, Sokol H. CARD9 impacts colitis by altering gut microbiota metabolism of tryptophan into aryl hydrocarbon receptor ligands. Nat Med. 2016 Jun;22(6):598-605. doi: 10.1038/nm.4102. Epub 2016 May 9.

    PubMed 27158904
  • Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Falony G, Almeida M, Arumugam M, Batto JM, Kennedy S, Leonard P, Li J, Burgdorf K, Grarup N, Jorgensen T, Brandslund I, Nielsen HB, Juncker AS, Bertalan M, Levenez F, Pons N, Rasmussen S, Sunagawa S, Tap J, Tims S, Zoetendal EG, Brunak S, Clement K, Dore J, Kleerebezem M, Kristiansen K, Renault P, Sicheritz-Ponten T, de Vos WM, Zucker JD, Raes J, Hansen T; MetaHIT consortium; Bork P, Wang J, Ehrlich SD, Pedersen O. Richness of human gut microbiome correlates with metabolic markers. Nature. 2013 Aug 29;500(7464):541-6. doi: 10.1038/nature12506.

    PubMed 23985870

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Fecal Microbiota Transplantation (FMT) in people with Ulcerative Colitis, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

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 13 inclusion and 11 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: under way, not looking for participants, as of the sponsor's last update on 15 Jan 2026. 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 France. 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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?

Steroid-free clinical and endoscopic remission (time frame: 12 weeks after FMT or sham-transplantation). 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 NCT03483246, which also lists 28 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 15 Jan 2026.

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