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Anorexia Nervosa Restricting TypeFMT-ANNCT06593366

Fecal Microbiota Transplant for Anorexia Nervosa

A study testing Fecal Microbiota Transplant in people with Anorexia Nervosa Restricting Type and Anorexia Nervosa, run by Hamilton Health Sciences Corporation.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The purpose of this pilot randomized-controlled trial is to determine whether Fecal Microbiota Transplant (FMT) treatment demonstrates feasibility, acceptability, and prelinary effectiveness among patients with anorexia nervosa (AN). Read more about this study

Who is it for?
Ages 12 to 17 years, women only
What is being tested?
Fecal Microbiota Transplant
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
No sites listed yet
Study dates
1 Jun 2026to 1 Jun 2027
Phase
Interventional
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 12 to 17 years
  • Women only
  • No healthy volunteers
  • Child

Inclusion Criteria: All study subjects will have been diagnosed with AN (restricting type or binge eating/purging type) by the primary physician on the ED team, as per standard approach. Study participants will:

  • Be 12-17 years-old at time of recruitment
  • Have capacity to consent
  • Be assigned female sex at birth (may be gender diverse)
  • Be active patients in the pediatric ED program at MCH
  • Have a weight that is <85% of the Treatment Goal Weight, as determined by the treating physician

Exclusion Criteria: Potential study subjects will be excluded due to the following reasons:

  • Exposure to antibiotics within two weeks of study randomization
  • Initiation of new probiotics / oral nutritional supplements within two weeks of randomization
  • Active pregnancy
  • Active psychosis or suicidal ideation
  • Other comorbidities that may affect weight or the gut microbiome including celiac disease, inflammatory bowel disease (or other conditions as determined by the study team)

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Jennifer L Couturier, MD, MSc contact

905-521-2100 ext. 76035

coutur@mcmaster.ca

About this study

Official title: A Pilot Feasibility Randomized Controlled Trial of Fecal Microbiota Transplant for Adolescent Anorexia Nervosa

The purpose of this pilot randomized-controlled trial is to determine whether Fecal Microbiota Transplant (FMT) treatment demonstrates feasibility, acceptability, and prelinary effectiveness among patients with anorexia nervosa (AN). Specifically, the investigators aim to compare changes in weight, gut microbiome, urine, blood biomarkers and mood symptoms between participants receiving the FMT intervention and placebo.

Read the detailed description

In the following pilot randomized-controlled trial, the investigators' aim is to determine whether FMT treatment demonstrates feasibility, acceptability, and preliminary effectiveness in pediatric AN participants. The investigators will assess how the use of FMT affects participants' rate of weight restoration, gut microbiome, relevant urine and blood biomarkers, and mood symptoms. The investigators' rationale for performing the study is to better understand the interactions between the intestinal microbiome, energy regulation, and behavior. This will be the first study to assess the role of FMT in pediatric AN and will help establish whether this adjunctive treatment modality has benefit in managing the metabolic and behavioral manifestations of this complex neuropsychiatric disorder.

In terms of study procedures, members of a pilot sample of 20 AN patients recruited from McMaster Children's Hospital will be randomized to receive FMT or placebo. All participants will be asked to complete a battery of assessments at regular intervals over the 8-week intervention period, and at a follow-up point at four weeks post-intervention.

The study's primary outcomes are recruitment and retention rates. Descriptive statistics will be used to determine the number of adolescents who will agree to participate in the study and those who will complete the study.

One of the study's secondary outcomes is participants' attitudes toward FMT. This will be measured through qualitative interviews among those who completed the intervention and those who do not agree to participate in the study.

The investigators will know we have reached saturation by using a method called "information power" and will explore how broad the research questions are, if there are clear theories to guide the analysis, how varied the participants in the study are, and how much useful information is accrued. Based on this, the investigators will determine the appropriate number of interviews to lead.

The remaining secondary outcome is a battery of preliminary outcomes (clinical, biological, biochemical and safety). The investigators will assess these outcomes at multiple timepoints using questionnaires, anthropometric data, stool analysis (16s rRNA), urine metabolic analysis, saliva ultra filtrates, changes in blood work, and common terminology criteria for adverse events for safety outcomes.

Being tested
Fecal Microbiota Transplant, Placebo
Keywords
anorexia nervosa, fecal microbiota transplant, pilot study, randomized controlled trial, feasibility
Medical subject headings
Anorexia Nervosa, Anorexia

What participants receive

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

  • Fecal Microbiota TransplantBiological

    An investigational biologic comprised of 15.0g of dried healthy donor stool contained within a size 00 gelatin capsule, to be taken twice per day, twice per week over an 8-week duration.

  • PlaceboDrug

    Oral placebo capsules (OPC) containing methylcellulose, to be taken twice per day, twice per week over an 8-week duration.

Study groups in NCT06593366
Study groupRoleWhat they receive
Fecal Microbiota TransplantActive comparatorBanked donor stools that have been previously screened, prepared and frozen per previous protocols will be used to prepare all oral FMT capsules (OFC) through the laboratory of a collaborator. Recipients will receive OFC (two capsules, twice a day, twice per week) prepared from a single donor throughout their 8-week treatment course, to support assessment of FMT engraftment in recipients; this totals to 64 capsules across the duration of the study. Each OFC will contain approximately 15.0g of dried healthy donor stool contained within a size 00 gelatin capsule.
Receives: Biological: Fecal Microbiota Transplant
PlaceboPlacebo comparatorMatching oral placebo capsules (OPC) containing methylcellulose will be identical in terms of size, colour, taste, and dosing. Participants will be asked to take the Placebo treatment capsules twice a day for two days per week for a duration of eight weeks (total 64 capsules).
Receives: Drug: Placebo

What is being measured

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

  1. Recruitment Rate

    The number of participants who are consented into the study divided by the number of participants who show interest in the study.

    Measured: Through study completion, an average of one year.

  2. Retention Rate

    The number of participants who completed the study divided by the number of participants consented into the study.

    Measured: Through study completion, an average of one year.

Secondary outcomes (21)
  1. Attitudes towards Fecal Microbiota Transplant

    Attitudes towards FMT will be studied via semi-structured qualitative interviews of all participants: the 20 adolescents and their parents in the trial, and the 10 adolescents and their parents who decline participation, and their guardians. Using Qualitative Description, interviews will explore patient and guardian attitudes toward FMT, as well as their impressions of efficacy (if they participated in the trial). Questions will include perceptions of "natural" versus "drug" products, perspectives on causes of AN, and interests in other potential treatments. Interviews will be conducted virtually, using Zoom for Healthcare, transcribed verbatim and then coded for themes using NVivo. This analysis stays close to the data with little to no interpretation. Our analysis will also include a summative content analysis.

    Measured: Week 12 (follow-up)

  2. Height

    Height will be collected.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  3. Weight

    Weight will be measured between hospital visits using home weight scales provided to study participants.

    Measured: Week 0 (baseline), Week 2, Week 4 (mid-treatment), Week 6, Week 8 (post-intervention), Week 10, Week 12 (follow-up)

  4. Eating Disorder Examination Questionnaire

    The EDEQ is a 28-item standardized questionnaire that measures the severity of symptoms of eating disorders, including menstrual status.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  5. Beck Depression Inventory

    The BDI is a 21-item questionnaire used to measure the severity of depressive symptoms.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  6. Beck Anxiety Inventory

    The BAI is a 21-item questionnaire used to measure the severity of anxiety symptoms.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  7. Yale-Brown-Cornell Eating Disorder Scale

    The YBC-EDS assesses impairment, persistence and degree of obsessional thinking and compulsiveness about eating behaviors.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  8. Gastrointestinal Symptom Rating Scale

    This is a 15-item rating scale to capture a variety of GI symptoms.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  9. Changes in stool metabolites

    Stool will be collected in to examine changes in alpha- and beta- diversity of microbiota, as well as engraftment of donor specific strains/genes and microbially-derived metabolite levels throughout the study. All stool samples will be collected using an at-home collection kit. Samples will be collected and stored in locked, secure -80°C study freezers upon being brought to the hospital or shipped by paid courier by participants. Stool samples will be sequenced for 16s rRNA gene profiling. All 16s rRNA analyses will be performed using in-house bioinformatics pipelines through the laboratory of a collaborator to identify amplicon sequence variants, perform taxonomic assignments, and analyze alpha- and beta-diversity and differential taxonomic abundance.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  10. Changes in urine metabolomics

    Urine samples will be collected from each participant. Nontargeted metabolite profiling is a method used to explore and identify as many metabolites as possible in a sample to identify whatever is present. This approach is designed to help discover new metabolites, and identify changes in metabolite levels that may correlate with other outcomes. We will report differences in highest-abundance metabolites using t-tests to compare their presence between groups, and correlation coefficients to identify associations between outcomes.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  11. Changes in saliva ultrafiltrates

    Saliva samples will be collected for metabolomic analysis. Saliva ultrafiltrates will be analyzed as described above for stool and urine samples by a collaborator. All saliva ultrafiltrates will be reported using the same multisegment injection-capillary electrophoresis-mass spectrometer, where metabolites are reported using effect sizes to compare relative concentrations against reference standards.

    Measured: Week 0 (baseline), Week 4 (mid-treatment), Week 8 (post-intervention), Week 12 (follow-up)

  12. Changes in complete blood count

    Using the provided blood samples, changes in complete blood count from baseline to post-intervention will be compared using paired t-tests. The complete blood count includes (with their measurement units):

    Red blood count (RBC)- cells/L Hemoglobin (Hb)- g/L Hematocrit- L/L Mean corpuscular volume (MCV)- fL Mean Corpuscular Hemoglobin (MCH)- pg Mean corpuscular hemoglobin concentration (MCHC)- g/L Red cell distribution width (RDW)- % White blood count (WBC) - cells/L Neutrophils - cells/L Lymphocytes - cells/L Eosinophils - cells/L Basophils - cells/L Monocytes - cells/L

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  13. Changes in C-reactive protein

    Using the provided blood samples, changes in C-reactive protein (CRP) from baseline to post-intervention will be compared using paired t-tests. CRP (measured in mg/L) is used to monitor inflammation in acute or chronic conditions.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  14. Changes in alkaline phosphatase

    Using the provided blood samples, changes in alkaline phosphatase (ALP) from baseline to post-intervention will be compared using paired t-tests. ALP (measured in U/L) is associated with liver function.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  15. Changes in alanine aminotransferase

    Using the provided blood samples, changes in alanine aminotransferase (ALT) from baseline to post-intervention will be compared using paired t-tests. ALT (measured in U/L) is associated with liver function.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  16. Changes in 25-OH Vitamin D

    Using the provided blood samples, changes in 25-OH Vitamin D from baseline to post-intervention will be compared using paired t-tests. 25-OH Vitamin D (measured in ng/ml) is used as a measure of Vitamin D levels.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  17. Changes in albumin

    Using the provided blood samples, changes in albumin from baseline to post-intervention will be compared using paired t-tests. Albumin (measured in g/L) is associated with liver and kidney function.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  18. Changes in follicle stimulating hormone

    Using the provided blood samples, changes in follicle stimulating hormone (FSH) from baseline to post-intervention will be compared using paired t-tests. FSH (measured in mIU/mL) is important for determining aspects of fertility and menstruation.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  19. Changes in luteinizing hormone

    Using the provided blood samples, changes in luteinizing hormone (LH) from baseline to post-intervention will be compared using paired t-tests. LH (measured in IU/L) is important for determining aspects of fertility and menstruation.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  20. Changes in free testosterone

    Using the provided blood samples, changes in free testosterone from baseline to post-intervention will be compared using paired t-tests. Free testosterone (measured in nmol/L) is important for assessing various bodily functions related to hormones.

    Measured: Week 0 (baseline), Week 8 (post-intervention)

  21. Presence of safety outcomes

    Common Terminology Criteria for Adverse Events (CTCAE) will be used to define adverse events and serious adverse events. This framework will be used to classify broad safety concerns throughout our trial.

    Measured: Through study completion, an average of one year.

Timeline

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

  1. First posted19 Sep 2024
  2. Study start1 Jun 2026 (estimated)
  3. Primary completion1 Jun 2027 (estimated)
  4. Study completion1 Jun 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 N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06593366
Sponsor's protocol ID
FMTAN
Acronym
FMT-AN
Status last verified
May 2026
First submitted
26 Jul 2024
Last updated
27 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no current plan to share individual participant data to other researchers.

Publications

  • Couturier J, Kenner E, Nicula M, Chowdhury F, Surette M, Pai N. Protocol for a pilot feasibility randomised controlled trial of fecal microbiota transplantation for adolescent anorexia nervosa. BMJ Open. 2026 Apr 20;16(4):e109115. doi: 10.1136/bmjopen-2025-109115.

    PubMed 42009386

Questions about this trial

What is this clinical trial studying?

A study testing Fecal Microbiota Transplant in people with Anorexia Nervosa Restricting Type and Anorexia Nervosa, run by Hamilton Health Sciences Corporation.

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

Who may be eligible to take part?

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: opening soon, as of the sponsor's last update on 27 May 2026. Status can change between updates, so confirm with the study contact before making plans.

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?

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?

Contact Jennifer L Couturier, MD, MSc (905-521-2100 ext. 76035, coutur@mcmaster.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recruitment Rate (time frame: Through study completion, an average of one year.). The study lists 2 primary outcomes in all. 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 NCT06593366, which also lists 1 linked publication.

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 27 May 2026.

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