Long-Term Follow-Up After Fecal Microbiota Transplantation via Freeze-Dried Capsules for Recurrent Clostridioides...

Area of Science:

• Gastroenterology
• Microbiology
• Infectious Diseases

Background:

• Fecal microbiota transplantation (FMT) is a standard therapy for recurrent Clostridioides difficile infection (CDI).
• Limited data exist on the durability of response after oral freeze-dried capsule FMT and the efficacy of repeat FMT for treatment failures.

Purpose of the Study:

• To evaluate the real-world effectiveness and durability of freeze-dried oral capsule FMT for recurrent CDI.
• To assess the success of repeated FMT in patients who initially failed or experienced late recurrences.

Main Methods:

• Retrospective cohort study of 129 patients with recurrent CDI treated with oral freeze-dried capsule FMT (March 2015-June 2022).
• Data collected via patient communication and medical records, defining recurrence within 90 days and additional episodes >90 days post-FMT.
• Long-term follow-up assessed durability of response and need for subsequent therapies.

Main Results:

• 80% of patients achieved remission at 3 months post-initial FMT.
• 20% experienced recurrence, with most successfully managed by 1-2 additional FMTs.
• Long-term follow-up (median 182 weeks) showed 17% of patients required further CDI management, often with repeat FMT.

Conclusions:

• FMT via freeze-dried capsules is an effective therapy for recurrent CDI in a real-world setting.
• Repeated FMT procedures are successful in managing both early treatment failures and late recurrences of CDI.