Standardized Microbiota Transplant Therapy in Crohn's Disease
Trial Parameters
Brief Summary
Crohn's disease (CD) develops because of a disruption of homeostasis between the gut microbiota and the host immune system resulting in excessive inflammation in the intestinal tract. Current drug therapies for CD are directed at the immune system. The emergence of fecal microbiota transplantation (FMT) for the treatment of recurrent C. difficile infections (rCDI) has opened a frontier of restorative therapies targeting the gut microbiome. This study aims to assess if two forms of encapsulated FMT material (MTP101C and MTP101S) can effectively engraft in the ileum and colon of individuals with CD. This study will also assess how the impact of CD phenotype impacts engraftment. Finally this study will explore symptom and endoscopic changes before and after these two therapies.
Eligibility Criteria
Inclusion Criteria: * Able and willing to provide informed consent. * 18-89 years of age. * English speaking. * Diagnosis of CD based on typical clinical and histologic features. * Active disease on endoscopy: * SES-CD \>= 6 * SES-CD \>= 4 for isolated ileal disease * Current CD therapies are in the maintenance phase of dosing at the time of randomization. * Any ongoing CD therapy (apart from steroid use) must be at stable doses for 4 weeks prior to randomization and remain stable over study course. * Steroid use 20mg or less by 5 days prior to randomization. * Steroid use stipulations: * Prednisone must be tapered below 20mg after 7 days. * Any use of budesonide over the study period is allowed although tapering is encouraged. * Rescue medications: Steroid courses (up to 40mg for two weeks with a planned taper) are allowed at the discretion of the treating provider. Study drug therapy will be stopped on a case-by-case basis on discussion with the participant and treating provider. * W