The efficacy of faecal microbiota transplants will be the centre of a new clinical trial at King’s College London.
Patients with advanced liver disease will take oral capsules made of freeze-dried stool from healthy volunteers to evaluate if it reduces the risk of patients developing infections.
Also known as cirrhosis, end-stage chronic liver disease, which is the third biggest cause of death and loss of working potential in the UK, causes people to be more susceptible to infection due to an increase number of harmful bacteria in their bowels.
The over-prescribing of antibiotics has led to these infections being harder to treat, with the only viable treatment option being a liver transplant. This cannot be safely performed if a patient has a antimicrobial resistant infection however.
To combat this, researchers have previously tested faecal microbiota transplants via endoscopy in the PROFIT trial which indicated the treatment was safe, well-tolerated and improved gut health.
King’s College London’s Professor Debbie Shawcross who was the trial chief investigator, said: “This landmark trial provides evidence that a faecal transplant can improve gut health by modifying the gut microbiome and reduce ammonia levels in patients with cirrhosis.”
This new study, called PROMISE, will look to develop the foundations laid by the previous research and investigate the potential of a less invasive procedure for patients.
Approximately 300 patients across 16 sites will be recruited and randomly allocated either faecal microbiota transplant capsules or a placebo treatment.
King’s College London’s Dr Lindsey Edwards, added: “There is an urgent and unmet need to tackle infection and antimicrobial resistance in chronic liver disease.
“If we can boost liver patients’ own immunity to reduce infections by modifying the microbiome, we can reduce the need for the prescription of antibiotics.
“This will reduce the incidence of antimicrobial resistance which is a huge global challenge.”
The trial will be funded by the National Institute for Health and Care Research and the Medical Research Council.
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