PWE-039 FMT as a treatment for IBD: a national survey of gastroenterologists in the UK

Abstract

Introduction Interest in the use of faecal microbiota transplantation (FMT) as a therapeutic treatment in inflammatory bowel disease (IBD) has increased following promising outcomes in patients with Clostridioides difficile infection (CDI). To date, 4 double blind randomised control trials have been conducted investigating the efficacy of FMT in patients with ulcerative colitis (UC). Whilst research exploring clinician awareness and attitude towards the use of FMT in CDI has been carried out, data for IBD is currently lacking, despite growing patient and clinician interest in the treatment. The primary aim of this survey was to assess the perceptions of gastroenterologists and current practice relating to FMT as a treatment for IBD in the UK. Methods The survey was developed using Snap Survey software, following literature review and author consensus. It was distributed amongst UK-based gastroenterology trainees and consultants through the British Society of Gastroenterology and British Society of Paediatric Gastroenterology, Hepatology and Nutrition e-newsletters, and at the BSG Conference in June 2017. Results In total, 61 respondents completed the survey including pre-subspecialty trainees, gastroenterology specialists, associate specialists and consultants. Almost all (95%; n=58) respondents stated that they had heard of FMT being used as a treatment for IBD prior to participating in the survey. Based on current evidence, 34% (n=21) of respondents would consider using FMT in patients with IBD, 26% (n=16) would not and 39% (n=24) were undecided. A total of 43% (n=26) respondents said that a patient had expressed interest in FMT and a small proportion (10%; n=6) said that they were aware of a patient that has undertaken FMT on their own without medical supervision. When asked to rank routes of delivery in terms of preference, nasogastric tube was the least preferred route (39%; n=24) and oral capsule was the most preferred route (34%; n=21). Conclusions A clear majority of UK gastroenterologists recognise FMT as a potential treatment for IBD, however uptake is limited. A significant proportion of clinicians would consider FMT in IBD based on currently available evidence and the majority would consider entering patients into clinical trials. Orally-delivered encapsulated FMT is the preferred route of administration and future work should explore the utility and efficacy of this route.