IEFFICACY AND SAFETY OF FAECAL MICROBIOTA TRANSPLANTATION FOR ACTIVE PERIPHERAL PSORIATIC ARTHRITIS: A RANDOMIZED SHAM-CONTROLLED TRIAL
Authors: M. Skov Kragsnaes et al.
Faecal microbiota transfer (FMT) has been proposed as a treatment option for extraintestinal inflammatory diseases. Results of a proof-of-concept, double-blind, parallel-group, sham- controlled superiority study are presented. 31 patients with active peripheral PsA despite MTX were randomized to receive one gastroscopic-guided FMT or sham transplantation into the duodenum. 30/31 completed the 26 weeks follow-up. Treatment failure was observed more frequently in the FMT group than in the sham treated patients (60% versus 19%, risk ratio 3.20 (95%CI 1.06–9.62, p = 0.018). No serious adverse events were observed.
The idea of modifying the gut microbiome in patients with psoriatic arthritis is intriguing given the association of inflammatory bowel diseases with spondyloarthropathies. Whether the use of several FMT´s would have resulted in improvement of peripheral arthritis that was not apparent after a single intervention might be discussed. As a rheumatologist I have to admit that I am not unhappy to discard FMT from my list of immunomodulatory treatments.