238 Journal of Crohn's and Colitis, 2021, 238–243 doi:10.1093/ecco-jcc/jjaa163 Advance Access publication September 15, 2020 Original Article © The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com Original Article Clinical Predictors of Response to Faecal Microbiota Transplantation in Patients with Active Ulcerative Colitis Ajit Sood, a Arshdeep Singh, a, Ramit Mahajan, a, Vandana Midha, b Kirandeep Kaur, c Dharmatma Singh, d Namita Bansal, e Khushdeep Dharni f a Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India b Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India c Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India d CRC, Research and Development Centre, Dayanand Medical College and Hospital, Ludhiana, Punjab, India e Research and Development Centre, Dayanand Medical College and Hospital, Ludhiana, Punjab, India f School of Business Studies, Punjab Agricultural University, Ludhiana, Punjab, India Corresponding author: Dr Ajit Sood, Professor and Head, Department of Gastroenterology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India. Tel: +919815400718; Email: ajitsood10@gmail.com Abstract Background: Faecal microbiota transplantation [FMT] has been shown to be effective for induction of remission in patients with active ulcerative colitis [UC]. At present, the clinical factors impacting the response to FMT in UC remain unclear. Methods: Patients with active UC treated with multisession FMT via colonoscopy at weeks 0, 2, 6, 10, 14, 18 and 22 were analysed. Response to FMT was defned as achievement of corticosteroid- free clinical remission at week 30. Patient and disease characteristics were evaluated to determine the predictors of response to FMT. Results: Of 140 patients with active UC treated with FMT, 93 (mean age 34.96 ± 11.27 years, 62.36% males [n = 58], mean Mayo clinic score 8.07 ± 2.00) who completed the multisession FMT protocol were analysed. Fifty-seven [61.29%] patients achieved clinical remission. Younger age (odds ratio [OR] for age 0.93, 95% confdence interval [CI] 0.89–0.97, p = 0.001), moderate [Mayo clinic score 6–9] disease severity [OR 3.01, 95% CI 1.12–8.06, p = 0.025] and endoscopic Mayo score 2 [OR 5.55, 95% CI 2.18–14.06, p < 0.001] were signifcant predictors of remission on univariate analysis. Younger age, disease extent E2 and endoscopic Mayo score 2 [OR 0.925, 95% CI 0.88–0.97, p = 0.002; OR 2.89, 95% CI 1.01–8.25, p = 0.04; and OR 8.43, 95% CI 2.38–29.84, p = 0.001, respectively] were associated with clinical remission on multivariate logistic regression. A mathematical model [nomogram] was developed for estimating the probability of remission with the FMT protocol. Conclusion: Younger age, disease extent E2 and endoscopic Mayo score 2 signifcantly predict achievement of clinical remission with FMT in active UC.The prediction model can help in selecting individuals for FMT. Validation in larger cohorts is needed. Key Words: Faecal microbiota transplantation; ulcerative colitis; clinical prediction rules, disease extent, disease severity, Mayo clinic score, endoscopic Mayo score Downloaded from https://academic.oup.com/ecco-jcc/article/15/2/238/5890140 by guest on 22 September 2023