Table 3

Summary of studies of FMT in non-CDI conditions

Study conditionSummary of outcomes from clinical studies
Inflammatory bowel diseaseFour randomised studies have collectively demonstrated FMT to be relatively safe and effective in inducing remission in mild-to-moderate UC. However, the relatively small size of trials and heterogeneity in their design has limited interpretability and applicability, and FMT is not currently recommended for this indication.74
Primary sclerosing cholangitis87 In a pilot study, 3/10 patients receiving FMT experienced a ≥50% decrease in ALP levels. There was correlation between bacterial taxa in the stool microbiome post-FMT and ALP levels.
Obesity88 In patients with obesity (but no other features of metabolic syndrome), no weight loss or change in GLP-1 levels were seen after FMT. However, stool microbiome and bile acid profiles were altered.
Metabolic syndrome89–91 FMT was associated with a transient improvement in peripheral insulin resistance, but this was not sustained. Furthermore, FMT from patients with metabolic syndrome into recipients with metabolic syndrome themselves resolved in transient worsening of insulin resistance.
Autism92
Intestinal decolonisation of multidrug-resistant organisms93 There are a growing number of case reports and case series suggesting that FMT may decolonise multidrug-resistant bacteria from the gut; however, a randomised controlled trial showed no difference in decolonisation rates between patients receiving FMT and those receiving no intervention.
Hepatic encephalopathy37 Patients receiving FMT (while receiving lactulose and rifaximin) may have fewer hospital admissions with encephalopathy compared with those receiving medical therapy alone.
Irritable bowel syndrome84 85 Variable results in the randomised studies performed to date, with overall disappointing outcomes. However, this may reflect heterogeneity of study design.
  • ALP, alkaline phosphatase; CDI, Clostridioides difficile infection; FMT, faecal microbiota transplant; GLP-1, glucagon-like peptide-1; UC, ulcerative colitis.