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Randomised Placebo-controlled Study of FMT to Impact Body Weight and Glycemic Control in Obese Subjects With T2DM

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ClinicalTrials.gov Identifier: NCT03127696
Recruitment Status : Recruiting
First Posted : April 25, 2017
Last Update Posted : June 15, 2018
Sponsor:
Information provided by (Responsible Party):
Siew Chien NG, Chinese University of Hong Kong

Brief Summary:
Faecal microbiota transplantation (FMT) represents a clinically feasible way to restore the gut microbial ecology, and has proven to be a breakthrough for the treatment of recurrent Clostridium difficile infection. Early results in human have shown that FMT from lean donor when transplanted into subjects with metabolic syndrome resulted in a significant improvement in insulin sensitivity and an increased in intestinal microbial diversity, including a distinct increase in butyrate-producing bacterial strains. The therapy is generally well tolerated and appeared safe. No clinical studies have assessed the efficacy of FMT in obese subjects with type 2 diabetes mellitus.

Condition or disease Intervention/treatment Phase
Type2 Diabetes Type 2 Diabetes Mellitus Obese Procedure: Fecal Microbiota Transplantation Behavioral: Lifestyle Modification Program Procedure: Sham Not Applicable

Detailed Description:

There is a worldwide epidemic of obesity and type 2 diabetes mellitus. The prevalence of obesity and type 2 diabetes mellitus continues to rise at an alarming rate. Weight loss is associated with reductions in risk of morbidity and mortality from obesity. Conventional non-pharmacological interventions based on diet and exercise showed limited long-term success in producing sustained weight loss. Although obese patients with type 2 diabetes mellitus may be treated by medications or by bariatric surgery, these alternatives are limited by incomplete resolution of the diseases, high cost or potential surgical-related morbidity. Further research focusing on increasing effectiveness of interventions and new ways to achieve weight loss in these individuals are needed.

Recently, accumulating evidence supports a role of the enteric microbiota in the pathogenesis of obesity-related insulin resistance. Obesity is associated with changes in the composition of the intestinal microbiota, and the obese microbiome appears to be more efficient in harvesting energy from the diet. Colonization of germ-free mice with an 'obese microbiota' results in a significantly greater increase in total body fat than colonization with a 'lean microbiota', suggesting gut microbiota as an additional contributing factor to the pathophysiology of obesity. Obese and lean phenotypes can also be induced in germ-free mice by transfer of fecal microbiota from human donors. These data have led to the use of microbiota therapeutics as a potential treatment for metabolic syndrome and obesity.

Clinical trials are being conducted to evaluate its use for other conditions. Early results in human have shown that FMT from lean donor when transplanted into subjects with metabolic syndrome resulted in a significant improvement in insulin sensitivity and an increased in intestinal microbial diversity, including a distinct increase in butyrate-producing bacterial strains. The therapy is generally well tolerated and appeared safe. No clinical studies have assessed the efficacy of FMT in obese subjects with type 2 diabetes mellitus.

No clinical studies have assessed the efficacy of FMT in obese subjects with type 2 diabetes mellitus.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Randomised Placebo-controlled Study of Fecal Microbiota Transplant (FMT) to Impact Body Weight and Glycemic Control in Obese Subjects With Type 2 Diabetes Mellitus
Actual Study Start Date : April 26, 2017
Estimated Primary Completion Date : April 30, 2020
Estimated Study Completion Date : September 30, 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: FMT + LMP
FMT and lifestyle modification program
Procedure: Fecal Microbiota Transplantation
FMT

Behavioral: Lifestyle Modification Program
Lifestyle

Experimental: FMT alone
Fecal Microbiota Transplantation
Procedure: Fecal Microbiota Transplantation
FMT

Sham Comparator: Sham + LMP
Sham and lifestyle modification program
Behavioral: Lifestyle Modification Program
Lifestyle

Procedure: Sham
Sham




Primary Outcome Measures :
  1. Proportion of at least 5% reduction in weight [ Time Frame: 24 weeks ]
    Determine the proportion of at least 5% reduction in weight compared with baseline weight at week 24


Secondary Outcome Measures :
  1. Proportion of subjects achieving at least 5% reduction in weight compared with baseline [ Time Frame: 52 weeks ]
    Proportion of subjects achieving at least 5% reduction in weight at 52 weeks

  2. Changes in waist circumference at weeks 24 and 52 compared with baseline [ Time Frame: 24 week and 52 week ]
    Compare the change in waist circumference among different treatment arms

  3. At least 5% decrease in waist to hip ratio [ Time Frame: 24 week and 52 week ]
    Compare the change in waist to hip ratio among different treatment arms

  4. At least 5% decrease in total body weight [ Time Frame: 24 week and 52 week ]
    Compare the change in total body weight among different treatment arms

  5. Changes in body weight to calculate body mass index (BMI) at weeks 24 and 52 compared with baseline [ Time Frame: 24 week and 52 week ]
    Compare the change in weight to calculate the BMI among different treatment arms

  6. Changes in biochemical parameters [ Time Frame: 24 week and 52 week ]
    Compare the change in biochemical parameters among different treatment arms at weeks 24 and 52 compared with baseline



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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18-70; and
  • BMI >=28 kg/m2 and < 45 kg/m2; and
  • A diagnosis of Type 2 diabetes mellitus for >=3 months; and
  • Written informed consent obtained

Exclusion Criteria:

  • Current pregnancy
  • Use of any weight loss medications in the preceding 1 year
  • Known history or concomitant significant gastrointestinal disorders (including Inflammatory Bowel Disease, current colorectal cancer, current GI infection)
  • Known history or concomitant significant food allergies
  • Immunosuppressed subjects
  • Known history of severe organ failure (including decompensated cirrhosis), inflammatory bowel disease, kidney failure, epilepsy, acquired immunodeficiency syndrome
  • Current active sepsis
  • Active malignant disease in recent 2 years
  • Known contraindications to oesophago-gastro-duodenoscopy (OGD)
  • Use of probiotic or antibiotics in recent 3 months

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03127696


Contacts
Contact: Amy LI +852 26373225 amyli@cuhk.edu.hk
Contact: Whitney TANG +852 35051519 whitneytang@cuhk.edu.hk

Locations
Hong Kong
The Chinese University of Hong Kong Recruiting
Sha Tin, Hong Kong, 000000
Contact: Siew Chien Ng, PhD    35053996    siewchienng@cuhk.edu.hk   
Sponsors and Collaborators
Chinese University of Hong Kong
Investigators
Principal Investigator: Siew NG, Prof. Chinese University of Hong Kong

Publications:

Responsible Party: Siew Chien NG, Professor, Chinese University of Hong Kong
ClinicalTrials.gov Identifier: NCT03127696     History of Changes
Other Study ID Numbers: FMT-DM-RCT study
First Posted: April 25, 2017    Key Record Dates
Last Update Posted: June 15, 2018
Last Verified: June 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Siew Chien NG, Chinese University of Hong Kong:
Fecal Microbiota Transplant

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Body Weight
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Signs and Symptoms