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Active, not recruitingNCT03524352POCAUpdated Feb 17, 2026

the Prophylaxis of Recurrent Pouchitis After Fecal Microbiota Transplant in UC With Ileo-anal Anastomosis

A Phase 3 interventional study of fecal microbiota and Placebo in Pouchitis, sponsored by Nantes University Hospital. Active, not recruiting at 13 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-02-17.

Sponsored by Nantes University Hospital · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
42
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Ulcerative colitis (UC) is a chronic inflammatory digestive (IBD) disease medically treated with corticosteroids, aminosalicylates, immunomodulators, and biologics. Almost one third of UC patients will require surgical interventions because of fulminant colitis, dysplasia, cancer, or medical refractory diseases. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the current standard surgical intervention. Anastomotic leak, pouch failure, pelvic sepsis, and pouch ischemia can occur after the procedure, but the most common long-term complication is pouchitis, an idiopathic inflammatory condition involving the ileal reservoir. Symptoms of pouchitis are increased stool frequency, urgency, incontinence, bloody stools, abdominal or pelvic discomfort, fatigue, malaise, and fever. The prevalence of pouchitis ranges from 23 to 46 %, with an annual incidence up to 40 %. Though the majority of initial cases of pouchitis are easily managed with a short course of antibiotics, in about 5 to 15 % of cases, inflammation of the pouch becomes chronic with very few treatments available.

Fecal microbiota transplantation (FMT) is a novel therapy to transfer normal intestinal flora from a healthy donor to a patient with a medical condition potentially caused by disrupted homeostasis of intestinal microbiota or dysbiosis. FMT has been widely used in refractory Clostridium difficile infection (CDI) and recently it has gained popularity for treatment of inflammatory bowel disease (IBD). Previous studies suggested that manipulating the composition of intestinal flora through antibiotics, probiotics, and prebiotic achieved significant results for treating acute episodes of UC-associated pouchitis. However, currently there is no established effective treatment for chronic antibiotic dependent pouchitis. Our project aims to evaluate the delay of relapse in chronic recurrent pouchitis after FMT versus sham transplantation.

02

Conditions studied

  • Pouchitis

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Keywords

  • recurrent pouchitis
  • fecal microbiota transplant
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

4.2. INCLUSION CRITERIA

Subjects must satisfy the following criteria to be enrolled in the study:

  1. Male or female ≥ 18 years at the time of signing the informed consent form (ICF).
  2. Subject must understand and voluntarily sign an ICF prior to conduct the study related assessments/procedure.
  3. Willing and able to adhere to the study visit scheduled and other protocol requirements.
  4. Subjects must have been operated with ileal pouch anal anastomosis (IPAA) with a duration of at least 6 month prior the screening visit.
  5. Subject must have a diagnosis of recurrent pouchitis defined as at least 2 episodes in the last year or relapsing immediately after a reasonable response to antibiotherapy (the antifungal medication is allowed until the day before transplantation).
  6. Subject must be in remission with a Pouchitis Disease Activity Index (PDAI) \< 7 at the screening
  7. Subject must affiliation with social security system or beneficiary from such system
  8. Female of childbearing potential must have a negative pregnancy test at screening and must agree to practice effective methods of contraception

4.3. NON-INCLUSION CRITERIA

Subjects who meet any of the following non inclusion criteria could not be enrolled in this study:

  1. Crohn disease or indeterminate colitis
  2. Anastomotic stenosis
  3. Subject with prior treatment by probiotic within 3 month prior to the transplantation visit
  4. Subject with prior treatment by corticosteroids within 6 weeks prior to the transplantation visit
  5. Subject with prior treatment by immunosuppressors within 3 month prior to the transplantation visit unless treatment has been introduced for more than 8 weeks at a stable dose.
  6. Prior treatment with a biologic within 3 month prior the transplantation visit unless treatment has been introduced for more than 8 weeks at a stable dose.
  7. Documented active infection of any kind in the last 6 months likely to require anti-infective treatment during the next months
  8. Absolute neutrophil count (ANC) \< 1.5 x 109 /L (1,500 mm3)
  9. Infection with chronic HIV
  10. Pregnant female or breastfeeding
  11. Chronic medical or psychiatric disease that may interfere with subject's ability to comply with study procedures
  12. Administration of investigational drug within 3 months prior to planned FMT
  13. Adults under guardianship, Safeguard justice or trusteeship
  14. Subject with difficulty in follow-up (vacation, job transfer, geographical distance, lack of motivation).
  15. Patients with contraindication to colonoscopy or anesthesia (if necessary)
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
42 participants (estimated)

Study arms

  • Experimental
    fecal microbiota

    Other: fecal microbiota

  • Placebo comparator
    placebo

    Other: Placebo

Interventions

  • Otherfecal microbiota

    fecal microbiota in suspension

  • OtherPlacebo

    sterile saline

05

What researchers measure

Primary outcomes

  1. Number of days between the date of transplantation and the date of relapse according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 106 weeks

Secondary outcomes

  1. Number of relapse rate according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 24 weeks

  2. Number of relapse rate according to pochitis disease activity index (physiological and endoscopic parameter)

    Time frame: 52 weeks

  3. Number of days within the transplantation and the instauration of an antibiotherapy or alternative treatment

    Time frame: 52 weeks

  4. Number of adverse events

    Time frame: 104 weeks

  5. Number of fecal microbiota engraftment by 16S sequencing

    Time frame: 8 weeks

  6. Number of evolution of health-related to disability according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: weeks -5

  7. Number of evolution of health-related to disability according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 0 week

  8. Number of evolution of health-related to disability according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 8 weeks

  9. Number of evolution of health-related to disability according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 24 weeks

  10. Number of evolution of health-related to disability according to physiological and endoscopic parameter (pochitis disease activity index)

    Time frame: 52 weeks

06

Study locations

13 sites
  • CHU Angers
    Angers, France
  • CHU Estaing
    Clermont-Ferrand, France
  • Hopital Beaujon, Clichy
    Clichy, France
  • CHU Henry Mondor
    Créteil, France
  • CHU Claude Huriez
    Lille, France
  • CHU Lyon Sud
    Lyon, France
  • CHRU Nancy
    Nancy, France
  • CHU of Nantes
    Nantes, France
  • CHU de l'Archet 2
    Nice, France
  • Hopital Saint Antoine
    Paris, France
  • Groupe Hospitalier Sud- Hopital Haut-lévêque
    Pessac, France
  • CHU Pontchaillou
    Rennes, France
  • CHU Toulouse
    Toulouse, France
07

References and documents

Publications

  • Trang-Poisson C, Kerdreux E, Poinas A, Planche L, Sokol H, Bemer P, Cabanas K, Hivernaud E, Biron L, Flet L, Montassier E, Le Garcasson G, Chiffoleau A, Jobert A, Lepelletier D, Caillon J, Le Pape P, Imbert BM, Bourreille A. Impact of fecal microbiota transplantation on chronic recurrent pouchitis in ulcerative colitis with ileo-anal anastomosis: study protocol for a prospective, multicenter, double-blind, randomized, controlled trial. Trials. 2020 Jun 3;21(1):455. doi: 10.1186/s13063-020-04330-1. PubMed 32493442 ↗
08

Registry details

Key details

Study ID
NCT03524352
Lead sponsor
Nantes University Hospital
Responsible party
Sponsor
First posted
May 14, 2018
Start date
Mar 12, 2020
Primary completion
May 12, 2028 (estimated)
Completion
May 12, 2028 (estimated)
Last update
Feb 17, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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