The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey

Simon Mark Dahl Baunwall; Elisabeth M. Terveer; Jens Frederik Dahlerup; Christian Erikstrup; Perttu Arkkila; Maria JGT Vehreschild; Gianluca Ianiro; Antonio Gasbarrini; Harry Sokol; Patrizia K. Kump; Reetta Satokari; Danny De Looze; Séverine Vermeire; Radislav Nakov; Jan Brezina; Morten Helms; Jens Kjeldsen; Anne A. Rode; Sabrina Just Kousgaard; Laurent Alric; Caroline Trang-Poisson; Julien Scanzi; Alexander Link; Andreas Stallmach; Juozas Kupcinskas; Peter Holger Johnsen; Kjetil Garborg; Eugenia Sánchez Rodríguez; Lena Serrander; Robert J. Brummer; Katerina Tatiana Galpérine; Simon D. Goldenberg; Benjamin H. Mullish; Horace RT Williams; Tariq H. Iqbal; Cyriel Ponsioen; Ed J. Kuijper; Giovanni Cammarota; Josbert J. Keller; Christian Lodberg Hvas

doi:10.1016/j.lanepe.2021.100181

The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey

Simon Mark Dahl Baunwall, Elisabeth M. Terveer, Jens Frederik Dahlerup, Christian Erikstrup, Perttu Arkkila, Maria JGT Vehreschild, Gianluca Ianiro, Antonio Gasbarrini, Harry Sokol, Patrizia K. Kump, Reetta Satokari, Danny De Looze, Séverine Vermeire, Radislav Nakov, Jan Brezina, Morten Helms, Jens Kjeldsen, Anne A. Rode, Sabrina Just Kousgaard, Laurent AlricCaroline Trang-Poisson, Julien Scanzi, Alexander Link, Andreas Stallmach, Juozas Kupcinskas, Peter Holger Johnsen, Kjetil Garborg, Eugenia Sánchez Rodríguez, Lena Serrander, Robert J. Brummer, Katerina Tatiana Galpérine, Simon D. Goldenberg, Benjamin H. Mullish, Horace RT Williams, Tariq H. Iqbal, Cyriel Ponsioen, Ed J. Kuijper, Giovanni Cammarota, Josbert J. Keller, Christian Lodberg Hvas^*

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Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10–64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100–28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need. Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056–00006B).

Originalsprog	Engelsk
Artikelnummer	100181
Tidsskrift	The Lancet Regional Health - Europe
Vol/bind	9
ISSN	2666-7762
DOI	https://doi.org/10.1016/j.lanepe.2021.100181
Status	Udgivet - okt. 2021

Bibliografisk note

Funding Information:
Maria Vehreschild reports research grants from 3 M, Astellas Pharma, Biontech, DaVolterra, Evonik, Gilead Sciences, Glycom, Immunic, MaaT Pharma, Merck/MSD, Organobalance, Seres Therapeutics, Takeda Pharmaceutical, and speaker fees and/or consulting from Alb Fils Kliniken GmbH, Arderypharm, Astellas Pharma, Basilea, Bio-Mérieux, DaVolterra, Farmak International Holding GmbH, Ferring, Gilead Sciences, Immunic AG, MaaT Pharma, Merck/MSD, Pfizer, Roche, Organobalance, and SocraTec R&D GmbH.

Funding Information:
Cyriel Ponsioen reports grant support form Takeda, consultancy fees from Takeda, Shire, and Pliant, and speaker's fees from Tillotts and Pfizer.

Funding Information:
Elisabeth Terveer and Ed Kuijper reports research grants from Vedanta Bioscience, Boston.

Funding Information:
Simon D. Goldenberg reports Consultancy fees from Astellas, Enterobiotix, Menarini, MSD, Pfizer, Shionogi and research grants from Shionogi.

Funding Information:
This study was funded by NordForsk under the Nordic Council and the Innovation Fund Denmark (j.no. 8056–00006B). The funding was independent of the study conduct. BHM is the recipient of an NIHR Academic Clinical Lectureship (CL-2019-21-002). The Department of Metabolism, Digestion and Reproduction at Imperial College London receives financial and infrastructure support from the NIHR Imperial Biomedical Research Centre (BRC) based at Imperial College Healthcare NHS Trust and Imperial College London

Funding Information:
The authors thank Stefan Haraldsson, MD, at the Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland for contributing data to the study. Data are available upon request in blinded format, respecting the anonymity of each institution. This study was funded by NordForsk under the Nordic Council and the Innovation Fund Denmark (j.no. 8056?00006B). The funding was independent of the study conduct. BHM is the recipient of an NIHR Academic Clinical Lectureship (CL-2019-21-002). The Department of Metabolism, Digestion and Reproduction at Imperial College London receives financial and infrastructure support from the NIHR Imperial Biomedical Research Centre (BRC) based at Imperial College Healthcare NHS Trust and Imperial College London

Publisher Copyright:
© 2021 The Authors

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10.1016/j.lanepe.2021.100181Licens: CC BY-NC-ND 4.0

Baunwall et al. (2021). The use of Faecal Microbiota Transplantation (FMT) in Europe - A Europe-wide surveyForlagets udgivne version, 622 KBLicens: CC BY-NC-ND 4.0

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Baunwall, S. M. D., Terveer, E. M., Dahlerup, J. F., Erikstrup, C., Arkkila, P., Vehreschild, M. JGT., Ianiro, G., Gasbarrini, A., Sokol, H., Kump, P. K., Satokari, R., De Looze, D., Vermeire, S., Nakov, R., Brezina, J., Helms, M., Kjeldsen, J., Rode, A. A., Kousgaard, S. J., ... Hvas, C. L. (2021). The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey. The Lancet Regional Health - Europe, 9, Artikel 100181. https://doi.org/10.1016/j.lanepe.2021.100181

@article{4f49c2a785dd4f0a93375384fd58d504,

title = "The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey",

abstract = "Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10–64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100–28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need. Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056–00006B).",

keywords = "Clostridioides difficile, Faecal microbiota transplantation, FMT, Stool banking",

author = "Baunwall, {Simon Mark Dahl} and Terveer, {Elisabeth M.} and Dahlerup, {Jens Frederik} and Christian Erikstrup and Perttu Arkkila and Vehreschild, {Maria JGT} and Gianluca Ianiro and Antonio Gasbarrini and Harry Sokol and Kump, {Patrizia K.} and Reetta Satokari and {De Looze}, Danny and S{\'e}verine Vermeire and Radislav Nakov and Jan Brezina and Morten Helms and Jens Kjeldsen and Rode, {Anne A.} and Kousgaard, {Sabrina Just} and Laurent Alric and Caroline Trang-Poisson and Julien Scanzi and Alexander Link and Andreas Stallmach and Juozas Kupcinskas and Johnsen, {Peter Holger} and Kjetil Garborg and Rodr{\'i}guez, {Eugenia S{\'a}nchez} and Lena Serrander and Brummer, {Robert J.} and Galp{\'e}rine, {Katerina Tatiana} and Goldenberg, {Simon D.} and Mullish, {Benjamin H.} and Williams, {Horace RT} and Iqbal, {Tariq H.} and Cyriel Ponsioen and Kuijper, {Ed J.} and Giovanni Cammarota and Keller, {Josbert J.} and Hvas, {Christian Lodberg}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2021",

month = oct,

doi = "10.1016/j.lanepe.2021.100181",

language = "English",

volume = "9",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier",

}

Baunwall, SMD, Terveer, EM, Dahlerup, JF, Erikstrup, C, Arkkila, P, Vehreschild, MJGT, Ianiro, G, Gasbarrini, A, Sokol, H, Kump, PK, Satokari, R, De Looze, D, Vermeire, S, Nakov, R, Brezina, J, Helms, M, Kjeldsen, J, Rode, AA, Kousgaard, SJ, Alric, L, Trang-Poisson, C, Scanzi, J, Link, A, Stallmach, A, Kupcinskas, J, Johnsen, PH, Garborg, K, Rodríguez, ES, Serrander, L, Brummer, RJ, Galpérine, KT, Goldenberg, SD, Mullish, BH, Williams, HRT, Iqbal, TH, Ponsioen, C, Kuijper, EJ, Cammarota, G, Keller, JJ & Hvas, CL 2021, 'The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey', The Lancet Regional Health - Europe, bind 9, 100181. https://doi.org/10.1016/j.lanepe.2021.100181

TY - JOUR

T1 - The use of Faecal Microbiota Transplantation (FMT) in Europe

T2 - A Europe-wide survey

AU - Baunwall, Simon Mark Dahl

AU - Terveer, Elisabeth M.

AU - Dahlerup, Jens Frederik

AU - Erikstrup, Christian

AU - Arkkila, Perttu

AU - Vehreschild, Maria JGT

AU - Ianiro, Gianluca

AU - Gasbarrini, Antonio

AU - Sokol, Harry

AU - Kump, Patrizia K.

AU - Satokari, Reetta

AU - De Looze, Danny

AU - Vermeire, Séverine

AU - Nakov, Radislav

AU - Brezina, Jan

AU - Helms, Morten

AU - Kjeldsen, Jens

AU - Rode, Anne A.

AU - Kousgaard, Sabrina Just

AU - Alric, Laurent

AU - Trang-Poisson, Caroline

AU - Scanzi, Julien

AU - Link, Alexander

AU - Stallmach, Andreas

AU - Kupcinskas, Juozas

AU - Johnsen, Peter Holger

AU - Garborg, Kjetil

AU - Rodríguez, Eugenia Sánchez

AU - Serrander, Lena

AU - Brummer, Robert J.

AU - Galpérine, Katerina Tatiana

AU - Goldenberg, Simon D.

AU - Mullish, Benjamin H.

AU - Williams, Horace RT

AU - Iqbal, Tariq H.

AU - Ponsioen, Cyriel

AU - Kuijper, Ed J.

AU - Cammarota, Giovanni

AU - Keller, Josbert J.

AU - Hvas, Christian Lodberg

PY - 2021/10

Y1 - 2021/10

N2 - Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10–64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100–28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need. Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056–00006B).

AB - Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10–64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100–28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need. Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056–00006B).

KW - Clostridioides difficile

KW - Faecal microbiota transplantation

KW - FMT

KW - Stool banking

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U2 - 10.1016/j.lanepe.2021.100181

DO - 10.1016/j.lanepe.2021.100181

M3 - Journal article

C2 - 34693388

AN - SCOPUS:85111661064

SN - 2666-7762

VL - 9

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 100181

ER -

The use of Faecal Microbiota Transplantation (FMT) in Europe: A Europe-wide survey

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