{"id":7353,"date":"2023-04-21T09:09:02","date_gmt":"2023-04-21T08:09:02","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=7353"},"modified":"2023-04-21T09:09:02","modified_gmt":"2023-04-21T08:09:02","slug":"a-pilot-study-on-the-effect-of-colesevelam-on-the-microbiome-in-primary-terminal-ileal-resected-crohns-disease-2023","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2023\/04\/21\/a-pilot-study-on-the-effect-of-colesevelam-on-the-microbiome-in-primary-terminal-ileal-resected-crohns-disease-2023\/","title":{"rendered":"A Pilot Study on the Effect of Colesevelam on the Microbiome in Primary Terminal Ileal Resected Crohn's Disease (2023)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\nKumar A.; Quraishi M.N.; Al-Hassi H.O.; Elasrag M.; Segal J.P.; Jain M.; Steed H.; *Butterworth J.; Farmer A.; McLaughlin J.; Beggs A.; Brookes M.<\/p>\n

Citation:<\/strong>
\nJournal of Crohn's and Colitis. Conference: 18th Congress of European Crohn's and Colitis Organisation, ECCO 2023. Copenhagen Denmark. 17(Supplement 1) (pp i532), 2023. Date of Publication: February 2023<\/p>\n

Abstract:<\/strong>
\nBackground: Surgery plays a pivotal role in ileal Crohn's disease despite the risk of endoscopic recurrence following an ileocaecal resection greater than 65% within 12 months of surgery. More than 90% of Crohn's patients have a concomitant diagnosis of bile acid diarrhoea following an ileal resection. This pilot study aimed to assess whether the use of bile acid sequestrants in post-operative Crohn's patients with bile acid diarrhoea can alter the microbiome and prevent disease recurrence. Method(s): Post-operative Crohn's patients with symptoms of diarrhoea underwent 75SeHCAT testing for bile acid diarrhoea. If positive (75SeHCAT < 15%), patients were treated with colesevelam and stool samples were collected at 4-weeks, 8-weeks and 6-12 months posttreatment. If negative (75SeHCAT > 15%), treatment was not given and were reviewed in clinic as per local guidelines. Patients underwent a 6-12 months post-operative colonoscopy where mucosal biopsies were taken. Disease activity was established using the endoscopic Rutgeert's score, with disease remission defined as Rutgeerts score < i2 and disease recurrence 3 i2. Faecal and mucosal 16S ribosomal RNA gene analysis was undertaken to assess a\/b-diversity and microbial composition. Result(s): A total of 44 faecal samples and 44 mucosal biopsies were sequenced from 14 patients. 1\/10 patients on colesevelam and 2\/4 patients not on colesevelam demonstrated disease recurrence. There was no significant difference in a\/b-diversity pre- and post-treatment. Pre-treatment, the three most abundant bacterial classes in all patients were Bacteroidia, Clostridia and Gammaproteobacteria (Figure 1). Following 6-12 months of treatment, out of the 9 patients on colesevelam, 5\/9 (55.6%) had a reduction in Bacteroidia, 9\/9 (100%) had an increase in Clostridia, and 7\/9 (77.8%) had a reduction in Gammaproteobacteria. Of the two patients not given colesevelam, 1\/2 (50%) showed a reduction in Bacteroidia, increase in Clostridia and a reduction in Gammaproteobacteria. Conclusion(s): This small pilot study demonstrated that patients who were given colesevelam, a bile acid sequestrant, were more likely to be in disease remission at their 6-12 months colonoscopy review. Furthermore, treatment with colesevelam may have a role in altering the microbiome to help maintain remission states in post-operative Crohn's disease. Larger mechanistic studies are now needed to confirm these findings and demonstrate statistical significance.<\/p>\n

Link to full-text<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Kumar A.; Quraishi M.N.; Al-Hassi H.O.; Elasrag M.; Segal J.P.; Jain M.; Steed H.; *Butterworth J.; Farmer A.; McLaughlin J.; Beggs A.; Brookes M. Citation: Journal of Crohn's and Colitis. Conference: 18th Congress of…<\/span><\/p>\n

Read more A Pilot Study on the Effect of Colesevelam on the Microbiome in Primary Terminal Ileal Resected Crohn's Disease (2023)<\/span> ›<\/span><\/a><\/div>\n

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