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Intestinal Graft Versus Host DiseasePhase 1NCT05067595

Fecal Microbiota Transplant and Dietary Fiber Supplementation for the Treatment of Gut Graft Versus Host Disease

A Phase 1 study testing Colonoscopy, Fecal Microbiota Transplantation and Nutritional Supplementation in people with Intestinal Graft Versus Host Disease, run by Fred Hutchinson Cancer Center at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This phase I trial studies how well fecal microbiota transplant and dietary fiber supplementation work in treating patients with gut graft versus host disease. Fecal microbiota transplant entails inoculating donor stool into a recipient's gastrointestinal tract. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Intestinal Graft Versus Host Disease
What is being tested?
Colonoscopy, Fecal Microbiota Transplantation and Nutritional Supplementation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
72 participants
Where
1 siteUnited States
Study dates
24 Jan 2025to 31 Dec 2027
Phase
Phase 1
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years of age or older
  • History of allogeneic hematopoietic stem cell transplant in the past 365 days
  • Post-engraftment, defined by time period following three consecutive days of sustained neutrophil engraftment with an absolute neutrophil count of at least 500 cells/mm^3
  • Mild to severe acute GI GvHD, at least stage 1, as measured by one of the following:
  • Modified Glucksberg criteria for GI GvHD averaged over 3 consecutive days and without another explanation for diarrhea such as laxative use or infection. In patients who have already had GI biopsy, biopsy histology must be compatible with GVHD, although biopsy is not required
  • Biopsy evidence of GI GVHD in the upper or lower GI tract

Who cannot join

  • History of previous serious adverse events associated with FMT
  • History of bowel perforation in the last 90 days
  • History of gastrointestinal resection in the last 90 days
  • History of small bowel obstruction without surgical intervention in the last 30 days, or 90 days with surgery, or history of large bowel obstruction in last 90 days
  • History of diverticulitis in the last 60 days
  • History of celiac disease confirmed by serologic testing or small bowel biopsy
Show all 13Show fewer
  • History of severe dietary allergy as designated by World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System grade 2 or more
  • Subjects who are cytomegalovirus (CMV) seronegative at the time of enrollment as indicated by clinical testing unless the fecal microbiota transplant (FMT) donor is CMV seronegative with negative plasma polymerase chain reaction (PCR) assays for CMV.
  • Known allergies to loperamide, sodium chloride, glycerol, theobroma oil, hide bovine gelatin, sodium lauryl sulfate, colorants FD\&C, titanium dioxide, polyethylene glycol, sodium sulfate, sodium bicarbonate, sodium phosphate, benzalkonium chloride, disodium EDTA or potassium chloride.
  • Currently pregnant, planning to become pregnant or breastfeeding during the study period. Women of childbearing potential (those who are not post-menopausal or post-hysterectomy) must be negative for pregnancy per urine pregnancy test at enrollment
  • Individuals with the ability to conceive children who are not willing to abstain from sexual activity or use an effective form of birth control during the duration of the study
  • Unwilling or unable to participate in study procedures including oral intake of FMT, colonoscopy, fiber supplementation, collection of stool samples and completion study surveys
  • Cannot reasonably and safely participate in the study in the opinion of the investigators

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

David Fredricks contact

206.667.1935

dfredric@fredhutch.org

United States1 site, 1 recruiting
  • Fred Hutch/University of Washington Cancer Consortium

    Seattle, Washington, 98109

    David Fredricks, 206-667-1935, dfredric@fredhutch.org

    David Fredricks

    Recruiting

Other trials in United States

About this study

Official title: A Randomized, Controlled, Phase I Study of Fecal Microbiota Transplant and Dietary Fiber Supplementation in Graft Versus Host Disease

This phase I trial studies how well fecal microbiota transplant and dietary fiber supplementation work in treating patients with gut graft versus host disease. Fecal microbiota transplant entails inoculating donor stool into a recipient's gastrointestinal tract. Changing the gut microbiome by fecal microbiota transplant and fiber supplementation may help treat gut graft versus host disease.

Read the detailed description

OUTLINE: Patients are randomized to 1 of 4 arms.

ARM I: Patients receive upper FMT capsules orally (PO) over 5 days or via post-pyloric or nasogastric (NG) feeding tube over 2 days.

ARM II: Patients undergo lower FMT via colonoscopy on day 0.

ARM III: Patients receive upper FMT capsules PO over 5 days or via post-pyloric or NG feeding tube over 2 days. Patients also receive fiber supplementation PO or via post-pyloric or NG feeding tube from the first day of FMT administration and up to 6 weeks post FMT.

ARM IV: Patients undergo lower FMT via colonoscopy on day 0. Patients also receive fiber supplementation PO or via post-pyloric or NG feeding tube from day 0 up to 6 weeks post FMT.

Patients also undergo tissue, stool, stool swabs, and blood sample collection throughout the study.

After completion of study treatment, patients are followed up for 365 days.

Being tested
Colonoscopy, Fecal Microbiota Transplantation, Nutritional Supplementation, Survey Administration, Biospecimen Collection

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ColonoscopyProcedure or surgery

    Undergo lower FMT via colonoscopy

  • Fecal Microbiota TransplantationBiological

    Also called Fecal Material Transplantation, Fecal Transplantation, FMT, Poo Transplant

    Given upper FMT PO or via post-pyloric or NG feeding tube

  • Fecal Microbiota TransplantationBiological

    Also called Fecal Material Transplantation, Fecal Transplantation, FMT, Poo Transplant

    Undergo lower FMT via colonoscopy

  • Nutritional SupplementationDietary supplement

    Also called Supplementation

    Given dietary fiber supplementation PO or via post-pyloric or NG feeding tube

  • Survey AdministrationOther

    Ancillary studies

  • Biospecimen CollectionProcedure or surgery

    Also called Biological Sample Collection

    Undergo tissue, stool, stool swabs, and blood sample collection

Study groups in NCT05067595
Study groupRoleWhat they receive
Arm I (upper FMT)ExperimentalPatients receive upper FMT capsules PO over 5 days or via post-pyloric or NG feeding tube over 2 days. Patients also undergo tissue, stool, stool swabs, and blood sample collection throughout the study.
Receives: Biological: Fecal Microbiota Transplantation; Other: Survey Administration; Procedure: Biospecimen Collection
Arm II (Lower FMT)ExperimentalPatients undergo lower FMT via colonoscopy on day 0. Patients also undergo tissue, stool, stool swabs, and blood sample collection throughout the study.
Receives: Procedure: Colonoscopy; Biological: Fecal Microbiota Transplantation; Other: Survey Administration; Procedure: Biospecimen Collection
Arm III (upper FMT, fiber supplementation)ExperimentalPatients receive upper FMT capsules PO over 5 days or via post-pyloric or NG feeding tube over 2 days. Patients also receive fiber supplementation PO or via post-pyloric or NG feeding tube from the first day of FMT administration and up to 6 weeks post FMT. Patients also undergo tissue, stool, stool swabs, and blood sample collection throughout the study.
Receives: Biological: Fecal Microbiota Transplantation; Dietary Supplement: Nutritional Supplementation; Other: Survey Administration; Procedure: Biospecimen Collection
Arm IV (Lower FMT, fiber supplementation)ExperimentalPatients undergo lower FMT via colonoscopy on day 0. Patients also receive fiber supplementation PO or via post-pyloric or NG feeding tube from day 0 up to 6 weeks post FMT. Patients also undergo tissue, stool, stool swabs, and blood sample collection throughout the study.
Receives: Procedure: Colonoscopy; Biological: Fecal Microbiota Transplantation; Dietary Supplement: Nutritional Supplementation; Other: Survey Administration; Procedure: Biospecimen Collection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Bacterial composition of stool

    Analyses will consist of summary statistics of the bacterial diversity in the microbiome (e.g., the alpha diversity, the abundance of bacterial species associated with protection from graft versus host disease [GvHD]).

    Measured: At baseline

  2. Bacterial genes in stool

    Specifically abundance of genes related to fiber fermentation and short chain fatty acids production metabolites in stool, specifically short chain fatty acids will be assessed.

    Measured: At baseline

  3. Incidence of adverse events

    Will by assessed by computing the total number of adverse events (AE)s and serious adverse events (SAE)s, the number per patient, and the number of patients with at least one event. The type of AE/SAE and whether the AE/SAE is related to the fecal microbiota transplant (FMT) or not will be tabulated. These summaries will be computed overall as well as by randomization arm and stratification factor (steroid-responsive, versus steroid-dependent or -refractory disease status). The odds will be compared of at least one SAE per patient by randomization arm and stratification factor using logistic regression with independent variables for route of FMT administration, fiber supplementation, and steroid-responsive, versus steroid-dependent or -refractory disease status. Interaction terms will be considered between these factors and may use exact or firth logistic regression in the event that some categories have zero patients with a SAE.

    Measured: Up to 3 years

Secondary outcomes (8)
  1. Complete response (CR) after the initial FMT

    Will be defined by stage 0 on the Modified Glucksberg GvHD scale, without abdominal pain or hematochezia. To account for variability in this measure, patient stool volume (inpatients only) and survey data (both inpatients and outpatients) from days 25-27 will be used to determine whether patients meet these criteria or not. Inpatients will be a compare measured stool volumes to those reported via survey, to assess how well the survey data may serve as a surrogate for stool volume. Subjects who die before day 28 will be counted as no CR. The number and proportion of patients with CR by steroid-responsive, versus steroid-dependent or -refractory disease status, and each randomization arm (route of FMT administration and receipt of fiber supplementation) as well as within combinations of these factors will be computed. To test for differences in CR by these factors, logistic regression models similar to those described above for SAE comparisons.

    Measured: At day 28

  2. CR or partial response (PR) after the initial FMT

    Will be assessed by CR or PR at day 28 will use similar analysis methods as to the CR at day 28 outcome analysis.

    Measured: At day 28

  3. Gut and overall GvHD grade

    Will be assessed using the Modified Glucksberg scale measurements at baseline and throughout follow-up to summarize decrease in stool volume. For both of these ordinal outcomes (GvHD grade and Modified Glucksberg scale stage), descriptive statistics and graphical summaries to show changes over time by stratification factor and randomization arm. Generalized linear mixed effects models to test for differences in these outcomes by stratification factor and randomization arm.

    Measured: Up to 6 months

  4. Six-month survival

    Will be evaluated using Kaplan-Meier curves and Cox proportional hazards regression with independent variables for the steroid- responsive, versus steroid-dependent or - refractory disease and randomization arm as specified in previous models.

    Measured: At 6 months

  5. Quality of life

    Will be summarized at baseline and during study using descriptive statistics.

    Measured: Up to 3 years

  6. Decrease in stool volume

    Measured: Up to 6 months

  7. Levels of MAIT cells in the periphery

    Will be assessed using plot cell counts and percentage of lymphocytes for MAIT cells over time to compare longitudinal patterns by study arm and stratification factor. Mann-Whitney tests will be used to evaluate differences in cell counts and percentage of lymphocytes for MAIT cells in recipients of upper versus lower FMT, and individuals who receive fiber supplementation versus those who do not at specific time points post-FMT. Linear mixed effects models may be used to test for differences in longitudinal patterns of these outcomes by randomization arm and stratification factor.

    Measured: Up to 6 months

  8. Levels of Treg cells in the periphery

    Will be assessed using plot cell counts and percentage of lymphocytes for Treg cells over time to compare longitudinal patterns by study arm and stratification factor. Mann-Whitney tests will be used to evaluate differences in cell counts and percentage of lymphocytes for Tregs in recipients of upper versus lower FMT, and individuals who receive fiber supplementation versus those who do not at specific time points post-FMT. Linear mixed effects models may be used to test for differences in longitudinal patterns of these outcomes by randomization arm and stratification factor.

    Measured: Up to 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Oct 2021
  2. Study start24 Jan 2025
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
72 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05067595
Sponsor's protocol ID
RG1006202
Other IDs
NCI-2019-07698, 10276, 1R01HL166107
Status last verified
Sep 2026
First submitted
10 Dec 2019
Last updated
11 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Colonoscopy, Fecal Microbiota Transplantation and Nutritional Supplementation in people with Intestinal Graft Versus Host Disease, run by Fred Hutchinson Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact David Fredricks (206.667.1935, dfredric@fredhutch.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Bacterial composition of stool (time frame: At baseline). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Sep 2026.

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