Dr Allegretti discusses her research into fecal microbiota transplantation in patients with inflammatory bowel disease and Clostridioides difficile infection, for which she has been recognized with the Sherman Emerging Leader Prize.

Jessica Allegretti, MD, is associate director of the Crohn's and Colitis Center and director of the Fecal Microbiota Transplant program at Brigham and Women's Hospital in Boston, Massachusetts. 

TRANSCRIPT

Hi, everyone. My name is Jessica Allegretti. I am the associate director of the Crohn's and Colitis Center at Brigham and Women's Hospital in Boston, where I also serve as the director of the fecal microbiota transplant program.

I'm extremely honored to have been chosen as a Sherman Prize Emerging Leader in IBD for 2020. I'm truly touched because the prize has chosen to recognize my work with patients with IBD who are unduly infected with C. diff infection. We know that this patient population is disproportionately affected by C. diff. Many of these patients will have at least a 10% lifetime chance of getting an infection and then, almost a 5-fold increase risk of developing recurrent disease. There certainly had been a lot of retrospective literature that showed that these patients do worse with a treatment such as fecal microbiota transplantation (FMT) to treat recurrent C. diff.

There was an initial concern that actually these patients had worse outcomes or increased IBD flares. In order to understand this a bit better, we undertook the first prospective trial to try to answer this question, specifically the ICON study, which took place at 4 sites around the US.

With the prospective trial of a single FMT delivered to patients with inflammatory bowel disease as well as recurrent C. diff. We follow these patients prospectively for 12 weeks to understand not only what the C. diff outcomes were but also what the IBD outcomes were.

We were extremely pleasantly surprised to find that not only did these patients achieve cure rates comparable to what we see in the non-IBD patient populations, in fact, we saw overwhelmingly that the majority of the patients in this study had either improvement in their IBD scores or no change at all.

In fact, we saw only 1 patient who met the definition of worsening of their underlying IDB, so debunking some of the initial retrospective data that had been out there. I now am confident that this is a very safe procedure that should be offered to patients with IBD who are suffering from recurring C. diff.

We're certainly excited to continue this work. We are undertaking a much larger study to continue to understand this very poorly understood vulnerable patient population. Stay tuned for some work in the future that should be coming.

Thank you again. I'm certainly extremely grateful to be recognized by the Sherman Prize. Thank you so much. Take care.