In a recent editorial published in the Journal of Hepatology (March 24, 2025), Professors Debbie Shawcross and Vishal C. Patel spotlight the THEMATIC trial—a phase II RCT investigating the safety of faecal microbiota transplantation (FMT) for patients with hepatic encephalopathy (HE) already on lactulose and rifaximin.
The trial included 60 patients across four cohorts, comparing FMT enemas, capsules, and placebo combinations. Key findings showed no FMT-emergent serious adverse events and a notably lower recurrence rate of HE (9%) in patients who received FMT versus placebo (40%).
This study further solidifies the potential of FMT as a safe, gut-microbiota-targeting therapy in cirrhosis. As future trials like PROMISE (UK) and ChiFT (Denmark) proceed, the field is moving closer to redefining microbiome-based therapies as standard care in advanced liver disease.
Thanks to the authors for pushing the boundaries of HE treatment!
Read the article: https://lnkd.in/dApGHNb3
