TURN2: Well-prepared FMT shows efficacy in UC

Anaerobically processed, donor-selected, and dual-route faecal microbiota transplantation (FMT) demonstrated superior efficacy compared to autologous FMT among patients with ulcerative colitis (UC).

The double-blind, multicentre, randomised controlled TURN2 trial (NCT05998213) included 82 patients with mild-to-moderate UC. Participants were randomised 1:1 to receive either anaerobically processed, donor-selected, dual-route FMT or autologous FMT. “With donor selection, we looked at donor alpha-diversity and predicted butyrate production, whilst avoiding proteobacteria and Ruminococcus gnavus,” clarified Ms Florine Zwezerijnen-Jiwa (Amsterdam University Medical Centre, the Netherlands) [1]. “Participants in the experimental and control arms received 4 treatments across 4 weeks.”

The primary endpoint was combined clinical remission and endoscopic improvement at Week 8. In total, 10 out of 44 participants in the experimental arm reached the primary endpoint, compared with 2 out of 38 participants in the control arm (P=0.028). “We observed 2 serious adverse events,” mentioned Ms Zwezerijnen-Jiwa. “One pneumothorax due to misplacement of the nasoduodenal tube, and one overnight hospitalisation for abdominal pain on day 1 post-FMT.”

In conclusion, anaerobically processed, donor-selected, dual-route FMT appears to be more efficacious than autologous FMT in patients with mild-to-moderate UC. Secondary outcome and mechanistic analyses are ongoing to elucidate the underlying microbiota and immune effects further.

1. Zwezerijnen-Jiwa FH, et al. Donor selection and anaerobic processing of faecal microbiota transplantation for the treatment of ulcerative colitis – results from the TURN2 study. LB02, Late-breaking trials in IBD. UEG Week, 4-7 October 2025, Berlin, Germany.

Medical writing support was provided by Robert van den Heuvel.
Copyright ©2025 Medicom Publishing Group



Posted on 9 October 2025