Faecal transplants may be future treatment for rheumatoid arthritis (RA)
4 May 2016
Faecal transplants as a treatment for rheumatoid arthritis (RA) may be closer than you think.
So says Tim Spector, professor of genetic epidemiology at King’s College London, who is visiting Darwin to speak at the scientific meeting of the Australian Rheumatology Association.
Prof Spector, a rheumatologist, says the microbes in our gut are key to the development of our immune systems and are clearly involved in autoimmune disease.
“It looks like you can predict if someone has rheumatoid arthritis just as well by taking a poo sample and looking at their microbes as you can with autoantibody tests.”
He says new studies are showing that how people respond to disease-modifying arthritis drugs very much depends on the type of microbes they have.
“This is an extremely new area that’s very exciting, and we’re just starting some research looking at whether we can we predict whether people will do well on their biologic drugs for their arthritis by the microbes they have. And if not, can we improve the treatment by replacing their gut microbes.”
This could be done by adding probiotics or making other changes to the diet, or through faecal transplants, he says.
“Faecal transplants are emerging from just being a joke subject to reality, and they’ve been approved for Clostridium difficile infections with a 90% success rates,” he says.
There are 160 studies faecal transplant studies currently registered, with some planned for rheumatoid arthritis.
Prof Spector says trials in inflammatory bowel disease may point the way to efficacy in RA.
“The latest one is showing a significant effect for ulcerative colitis and Crohn’s disease, which is going to be published soon. There’s a good chance that what works in colitis is also going to work in rheumatoid arthritis.”
He says faecal transplants may be effective for people with RA who are failing biologic therapy, as it seems changing the makeup of the microbiome affects how well immunotherapy works.
“We’re still at the early stages of how it’s done. Obviously faecal transplant is a very crude therapy because we don’t know what’s in it. It’s a blunderbuss approach and it goes against all conventional wisdom of doctors, and that’s probably why it’s had some resistance. But it does seem to work.”
He says it’s a question of understanding who it’s going to work for. There may be a genetic component, and donors may also have to be genetically matched.
“But I think in 5 years this is going to be fairly commonplace.”
Last Reviewed: 04/05/2016
Rheumatoid arthritis: prescription medicines
Prescription medicines are an important part treatment for rheumatoid arthritis (RA). While these medicines do not cure RA, they suppress inflammation, prevent joint damage and relieve symptoms.
Rheumatoid arthritis (RA) is a type of chronic arthritis that affects joints such as the hands, fingers, wrists and knees, and affects joints on both sides of the body at the same time.
What to eat if you have rheumatoid arthritis
While diet can't replace medicines in rheumatoid arthritis (RA), there are some dietary changes that may help people with their RA symptoms.
Why your gut microbiome should matter to you
Each of us has a unique gut microbiome - the composition of which can change on a daily basis. Your microbiome can affect your weight, your food cravings, your immune system and your mental health.
Juvenile chronic arthritis
Juvenile chronic arthritis or juvenile idiopathic arthritis (JIA) is long-term joint inflammation (arthritis) in children. The main symptom is having painful joints for no obvious reason.