Compositions and methods for treating diverticulitis and related disorders
The present disclosure is in the field of pharmaceutical compositions suitable for the treatment of diseases in mammals. The disclosure provides novel compositions comprising non-pathogenic fecal microbes for treating recurrent diverticulitis and related diseases. The disclosure also provides methods for treating a subject with the compositions disclosed herein.
1. A method for treating recurrent diverticulitis in a subject in need thereof, said method comprising administering to said subject a pharmaceutically active dose of a therapeutic composition comprising a community of live non-pathogenic fecal bacteria derived from a stool of a healthy human donor, wherein said treating alleviates at least one symptom of said recurrent diverticulitis for at least 3 months.
2. The method of claim 1 , wherein said recurrent diverticulitis is at a clinical stage selected from the group consisting of Stages I to IV.
3. The method of claim 1 , wherein said composition comprises a non-selected fecal microbiota.
4. The method of claim 1 , wherein said dose is administered at least once daily for at least 2 weeks.
5. The method of claim 1 , wherein said dose is administered at least twice weekly for at least 2 weeks.
6. The method of claim 1 , wherein said dose is administered at least twice weekly for at least 4 weeks.
7. The method of claim 1 , wherein said dose is administered at least twice weekly for at least 8 weeks.
8. The method of claim 1 , wherein said dose is administered at least three times weekly for at least 4 weeks.
9. The method of claim 1 , wherein said therapeutic composition comprises both live nonpathogenic fecal bacteria and a non-cellular fecal filtrate.
10. The method of claim 1 , wherein said method comprises a first dosing schedule followed by a second dosing schedule, wherein said second dosing schedule comprises a maintenance dose lower or equal to the dose of said first dosing schedule.
11. The method of claim 1 , wherein said composition is formulated as a delayed or gradual enteric release form.
12. The method of claim 1 , wherein said composition is formulated as an enteric coated capsule or an acid-resistant capsule.
13. The method of claim 1 , wherein said pharmaceutically active dose is from 10 8 to 10 14 cfu or total number of cells.
14. The method of claim 3 , wherein said fecal microbiota comprises a donor's entire fecal microbiota.
15. The method of claim 1 , wherein said composition is in a liquid, frozen, freeze-dried, spray-dried, lyophilized, or powder form.
16. The method of claim 1 , wherein said composition comprises a cryoprotectant selected from the group consisting of polyethylene glycol, skim milk, erythritol, arabitol, sorbitol, glucose, fructose, alanine, glycine, proline, sucrose, lactose, ribose, trehalose, dimethyl sulfoxide (DMSO), glycerol, or a combination thereof.
17. The method of claim 1 , wherein said composition is substantially free of non-living matter.
18. The method of claim 1 , wherein said subject is pretreated with an antibiotic prior to administration of said composition.
19. The method of claim 1 , wherein said at least one symptom of said recurrent diverticulitis is selected from the group consisting of left lower quadrant pain, shifting bowel habits, nausea, vomiting, constipation, diarrhea, flatulence, and bloating, abscess, phlegmon, fistula, stricture, stenosis, obstruction, bleeding, and perforation.
20. The method of claim 1 , wherein said method further comprises administering a 5-aminosalicylic acid agent, a corticosteroid, an immunosuppressant, or a combination thereof.