Vancomycin found effective for Inflammatory Bowel Disease, suggests study

Researchers have found in a new study that common antibiotic Vancomycin may also be effective in treating individuals with a specific type of inflammatory bowel disease.

Results published in the Journal of Crohn's and Colitis revealed that an antibiotic called vancomycin may also be effective in treating people who have a specific type of inflammatory bowel disease (IBD), which develops in the context of an incurable autoimmune liver disease called primary sclerosing cholangitis (PSC). Notably, four in five patients who participated in the study achieved remission after taking the drug as part of a clinical trial.

This study conducted by researchers from the University of Birmingham is significant, as several participants with this disease had not responded to other IBD treatments. Moreover, IBD and PSC are closely correlated, with most individuals who have PSC developing IBD, and up to 14% of patients with IBD also developing PSC. This increases the chances of needing colon surgery and getting colon or liver cancer, needing a liver transplant, and the overall risks of death.

Dr Mohammed Nabil Quraishi, University of Birmingham, corresponding author of the study said:

“Our findings suggest that vancomycin could offer a new therapeutic option for patients with this challenging combination of IBD and autoimmune liver disease. While these results are preliminary, they provide a strong foundation for further research.”

80% achieved clinical remission

As part of the trial, participants were treated with the oral antibiotic for four weeks and followed up for a further four weeks during which the medication was discontinued. After four weeks of treatment, 80% of patients achieved clinical remission with a significant decrease in inflammatory markers, and 100% showed mucosal healing. When treatment was stopped, symptoms returned. Vancomycin was also shown to induce changes in certain bile acids, which are now being further investigated to develop and refine treatments for IBD associated PSC.

Dr Palak Trivedi, Associate Professor and Honorary Consultant Hepatologist at the University of Birmingham’s Department of Immunology and Immunotherapy, researcher at the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Consultant Hepatologist and Clinician Scientist at University Hospitals Birmingham NHS Foundation Trust, and senior author of the paper, said:

“We are now preparing applications for a randomised controlled trial to determine the therapeutic effects of vancomycin. This next phase of research is crucial to understanding the full potential of vancomycin in PSC-IBD treatment.”

Reference:

Mohammed Nabil Quraishi, Jonathan Cheesbrough, Peter Rimmer, Benjamin H Mullish, Naveen Sharma, Elena Efstathiou, Animesh Acharjee, Georgios Gkoutus, Arzoo Patel, Julian R Marchesi, Stephane Camuzeaux, Katie Chappell, Maria A Valdivia-Garcia, James Ferguson, Matthew Brookes, Martine Walmsley, Amanda Rossiter, Willem van Schaik, Ross S McInnes, Rachel Cooney, Michael Trauner, Andrew Beggs, Tariq Iqbal, Palak J Trivedi, Open label vancomycin in primary sclerosing cholangitis-inflammatory bowel disease: improved colonic disease activity and associations with changes in host-microbiome-metabolomic signatures, Journal of Crohn's and Colitis, 2024;, jjae189, https://doi.org/10.1093/ecco-jcc/jjae189