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Fecal microbiota transplantation (FMT) is an investigational microbiome therapy that was studied by Odense University Hospital for the treatment of psoriatic arthritis. The therapeutic approach involves transferring minimally processed fecal matter from a healthy, screened donor into the recipient's gastrointestinal tract to restore a healthy gut microbial community. The presumed mechanism of action is the modulation of the host's immune system via the restored gut microbiota, which is hypothesized to reduce the systemic inflammation that drives psoriatic arthritis. A Phase 2, double-blind, randomized, placebo-controlled trial (the FLORA trial, NCT03058900) evaluated a single gastroscopic-guided FMT administration into the duodenum as an add-on to methotrexate in patients with active peripheral psoriatic arthritis. [12, 17] While the procedure was found to be safe, it did not demonstrate efficacy over the placebo and was associated with a higher rate of treatment failure. [12, 16, 22]
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