P0856Acceptability of Probiotics, Fecal Microbiota Transplantation, and Emerging Microbiome-Derived Therapies in IBD: A Cross-Sectional Survey Study

Abstract Background Novel gut microbiota–based approaches are emerging to control intestinal inflammation in inflammatory bowel diseases (IBD). Beyond promising preclinical data, patient acceptability of such approaches remains poorly explored. This study evaluated and compared the acceptability of microbiota-based treatments among patients with IBD. Methods A single-center cross-sectional survey was conducted between April and July 2024 at Saint-Antoine Hospital, including consecutive patients with Crohn’s disease or ulcerative colitis followed in day-hospital care. The questionnaire included closed-ended items assessing perceptions and acceptability of four microbiota-derived strategies: probiotics, fecal microbiota transplantation (FMT), and emerging microbiome-derived therapies comprising chemically modified bacteria (CMB) and genetically modified bacteria (GMB). Open-ended questions captured underlying motivations. Analyses combined descriptive and inferential statistics with thematic analysis of qualitative data. Multiple logistic regression identified predictors of acceptance. Results Of the 324 respondents, 48.5% were women with a median age of 41.6 years (Table 1). Crohn’s disease accounted for 63.3% of cases, with a median disease duration of 15.6 years. The majority of patients (82.4%) were in clinical remission according to the CDAI or partial Mayo score, and 77.5% had previously been exposed to anti-TNF therapy. When asked to choose between probiotics and FMT, 39.5% of patients preferred probiotics, 37.7% were open to trying both, 14.2% did not want either option and 4.0% preferred FMT alone (Figure 1). The three main reasons for preferring probiotics were ease of administration/practicality, reluctance towards FMT and perceived efficacy. The predictors of acceptance of both probiotics and FMT were level of education (years of study since graduation) (aOR=1.12, 95% CI 1.01–1.24, p = 0.02) and moderate-to-severe active IBD (aOR=3.41, 95% CI 1.23–10.4, p = 0.02). When asked to choose between probiotics, FMT, CMB and GMB, 35.5% of patients preferred probiotics, 24.1% preferred CMB, 16.7% preferred abstention, 12.7% preferred FMT, 6.5% preferred GMB, and 4.6% accepted all treatments. Conclusion Of all the microbiome-based therapies, IBD patients preferred probiotics because of their perceived efficacy and practicality. FMT was one of the last treatments to be accepted, with a high number of patients being reluctant to try it. Our study suggests that a high level of education and active disease may predict acceptance of innovative microbiome-based therapies. Understanding patient perception is essential for successfully implementing these emerging treatments in IBD care. Conflict of interest: Dr. Grellier, Nathan: Nathan Grellier received hospitality, registration fee support, and participation agreements for events from Norgine, Celltrion Healthcare, Takeda, and Lilly. Policar, Clotilde: No conflict of interest Bourrier, Anne: No conflict of interest Landman, Cecilia: No conflict of interest Nion-Larmurier, Isabelle: No conflict of interest Mclellan, Paul: No conflict of interest Kirchgesner, Julien: Lecture fees and/or consulting fees from from Abbvie, Amgen, Astrazeneca, Celltrion, Galapagos, Janssen, Lilly, MSD, Takeda, Tillots, Pfizer. Sokol, Harry: - Consulting : Amgen, Fresenius, IPSEN, Actial, Astellas, Danone, THAC, Biose, BiomX, Eligo, Immusmol, Adare, Nestle, Ferring - Conference : Amgen, MSD, Ferring, Bledina, Astellas, Pfizer, Biocodex, BMS, Bromatech, Ferring, Fresenius, Gieal, Janssen, Mayoli, Roche, Sanofi, Servier, Takeda, Abbvie - stocks : Enterome bioscience - co-founder of Exeliom Biosciences Macia, Enguerran: No conflict of interest Seksik, Philippe: I received personal fees from Takeda, Janssen, Merck MSD, Biocodex, Ferring, Fresenius Kabi, Astellas, Amgen, Pfizer, Pilege and Abbvie