The gut-liver axis in hepatobiliary diseases

Table 1 Clinical trials targeting the microbiota in the treatment for PSC

Treatment	Drug	Study design	n	Duration	Outcome	Reference
Antibiotic	Metronidazole (< 75 kg 600 mg, > 75 kg 800 mg) or placebo	RCT	80	3 years	ALP -52% (metronidazole) vs -38% (placebo)	Farkkila et al. 2004 [102]
Antibiotic	Vancomycin (125 mg or 250 mg qid) or metronidazole (250 mg or 500 mg tid)	RCT	35	12 weeks	ALP -40% and -46% (vancomycin 125 and 250 mg) vs +13% and -33% (metronidazole 250 and 500 mg)	Tabibian et al. 2013 [103]
Antibiotic	Vancomycin (125 mg qid) or placebo	RCT	29	12 weeks	ALP -53% (vancomycin) vs -8% (placebo)	Rahimpour et al. 2016 [104]
Probiotic	4 lactobacilli, 2 Bifidobacterium	RCT, cross over	14	12 weeks × 2 plus wash-out	No change in liver biochemistry	Vleggaar et al. 2008 [105]
FMT	Faecal sample from a healthy donoradministered during colonoscopy	Open-label pilot study	10	24 weeks observation	No change in liver biochemistry Gut microbiota profiles were changed with increased diversity, persisting for up to 24 weeks	Allegretti et al. 2019 [106]

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