Could a gut microbiome transplant ease axial spondyloarthritis?

This trial tests whether transferring gut bacteria from a healthy donor (fecal microbiota transplantation, or FMT) can reduce disease activity in people with axial spondyloarthritis (axSpA) who haven't fully responded to biologic therapy. Participants receive a single enema with either donor FMT or their own stool (placebo) and are followed for a year. The study aims to see if FMT can improve symptoms like pain and fatigue and restore a healthier gut microbiome.