An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis

• Published in: Medicine (Baltimore) Vol. 101; no. 30; p. e29790
• Main Authors: Huang, Taobi, Xu, Jinlan, Wang, Maoying, Pu, Ke, Li, Longquan, Zhang, Huiyun, Liang, Yuan, Sun, Weiming, Wang, Yuping
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 29.07.2022
• Subjects: Colitis, Ulcerative - drug therapy; Fecal Microbiota Transplantation - adverse effects; Humans; Remission Induction; Systematic Review and Meta-Analysis
• ISSN: 1536-5964; 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000029790

Fecal microbiota transplantation (FMT) as a promising therapy for ulcerative colitis (UC) remains controversial. We conducted a systematic review and meta-analysis to assess the efficiency and safety of FMT as a treatment for UC. The target studies were identified by searching PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials and by manual supplementary retrieval. We conducted a general review and quantitative synthesis of included studies. We used the RevMan and Stata programs in the meta-analysis. The outcomes were total remission, clinical remission, steroid-free remission, and serious adverse events. We also performed subgroup analyses based on different populations. A total of 34 articles were included in the general review. Only 16 articles, including 4 randomized controlled trials, 2 controlled clinical trials, and 10 cohort studies, were selected for the meta-analysis. We found that donor FMT might be more effective than placebo for attaining total remission (risk ratio [RR]: 2.77, 95% confidence interval [CI]: 1.54-4.98; P = .0007), clinical remission (RR: 0.33, 95% CI: 0.24-0.41; P < .05), and steroid-free remission (RR: 3.63, 95% CI: 1.57-8.42; P = .003), but found no statistically significant difference in the incidence of serious adverse events (RR: 0.88, 95% CI: 0.34-2.31, P = .8). The subgroup analyses revealed significant differences between the pooled clinical remission rates for different regions, degrees of severity of the disease, and patients with steroid- or nonsteroid-dependent UC. FMT can achieve clinical remission and clinical response in patients with UC.