AIM: To study the clinical efficacy and safety of Fecal microbiota transplantation (FMT). We systematically reviewed FMT used as clinical therapy. METHODS: We searched MEDLINE, EMBASE, the Cochrane Library and Conference proceedings from inception to July, 2013. Treatment effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category, on an intention-to-treat basis. RESULTS: We included 45 studies; 34 on Clostridium difficile-infection (CDI), 7 on inflammatory bowel disease, 1 on metabolic syndrome, 1 on constipation, 1 on pouchitis and 1 on irritable bowel syndrome (IBS). In CDI 90% resolution of diarrhea in 33 case series (n = 867) was reported, and 94% resolution of diarrhea after repeated FMT in a randomized controlled trial (RCT) (n = 16). In ulcerative colitis (UC) remission rates of 0% to 68% were found (n = 106). In Crohn's disease (CD) (n = 6), no benefit was observed. In IBS, 70% improvement of symptoms was found (n = 13). 100% Reversal of symptoms was observed in constipation (n = 3). In pouchitis, none of the patients (n = 8) achieved remission. One RCT showed significant improvement of insulin sensitivity in metabolic syndrome (n = 10). Serious adverse events were rare. CONCLUSION: FMT is highly effective in CDI, and holds promise in UC. As for CD, chronic constipation, pouchitis and IBS data are too limited to draw conclusions. FMT increases insulin sensitivity in metabolic syndrome.
AIM: To study the clinical efficacy and safety of Fecal microbiota transplantation (FMT). We systematically reviewed FMT used as clinical therapy. METHODS: We searched MEDLINE, EMBASE, the Cochrane Library and Conference proceedings from inception to July, 2013. Treatment effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category, on an intention-to-treat basis. RESULTS: We included 45 studies; 34 on Clostridium difficile-infection (CDI), 7 on inflammatory bowel disease, 1 on metabolic syndrome, 1 on constipation, 1 on pouchitis and 1 on irritable bowel syndrome (IBS). In CDI 90% resolution of diarrhea in 33 case series (n = 867) was reported, and 94% resolution of diarrhea after repeated FMT in a randomized controlled trial (RCT) (n = 16). In ulcerative colitis (UC) remission rates of 0% to 68% were found (n = 106). In Crohn's disease (CD) (n = 6), no benefit was observed. In IBS, 70% improvement of symptoms was found (n = 13). 100% Reversal of symptoms was observed in constipation (n = 3). In pouchitis, none of the patients (n = 8) achieved remission. One RCT showed significant improvement of insulin sensitivity in metabolic syndrome (n = 10). Serious adverse events were rare. CONCLUSION: FMT is highly effective in CDI, and holds promise in UC. As for CD, chronic constipation, pouchitis and IBS data are too limited to draw conclusions. FMT increases insulin sensitivity in metabolic syndrome.
Authors: Anne Vrieze; Els Van Nood; Frits Holleman; Jarkko Salojärvi; Ruud S Kootte; Joep F W M Bartelsman; Geesje M Dallinga-Thie; Mariette T Ackermans; Mireille J Serlie; Raish Oozeer; Muriel Derrien; Anne Druesne; Johan E T Van Hylckama Vlieg; Vincent W Bloks; Albert K Groen; Hans G H J Heilig; Erwin G Zoetendal; Erik S Stroes; Willem M de Vos; Joost B L Hoekstra; Max Nieuwdorp Journal: Gastroenterology Date: 2012-06-20 Impact factor: 22.682
Authors: Eero Mattila; Raija Uusitalo-Seppälä; Maarit Wuorela; Laura Lehtola; Heimo Nurmi; Matti Ristikankare; Veikko Moilanen; Kimmo Salminen; Maaria Seppälä; Petri S Mattila; Veli-Jukka Anttila; Perttu Arkkila Journal: Gastroenterology Date: 2011-12-07 Impact factor: 22.682
Authors: Lawrence J Brandt; Olga C Aroniadis; Mark Mellow; Amy Kanatzar; Colleen Kelly; Tina Park; Neil Stollman; Faith Rohlke; Christina Surawicz Journal: Am J Gastroenterol Date: 2012-03-27 Impact factor: 10.864