Neeraj Narula1, Zain Kassam, Yuhong Yuan, Jean-Frederic Colombel, Cyriel Ponsioen, Walter Reinisch, Paul Moayyedi. 1. *Division of Gastroenterology, Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada; †OpenBiome, Somerville, Massachusetts; ‡Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; and §Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Changes in the colonic microbiota may play a role in the pathogenesis of ulcerative colitis (UC) and restoration of healthy gut microbiota may ameliorate disease. A systematic review and meta-analysis was conducted to assess fecal microbiota transplantation (FMT) as a treatment for active UC. METHODS: A literature search was conducted to identify high-quality studies of FMT as a treatment for patients with UC. The primary outcome was combined clinical remission and endoscopic remission or response. Secondary outcomes included clinical remission, endoscopic remission, and serious adverse events. Odds ratios with 95% confidence intervals (CIs) are reported. RESULTS: Overall, 4 studies with 277 participants were eligible for inclusion. Among 4 randomized controlled trials, FMT was associated with higher combined clinical and endoscopic remission compared with placebo (risk ratio UC not in remission was 0.80; 95% CI: 0.71-0.89) with a number needed to treat of 5 (95% CI: 4-10). There was no statistically significant increase in serious adverse events with FMT compared with controls (risk ratio adverse event was 1.4; 95% CI: 0.55-3.58). CONCLUSIONS: Among randomized controlled trials, short-term use of FMT shows promise as a treatment to induce remission in active UC based on the efficacy and safety observed. However, there remain many unanswered questions that require further research before FMT can be considered for use in clinical practice.
BACKGROUND: Changes in the colonic microbiota may play a role in the pathogenesis of ulcerative colitis (UC) and restoration of healthy gut microbiota may ameliorate disease. A systematic review and meta-analysis was conducted to assess fecal microbiota transplantation (FMT) as a treatment for active UC. METHODS: A literature search was conducted to identify high-quality studies of FMT as a treatment for patients with UC. The primary outcome was combined clinical remission and endoscopic remission or response. Secondary outcomes included clinical remission, endoscopic remission, and serious adverse events. Odds ratios with 95% confidence intervals (CIs) are reported. RESULTS: Overall, 4 studies with 277 participants were eligible for inclusion. Among 4 randomized controlled trials, FMT was associated with higher combined clinical and endoscopic remission compared with placebo (risk ratio UC not in remission was 0.80; 95% CI: 0.71-0.89) with a number needed to treat of 5 (95% CI: 4-10). There was no statistically significant increase in serious adverse events with FMT compared with controls (risk ratio adverse event was 1.4; 95% CI: 0.55-3.58). CONCLUSIONS: Among randomized controlled trials, short-term use of FMT shows promise as a treatment to induce remission in active UC based on the efficacy and safety observed. However, there remain many unanswered questions that require further research before FMT can be considered for use in clinical practice.
Authors: Daniel Selvig; Yvette Piceno; Jonathan Terdiman; Martin Zydek; Sarah E Umetsu; Dana Balitzer; Doug Fadrosh; Kole Lynch; Brandon Lamere; Tom Leith; Zain Kassam; Kendall Beck; Sara Lewin; Averil Ma; Ma Somsouk; Susan V Lynch; Najwa El-Nachef Journal: Dig Dis Sci Date: 2019-07-13 Impact factor: 3.199
Authors: Jolanta Artym; Maja Kocięba; Ewa Zaczyńska; Michał Zimecki; Wojciech Kałas; Leon Strządała; Alicja Pawlak; Małgorzata Jeleń; Beata Morak-Młodawska; Krystian Pluta; Katarzyna Kaleta-Kuratewicz; Jan P Madej; Piotr Kuropka; Jan Kuryszko Journal: Histol Histopathol Date: 2019-12-13 Impact factor: 2.303