Fecal Microbiota Transplantation May Be a Viable Option for Treating Ulcerative Colitis
Fecal microbiota transplantation (FMT) may aid in achieving clinical remission and clinical response in patients with ulcerative colitis (UC), according to the results of a recent study.
A total of 34 articles were included in the systematic review, of which 16 articles (4 randomized controlled trials, 2 controlled clinical trials, and 10 cohort studies) were selected for the meta-analysis.
The primary outcomes were total remission, clinical remission, steroid-free remission, and serious adverse events. The secondary outcomes included clinical remission, clinical response, endoscopic remissions or response, and serious adverse events. Subgroup analyses were performed based on different populations.
Results revealed that donor FMT may be more effective than placebo for reaching total remission (RR, 2.77; 95% 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). No statistically significant difference in the incidence of serious adverse events (RR, 0.88; 95% CI, 0.34 - 2.31, P = .8) was found. The subgroup analyses revealed significant variance between the pooled clinical remission rates for different regions, degrees of severity of the disease, and patients with steroid- or nonsteroid-dependent UC.
“FMT provides a reliable therapy for adult UC, especially in Asian patients with mild-to-moderate and steroid-dependent UC. FMT can achieve clinical remission and may achieve steroid-free remission in patients with UC,” the researchers concluded. “The efficacy of FMT in children with UC is uncertain. Many routes can be used to deliver FMT, and capsule-delivered FMT may become more common in the future.”
—Yvette C. Terrie, BSPharm, RPh
Huang T, Xu J, Wang M, et al. An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis. Medicine (Baltimore). 2022;101(30):e29790. doi:10.1097/MD.0000000000029790