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

Huang, Taobi; Xu, Jianing; Wang, Maoying; Pu, Ke; Li, Longquan; Zhang, Huiyun; Liang, Yuan; Sun, Weiming; Wang, Yuping

doi:10.1097/md.0000000000029790

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…Many routes of administration have been used in the aforementioned clinical trials, among them were nasal duodenal tube, capsules as upper GI route and enemas and colonoscopies for the rectal route. Meta-analyses provided conflicting results [57][58][59][60][61][62][63][64][65][66].…”

Section: Clinical Trials With Microbiota Interventions Other Than Fmt...mentioning

confidence: 99%

Microbiota Therapy in Inflammatory Bowel Disease

Biedermann,

Kreienbühl,

Rogler

2024

Visc Med

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Background: In both Crohn’s disease (CD) and ulcerative colitis (UC), the two major forms of inflammatory bowel disease (IBD) the immune reaction is – at least partially – directed against components of the luminal microbiota of the gut. These immune responses as well as other factors contribute to a phenomenon frequently described as “dysbiosis” meaning an alteration of the composition of the colonic microbiota. To improve the dysbiosis and to restore the normal composition of the colonic microbiota, fecal microbiota transplantation (FMT) has been tested as a therapeutic option to induce and maintain remission in IBD patients. Summary: This review will first discuss changes in the composition of the intestinal microbiota found in IBD patients and second the therapeutic potential of microbiological interventions for the treatment of these patients. FMT has been studied in several clinical trials in both, CD and UC. Reported results and subsequent meta-analyses indicate that FMT may be effective to induce remission in UC. However, the optimal route of FMT, the necessary number of administrations and the question whether life bacteria of freshly prepared stool is more effective than frozen are still unclear. Concepts associated with an optimization of FMT such as the “super donor concept” or the “consortia-approach” will be discussed to illustrate open questions and difficulties associated with microbiota therapy in IBD. Key Messages: The microbiota composition in IBD patients shows significant alterations compared to healthy individuals termed as “dysbiosis”. FMT and other therapeutic approaches to modify the microbiota composition have been studied in clinical trials in recent years. Efficacy has been shown in UC; however, many questions with respect to the optimization of microbiota therapy remain to be answered.

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Section: Clinical Trials With Microbiota Interventions Other Than Fmt...mentioning

confidence: 99%

Microbiota Therapy in Inflammatory Bowel Disease

Biedermann,

Kreienbühl,

Rogler

2024

Visc Med

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Faecal microbiota transplantation for eradicatingHelicobacter pyloriinfection: clinical practice and theoretical postulation

Ye,

Eslick,

Huang

et al. 2024

egastro

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The sustained increase in antibiotic resistance leads to a declining trend in the eradication rate ofHelicobacter pylori(H. pylori) infection with antibiotic-based eradication regimens. Administration of a single probiotic shows limited efficacy in eradicatingH. pyloriinfection. This review indicates that faecal microbiota transplantation (FMT), a novel therapeutic approach, either as a monotherapy or adjunctive therapy, exhibits beneficial effects in terms of the eradication ofH. pyloriinfection and the prevention of adverse events. The role of FMT inH. pylorieradication may be associated directly or indirectly with some therapeutic constituents within the faecal suspension, including bacteria, viruses, antimicrobial peptides and metabolites. In addition, variations in donor selection, faecal suspension preparation and delivery methods are believed to be the main factors determining the effectiveness of FMT for the treatment ofH. pyloriinfection. Future research should refine the operational procedures of FMT to achieve optimal efficacy forH. pyloriinfection and explore the mechanisms by which FMT acts againstH. pylori.

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Safety comparison of single-donor and pooled fecal microbiota transfer product preparation in ulcerative colitis: systematic review and meta-analysis

Laperrousaz,

Levast,

Fontaine

et al. 2024

BMC Gastroenterol

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Background Multiple studies have evaluated fecal microbiota transfer (FMT) in patients with ulcerative colitis (UC) using single-donor (SDN) and multidonor (MDN) products. Systematic review and meta-analysis were performed to compare the safety of SDN and MDN products. Methods Systematic searches were performed in Web of Science, Scopus, PubMed, and Orbit Intelligence to identify studies that compared FMT products manufactured using SDN or MDN strategies against control treatment in patients with UC. Fifteen controlled studies were selected for meta-analysis (11 randomized controlled trials and 4 controlled cohort trials). Safety of each treatment type was assessed using the counts of adverse events and serious adverse events using fixed- and random-effects models. Significance of the indirect difference between FMT preparations was assessed using a network approach. Benefit-risk ratios were calculated by multiplicative utility model, incorporating geometric mean of risk ratios (RRs) of efficacy and safety. Results Safety data was collected for a total of 587 patients (193 exposed to SDN products, 114 exposed to MDN products and 280 exposed to control treatment). The 12 studies showed similar overall safety event counts for MDN and SDN versus placebo (RRs: 0.90 and 1.09, respectively [ P = 0.206 and P = 0.420, respectively]). Results indicated similar risk of safety events for MDN compared to SDN (RR: 0.83, P = 0.159). Positive benefit-risk ratios were demonstrated for MDN and SDN versus placebo (RRs: 1.70 and 1.16, respectively [ P = 0.003 and P = 0.173, respectively]). MDN had a greater benefit-risk ratio compared to SDN (RR: 1.46, P = 0.072). Conclusion Similar safety profiles were observed for MDN and SDN strategies. Alongside previously described superior efficacy, treatment with MDN has greater benefit-risk ratio than SDN in patients with UC. Further development of MDN FMT treatment for UC should be considered. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-024-03487-2.

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

Cited by 3 publications

References 56 publications

Microbiota Therapy in Inflammatory Bowel Disease

Microbiota Therapy in Inflammatory Bowel Disease

Faecal microbiota transplantation for eradicatingHelicobacter pyloriinfection: clinical practice and theoretical postulation

Safety comparison of single-donor and pooled fecal microbiota transfer product preparation in ulcerative colitis: systematic review and meta-analysis

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