Fecal Microbiota Transplant via Endoscopic Delivering Through Small Intestine and Colon: No Difference for Crohn’s Disease

Yang, Zhenyu; Bu, Chibin; Wei, Yuan; Shen, Zhaohua; Quan, Yongsheng; Wu, Shuai; Zhu, Changxin; Wang, Xiaoyan

doi:10.1007/s10620-019-05751-y

Cited by 36 publications

(81 citation statements)

References 29 publications

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“…The list of the 60 included references is provided in the Supplemental Digital Content (S1 Table). The 36 records included in the quantitative synthesis comprised all the quasi-experimental studies and RCTs [45][46][47][48][49][50][51][52][53]. Data on these studies are provided in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…In the sub-analysis by donor type, seven studies did not specify the source of stool [17,19,32,36,38,47,51], showing a remission of 36.4%. In nine studies [18, 20, 23, 24, 26, 29, 30, 33, 42], the donors of fecal material were relatives or acquaintances, resulting in a clinical remission of 24.8%.…”

Section: Proportions Meta-analysesmentioning

confidence: 99%

“…Patients with Crohn's disease presented a remission rate of 47.6% [18,21,27,33,36,38,39,42,51,52], whereas patients with ulcerative colitis showed a remission rate of 35.0% [17-23, 25, 29-31, 34, 35, 37, 42, 43, 45-49, 53]. Three studies assessed FMT without discriminating the type of IBD [24,26,28], resulting in a remission of 41.0%, and two studies [32,50] reported a 7.4% remission rate in patients with chronic pouchitis.…”

Section: Proportions Meta-analysesmentioning

confidence: 99%

“…When the fecal material was provided by relatives or acquaintances [18,20,23,24,26,29,30,44], the pooled clinical response was 37.1%, whereas patients who received fecal material from universal donors [21, 22, 27, 28, 31, 35, 37, 39-41, 43, 45, 46, 48-50] exhibited a response of 59.7%. Seven studies did not specify the type of donor, resulting in a prevalence of 58.9% for the clinical response [17,19,32,36,38,47,51]. Two studies did not report the donor type [25,34].…”

Section: Proportions Meta-analysesmentioning

confidence: 99%

“…Three studies did not distinguish the IBD subtype, resulting in a clinical response of 58.1% [24,26,28]. Seven studies [18,21,27,36,38,39,51] included patients with Crohn's disease, resulting in a 57.9% clinical response, whereas ulcerative colitis patients (evaluated in 22 studies [17-23, 25, 29-31, 34, 35, 37, 40, 43-49]) exhibited a response of 54.6%. Three studies [32,41,50] assessed patients with chronic pouchitis, resulting in a response of 21.8%.…”

Section: Proportions Meta-analysesmentioning

confidence: 99%

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Fecal microbiota transplantation in inflammatory bowel disease patients: A systematic review and meta-analysis

et al. 2020

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Objectives Current evidence on fecal microbiota transplantation for inflammatory bowel disease is inconclusive. We conducted a systematic review to gather evidence on the efficacy and safety of fecal microbiota transplantation for inflammatory bowel disease. Methods Systematic searches were conducted in PubMed, Scopus, and Web of Science. Clinical remission was considered as the primary endpoint. Pairwise meta-analyses were performed for the randomized controlled studies (Mantel Haenszel, random effects model). Proportion meta-analyses, accounting for weighted pooled rates reported in the interventional studies, were conducted using the mixed effects model. Subgroup analyses considering the type of stool, donor type, and disease subtype were also performed. Cumulative meta-analyses to assess further needs of evidence were conducted. Results Sixty studies were included, from which 36 could be synthesized in the quantitative analyses. Pairwise meta-analyses of six controlled trials showed significant differences in favor of fecal microbiota transplantation compared with placebo (clinical remission: RR 1.70 [95% CI 1.12, 2.56]; clinical response: RR 1.68 [95% CI 1.04, 2.72]). An overall clinical remission of 37%, overall clinical response of 54%, and a prevalence of 29% of adverse events were found for the interventional studies. Frozen fecal material and universal donors were related to better efficacy outcomes. In addition, Crohn's disease patients seemed to benefit more from the procedure. Conclusions The comparative analyses demonstrated that frozen fecal material from universal donors may be related to a higher rate of clinical remission, especially for Crohn's disease.

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