Clinical remission of ulcerative colitis after different modes of faecal microbiota transplantation: a meta-analysis

Int J Colorectal Dis. 2020 Jun;35(6):1025-1034. doi: 10.1007/s00384-020-03599-7. Epub 2020 May 9.

Abstract

Background: Ulcerative colitis (UC) is a chronic, recurrent and destructive disease of the gastrointestinal tract. Faecal microbiota transplantation (FMT) is a therapeutic measure in which faecal microbiota from healthy people is transplanted into patients.

Aim: To systematically evaluate the safety and effectiveness of treating UC with different modes of FMT.

Methods: Seven databases were searched by two independent researchers and studies related to randomized controlled trials were included in the analysis.

Results: Seven studies on UC involving 431 patients were included in the analysis. The results showed that FMT had better efficacy than placebo (OR = 2.29, 95% CI 1.48-3.53, P = 0.0002). Subgroup analyses of influencing factors showed that frozen faeces from multiple donors delivered via the lower gastrointestinal tract had a better curative effect than placebo (OR = 2.76, 95% CI 1.59-4.79, P = 0.0003; OR = 2.93, 95% CI 1.67-5.71, P = 0.0002; and OR = 2.70, 95% CI 1.67-4.37, P < 0.0001); the difference in efficacy between mixed faeces from a single donor transplanted through the upper gastrointestinal tract and placebo was not significant(P = 0.05, P = 0.09 and P = 0.98). The analysis of side effects showed no significant difference between FMT and placebo (P = 0.43).

Conclusions: It may be safe and effective to transplant frozen faeces from multiple donors through the lower gastrointestinal tract to treat UC.

Keywords: Meta-analysis; Microbiology; Ulcerative colitis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Colitis, Ulcerative / therapy*
  • Donor Selection
  • Fecal Microbiota Transplantation / adverse effects
  • Fecal Microbiota Transplantation / methods*
  • Freezing
  • Humans
  • Treatment Outcome