Fecal microbiota transplantation is emerging as a novel therapy for ulcerative colitis.
Interpretation of efficacy of fecal microbiota transplantation for ulcerative colitis is complicated by differences among studies in blinding, fecal microbiota transplantation administration procedures, intensity of therapy and donor stool processing methods.
Dr Costello and colleagues from Australia determined whether fecal microbiota transplantation is effective and safe for the induction of remission in active ulcerative colitis.
Medline (Ovid), Embase and the Cochrane Library were searched from inception through 2017.
|Clinical response was achieved in 49% of donor fecal microbiota transplantation patients |
|Alimentary Pharmacology & Therapeutics|
The research team included original studies reporting remission rates following fecal microbiota transplantation for active ulcerative colitis.
All study designs were included in the systematic review and a meta-analysis performed including only randomized controlled trials.
The research team found 14 cohort studies and 4 randomized controlled trials that used markedly different protocols.
In the meta-analysis of randomized controlled trials, clinical remission was achieved in 28% of patients in the donor fecal microbiota transplantation groups compared with 9% of patients in the placebo groups.
Clinical response was achieved in 49% of donor fecal microbiota transplantation patients compared to 28% of placebo patients.
In cohort studies, the team found that 24% achieved clinical remission.
Dr Costello's team concludes, "Despite variation in processes, fecal microbiota transplantation appears to be effective for induction of remission in ulcerative colitis, with no major short-term safety signals."
"Further studies are needed to better define dose frequency and preparation methods and explore its feasibility, efficacy and safety as a maintenance agent."