Fecal Microbiota Transplantation for Ulcerative Colitis: A Systematic Review and Meta-Analysis.
BACKGROUND
Fecal microbiota transplantation (FMT) has been recognized as a novel treatment for ulcerative colitis (UC). However, its efficacy and safety remain unclear.


OBJECTIVE
We conducted this systematic review to assess the efficacy and safety of FMT in UC.


METHODS
PubMed, EMBASE, Cochrane Central, Web of Science Core Collection, and three other Chinese databases were searched for reports of FMT in UC with clear outcomes.


METHODS
We estimated pooled rates [with 95% confidence interval (CI)] of clinical remission among 15 cohort studies and clinical response among 16 cohort studies.


RESULTS
Twenty five studies (2 randomized controlled trials, 15 cohort studies, and 8 case studies) with 234 UC patients were included. Overall, 41.58% (84/202) patients achieved clinical remission (CR) and 65.28% (126/193) achieved clinical response. Among the cohort studies, the pooled estimate of patients who achieved CR and clinical response were 40.5% (95% CI 24.7%-58.7%), and 66.1% (95% CI 43.7%-83.0%). Most adverse events were slight and self-resolving. The analyses of gut microbiota in 7 studies showed that FMT could increase microbiota diversity and richness, similarity, and certain change of bacterial composition.


CONCLUSIONS
FMT provides a promising effect for UC with few adverse events. Successful FMT may be associated with an increase in microbiota diversity and richness, similarity, and certain change of bacterial composition.
The Second Clinical Medical School, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Yanqiang
Y
Shi
The Second Clinical Medical School, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Yiwei
Y
Dong
The Second Clinical Medical School, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Wenhui
W
Huang
The Second Clinical Medical School, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Decong
D
Zhu
Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Hua
H
Mao
Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, 510280, Guangzhou City, Guangdong Province, China.
Peizhu
P
Su
D003093:Colitis, Ulcerative / Q000382:microbiology* / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation / Q000009:adverse effects* / Q000379:methods*; D005243:Feces / Q000382:microbiology; D000069196:Gastrointestinal Microbiome; D006801:Humans; D012074:Remission Induction; D016896:Treatment Outcome