Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis
Purpose Fecal microbiota transplantation (FMT) has been found to be a potential treatment for Crohn's disease (CD). We sought to perform a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD. Methods Electronic databases were searched for studies until January 2...
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container_title | International journal of colorectal disease |
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creator | Zhou, Siyu Cui, Ying Zhang, Yun Zhao, Tianyu Cong, Jing |
description | Purpose
Fecal microbiota transplantation (FMT) has been found to be a potential treatment for Crohn's disease (CD). We sought to perform a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD.
Methods
Electronic databases were searched for studies until January 2023. Clinical remission was established as the primary outcome. The secondary outcome was clinical response, endoscopic remission, minor adverse events, serious adverse events, and changes in disease activity indices, biochemical indicators, and microbial diversities. Pooled effect sizes and 95% confidence intervals (CIs) were calculated under the random effects model.
Results
Eleven cohort studies and one randomized controlled trial involving 228 patients were included. In a meta-analysis, the pooled proportion of adult patients with active CD that achieved clinical remission 2 to 4 weeks after FMT was 57% (95% CI = 49–64%) with a low risk of heterogeneity (
I
2
= 37%). Furthermore, our results showed that FMT significantly (standardized mean difference = −0.66; 95% CI = −1.12 to −0.20;
I
2
= 0) reduced Crohn’s disease activity index scores 4 to 8 weeks after FMT. Subgroup analyses showed no difference between FMT methodologies, except for pre-FMT treatment with antibiotics (
P
= 0.02). Most adverse events were self-limiting and disappeared spontaneously within hours or days after FMT. Microbiota analysis showed an increased Shannon diversity and a shift toward donor-like microbiome after FMT.
Conclusion
FMT could be a promising therapy in the short-term treatment of active CD. More placebo-controlled randomized trials with a long-term follow-up treatment are necessary.
Trial registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322694
No. CRD42022322694. |
doi_str_mv | 10.1007/s00384-023-04354-4 |
format | Article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2784838715</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A740025167</galeid><sourcerecordid>A740025167</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-b8303d35da8709cbad31543f2ba440e352118c50c5e6e21dfcbf855498f1d8473</originalsourceid><addsrcrecordid>eNp9kc9qFTEUxgex2Fp9ARcScONm2vydSd2Vi1Wh0E1dh0xyUlNmkmvOjOXu-hq-nk9ibqeKgkgWyUl-3-Hk-5rmFaMnjNL-FCkVWraUi5ZKoWQrnzRHTAreMt7xp3-cD5vniLeUsr7r5bPmUHRa807po-buApwdyRRdyUPMsyVzsQm3o02znWNOJORCYvKLe6hyIAWmiLgvYiKbkr-kH_ffkfiIYBHeEUtwhzNMVe4q_C3CHbHJkwlm29pkxx1GfNEcBDsivHzcj5vPF--vNx_by6sPnzbnl62TTM7toAUVXihvdU_P3GC9YEqKwAcrJQWhOGPaKeoUdMCZD24IWil5pgPzWvbiuHm79t2W_HUBnE0d3sFY_wd5QcN7LbXQPVMVfbOiN3YEE1PI1Qq3x815LynlinX7hif_oOry1RaXE4RY7_8S8FVQHUYsEMy2xMmWnWHU7HM0a46m5mgecjSyil4_jr0ME_jfkl_BVUCsANandAPF3OalVHPxf21_AuGEqX0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2784838715</pqid></control><display><type>article</type><title>Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zhou, Siyu ; Cui, Ying ; Zhang, Yun ; Zhao, Tianyu ; Cong, Jing</creator><creatorcontrib>Zhou, Siyu ; Cui, Ying ; Zhang, Yun ; Zhao, Tianyu ; Cong, Jing</creatorcontrib><description>Purpose
Fecal microbiota transplantation (FMT) has been found to be a potential treatment for Crohn's disease (CD). We sought to perform a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD.
Methods
Electronic databases were searched for studies until January 2023. Clinical remission was established as the primary outcome. The secondary outcome was clinical response, endoscopic remission, minor adverse events, serious adverse events, and changes in disease activity indices, biochemical indicators, and microbial diversities. Pooled effect sizes and 95% confidence intervals (CIs) were calculated under the random effects model.
Results
Eleven cohort studies and one randomized controlled trial involving 228 patients were included. In a meta-analysis, the pooled proportion of adult patients with active CD that achieved clinical remission 2 to 4 weeks after FMT was 57% (95% CI = 49–64%) with a low risk of heterogeneity (
I
2
= 37%). Furthermore, our results showed that FMT significantly (standardized mean difference = −0.66; 95% CI = −1.12 to −0.20;
I
2
= 0) reduced Crohn’s disease activity index scores 4 to 8 weeks after FMT. Subgroup analyses showed no difference between FMT methodologies, except for pre-FMT treatment with antibiotics (
P
= 0.02). Most adverse events were self-limiting and disappeared spontaneously within hours or days after FMT. Microbiota analysis showed an increased Shannon diversity and a shift toward donor-like microbiome after FMT.
Conclusion
FMT could be a promising therapy in the short-term treatment of active CD. More placebo-controlled randomized trials with a long-term follow-up treatment are necessary.
Trial registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322694
No. CRD42022322694.</description><identifier>ISSN: 1432-1262</identifier><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-023-04354-4</identifier><identifier>PMID: 36882658</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Analysis ; Anti-Bacterial Agents ; Crohn Disease - therapy ; Databases, Factual ; Fecal Microbiota Transplantation - adverse effects ; Gastroenterology ; Hepatology ; Humans ; Internal Medicine ; Medicine ; Medicine & Public Health ; Microbiota (Symbiotic organisms) ; Proctology ; Randomized Controlled Trials as Topic ; Remission Induction ; Review ; Surgery</subject><ispartof>International journal of colorectal disease, 2023-03, Vol.38 (1), p.62-62, Article 62</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-b8303d35da8709cbad31543f2ba440e352118c50c5e6e21dfcbf855498f1d8473</citedby><cites>FETCH-LOGICAL-c414t-b8303d35da8709cbad31543f2ba440e352118c50c5e6e21dfcbf855498f1d8473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-023-04354-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-023-04354-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36882658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Siyu</creatorcontrib><creatorcontrib>Cui, Ying</creatorcontrib><creatorcontrib>Zhang, Yun</creatorcontrib><creatorcontrib>Zhao, Tianyu</creatorcontrib><creatorcontrib>Cong, Jing</creatorcontrib><title>Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
Fecal microbiota transplantation (FMT) has been found to be a potential treatment for Crohn's disease (CD). We sought to perform a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD.
Methods
Electronic databases were searched for studies until January 2023. Clinical remission was established as the primary outcome. The secondary outcome was clinical response, endoscopic remission, minor adverse events, serious adverse events, and changes in disease activity indices, biochemical indicators, and microbial diversities. Pooled effect sizes and 95% confidence intervals (CIs) were calculated under the random effects model.
Results
Eleven cohort studies and one randomized controlled trial involving 228 patients were included. In a meta-analysis, the pooled proportion of adult patients with active CD that achieved clinical remission 2 to 4 weeks after FMT was 57% (95% CI = 49–64%) with a low risk of heterogeneity (
I
2
= 37%). Furthermore, our results showed that FMT significantly (standardized mean difference = −0.66; 95% CI = −1.12 to −0.20;
I
2
= 0) reduced Crohn’s disease activity index scores 4 to 8 weeks after FMT. Subgroup analyses showed no difference between FMT methodologies, except for pre-FMT treatment with antibiotics (
P
= 0.02). Most adverse events were self-limiting and disappeared spontaneously within hours or days after FMT. Microbiota analysis showed an increased Shannon diversity and a shift toward donor-like microbiome after FMT.
Conclusion
FMT could be a promising therapy in the short-term treatment of active CD. More placebo-controlled randomized trials with a long-term follow-up treatment are necessary.
Trial registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322694
No. CRD42022322694.</description><subject>Adult</subject><subject>Analysis</subject><subject>Anti-Bacterial Agents</subject><subject>Crohn Disease - therapy</subject><subject>Databases, Factual</subject><subject>Fecal Microbiota Transplantation - adverse effects</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microbiota (Symbiotic organisms)</subject><subject>Proctology</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Remission Induction</subject><subject>Review</subject><subject>Surgery</subject><issn>1432-1262</issn><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9qFTEUxgex2Fp9ARcScONm2vydSd2Vi1Wh0E1dh0xyUlNmkmvOjOXu-hq-nk9ibqeKgkgWyUl-3-Hk-5rmFaMnjNL-FCkVWraUi5ZKoWQrnzRHTAreMt7xp3-cD5vniLeUsr7r5bPmUHRa807po-buApwdyRRdyUPMsyVzsQm3o02znWNOJORCYvKLe6hyIAWmiLgvYiKbkr-kH_ffkfiIYBHeEUtwhzNMVe4q_C3CHbHJkwlm29pkxx1GfNEcBDsivHzcj5vPF--vNx_by6sPnzbnl62TTM7toAUVXihvdU_P3GC9YEqKwAcrJQWhOGPaKeoUdMCZD24IWil5pgPzWvbiuHm79t2W_HUBnE0d3sFY_wd5QcN7LbXQPVMVfbOiN3YEE1PI1Qq3x815LynlinX7hif_oOry1RaXE4RY7_8S8FVQHUYsEMy2xMmWnWHU7HM0a46m5mgecjSyil4_jr0ME_jfkl_BVUCsANandAPF3OalVHPxf21_AuGEqX0</recordid><startdate>20230308</startdate><enddate>20230308</enddate><creator>Zhou, Siyu</creator><creator>Cui, Ying</creator><creator>Zhang, Yun</creator><creator>Zhao, Tianyu</creator><creator>Cong, Jing</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230308</creationdate><title>Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis</title><author>Zhou, Siyu ; Cui, Ying ; Zhang, Yun ; Zhao, Tianyu ; Cong, Jing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-b8303d35da8709cbad31543f2ba440e352118c50c5e6e21dfcbf855498f1d8473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Anti-Bacterial Agents</topic><topic>Crohn Disease - therapy</topic><topic>Databases, Factual</topic><topic>Fecal Microbiota Transplantation - adverse effects</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microbiota (Symbiotic organisms)</topic><topic>Proctology</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Remission Induction</topic><topic>Review</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Siyu</creatorcontrib><creatorcontrib>Cui, Ying</creatorcontrib><creatorcontrib>Zhang, Yun</creatorcontrib><creatorcontrib>Zhao, Tianyu</creatorcontrib><creatorcontrib>Cong, Jing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Siyu</au><au>Cui, Ying</au><au>Zhang, Yun</au><au>Zhao, Tianyu</au><au>Cong, Jing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2023-03-08</date><risdate>2023</risdate><volume>38</volume><issue>1</issue><spage>62</spage><epage>62</epage><pages>62-62</pages><artnum>62</artnum><issn>1432-1262</issn><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
Fecal microbiota transplantation (FMT) has been found to be a potential treatment for Crohn's disease (CD). We sought to perform a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD.
Methods
Electronic databases were searched for studies until January 2023. Clinical remission was established as the primary outcome. The secondary outcome was clinical response, endoscopic remission, minor adverse events, serious adverse events, and changes in disease activity indices, biochemical indicators, and microbial diversities. Pooled effect sizes and 95% confidence intervals (CIs) were calculated under the random effects model.
Results
Eleven cohort studies and one randomized controlled trial involving 228 patients were included. In a meta-analysis, the pooled proportion of adult patients with active CD that achieved clinical remission 2 to 4 weeks after FMT was 57% (95% CI = 49–64%) with a low risk of heterogeneity (
I
2
= 37%). Furthermore, our results showed that FMT significantly (standardized mean difference = −0.66; 95% CI = −1.12 to −0.20;
I
2
= 0) reduced Crohn’s disease activity index scores 4 to 8 weeks after FMT. Subgroup analyses showed no difference between FMT methodologies, except for pre-FMT treatment with antibiotics (
P
= 0.02). Most adverse events were self-limiting and disappeared spontaneously within hours or days after FMT. Microbiota analysis showed an increased Shannon diversity and a shift toward donor-like microbiome after FMT.
Conclusion
FMT could be a promising therapy in the short-term treatment of active CD. More placebo-controlled randomized trials with a long-term follow-up treatment are necessary.
Trial registration
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322694
No. CRD42022322694.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36882658</pmid><doi>10.1007/s00384-023-04354-4</doi><tpages>1</tpages></addata></record> |
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source | MEDLINE; SpringerLink Journals - AutoHoldings |
subjects | Adult Analysis Anti-Bacterial Agents Crohn Disease - therapy Databases, Factual Fecal Microbiota Transplantation - adverse effects Gastroenterology Hepatology Humans Internal Medicine Medicine Medicine & Public Health Microbiota (Symbiotic organisms) Proctology Randomized Controlled Trials as Topic Remission Induction Review Surgery |
title | Fecal microbiota transplantation for induction of remission in Crohn’s disease: a systematic review and meta-analysis |
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