The First Clinical Medical College, Lanzhou University, Lanzhou, China.
Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China.
Medicine (Baltimore). 2022 Jul 29;101(30):e29790. doi: 10.1097/MD.0000000000029790.
Fecal microbiota transplantation (FMT) as a promising therapy for ulcerative colitis (UC) remains controversial. We conducted a systematic review and meta-analysis to assess the efficiency and safety of FMT as a treatment for UC.
The target studies were identified by searching PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials and by manual supplementary retrieval. We conducted a general review and quantitative synthesis of included studies. We used the RevMan and Stata programs in the meta-analysis. The outcomes were total remission, clinical remission, steroid-free remission, and serious adverse events. We also performed subgroup analyses based on different populations.
A total of 34 articles were included in the general review. Only 16 articles, including 4 randomized controlled trials, 2 controlled clinical trials, and 10 cohort studies, were selected for the meta-analysis. We found that donor FMT might be more effective than placebo for attaining total remission (risk ratio [RR]: 2.77, 95% confidence interval [CI]: 1.54-4.98; P = .0007), clinical remission (RR: 0.33, 95% CI: 0.24-0.41; P < .05), and steroid-free remission (RR: 3.63, 95% CI: 1.57-8.42; P = .003), but found no statistically significant difference in the incidence of serious adverse events (RR: 0.88, 95% CI: 0.34-2.31, P = .8). The subgroup analyses revealed significant differences between the pooled clinical remission rates for different regions, degrees of severity of the disease, and patients with steroid- or nonsteroid-dependent UC.
FMT can achieve clinical remission and clinical response in patients with UC.
粪便微生物群移植（FMT）作为溃疡性结肠炎（UC）的一种有前途的治疗方法仍然存在争议。我们进行了系统评价和荟萃分析，以评估 FMT 作为 UC 治疗的有效性和安全性。
通过搜索 PubMed、EMBASE、Cochrane 图书馆、Web of Science 和 ClinicalTrials，并进行手动补充检索，确定目标研究。我们对纳入的研究进行了综合评价和定量综合分析。我们在荟萃分析中使用了 RevMan 和 Stata 程序。结果是总缓解率、临床缓解率、无类固醇缓解率和严重不良事件。我们还根据不同人群进行了亚组分析。
共纳入 34 篇综述文章。只有 16 篇文章，包括 4 项随机对照试验、2 项对照临床试验和 10 项队列研究，被选入荟萃分析。我们发现，供体 FMT 可能比安慰剂更有效地实现总缓解（风险比 [RR]：2.77，95%置信区间 [CI]：1.54-4.98；P =.0007）、临床缓解（RR：0.33，95% CI：0.24-0.41；P <.05）和无类固醇缓解（RR：3.63，95% CI：1.57-8.42；P =.003），但严重不良事件的发生率无统计学差异（RR：0.88，95% CI：0.34-2.31，P =.8）。亚组分析显示，不同地区、疾病严重程度和使用类固醇或非类固醇依赖性 UC 的患者的汇总临床缓解率存在显著差异。
FMT 可使 UC 患者达到临床缓解和临床反应。
