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Faecal Microbiota Transplantation for Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Open accessAbstract
BACKGROUND: Faecal microbiota transplantation [FMT] has been investigated as a potential treatment for inflammatory bowel disease [IBD]. We thus performed a systematic review and meta-analysis assessing the effectiveness and safety of FMT in IBD. METHODS: A systematic review was conducted until January 2017. Studies were excluded if patients had co-infection or data were pooled across disease subtypes (ulcerative colitis [UC], Crohn's disease [CD], pouchitis). Clinical remission was established as the primary outcome. Pooled effect sizes and 95% confidence intervals were obtained using the random effects model. RESULTS: In all, 53 studies were included [41 in UC, 11 in CD, 4 in pouchitis]. Overall, 36% [201/555] of UC, 50.5% [42/83] of CD, and 21.5% [5/23] of pouchitis patients achieved clinical remission. Among cohort studies, the pooled proportion achieving clinical remission was 33% (95% confidence interval [CI] = 23%-43%] for UC and 52% [95% CI = 31%-72%] for CD, both with moderate risk of heterogeneity. For four RCTs in UC, significant benefit in clinical remission (pooled odds ratios [[P-OR] = 2.89, 95% CI = 1.36-6.13, p = 0.006) with moderate heterogeneity [Cochran's Q, p = 0.188; I2 = 37%] was noted. Sub-analyses suggest remission in UC improved with increased number of FMT infusions and lower gastrointestinal tract administration. Most adverse events were transient gastrointestinal complaints. Microbiota analysis was performed in 24 studies, with many identifying increased diversity and a shift in recipient microbiota profile towards the donor post-FMT. CONCLUSIONS: FMT appears effective in UC remission induction, but long-term durability and safety remain unclear. Additional well-designed controlled studies of FMT in IBD are needed, especially in CD and pouchitis.
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“The results showed that the rates of clinical remission in UC, CD, and pouchitis were 36, 50.5, and 21.5%, respectively.”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [146]
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Cryan, J. F., O'Riordan, K. J., Cowan, C. S. M., Sandhu, K. V., Bastiaanssen, T. F. S., Boehme, M., Codagnone, M. G., Cussotto, S., Fulling, C., Golubeva, A. V., et al. (2019) · Physiological Reviews · doi:10.1152/physrev.00018.2018 · Cited by 5,286
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Metadata
- Authors
- Paramsothy, S., Paramsothy, R., Rubin, D. T., Kamm, M. A., Kaakoush, N. O., Mitchell, H. M., & Castaño-Rodríguez, N.
- Affiliations
- UNSW Sydney (AU)
- Liverpool Hospital (AU)
- University of Chicago (US)
- The University of Melbourne (AU)
- Venue
- Journal of Crohn s and Colitis
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-05-09
- Volume
- 11
- Issue
- 10
- Pages
- 1180-1199
- ISSN
- 1873-9946 (ISSN-L)
- 1876-4479
- OpenAlex
- W2586374101
- Cited by
- 436
- References
- 71
- Citations by year
- 2026: 21 · 2025: 36 · 2024: 41 · 2023: 39 · 2022: 56 · 2021: 56 · 2020: 77 · 2019: 62 · 2018: 40 · 2017: 7
- FWCI
- 6.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Crohn s and Colitis (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- Funders
- Cancer Institute NSW
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Microscopic Colitis
- Keywords
- fecal microbiota transplantation, inflammatory bowel disease
- MeSH terms
- Gastrointestinal Microbiome, Fecal Microbiota Transplantation, Colitis, Ulcerative, Crohn Disease, Humans, Inflammatory Bowel Diseases, Treatment Outcome
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