Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews
Abstract Aim The current overview on published systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically gather, evaluate, and synthesize solid evidence for using fecal microbiota transplantation (FMT) to treat ulcerative colitis (UC). Methods Relevant articles published before Januar...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Microbiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12866-023-03107-1 |
| _version_ | 1797415826613075968 |
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| author | Haixia Liu Jing Li Jiaxin Yuan Jinke Huang Youqi Xu |
| author_facet | Haixia Liu Jing Li Jiaxin Yuan Jinke Huang Youqi Xu |
| author_sort | Haixia Liu |
| collection | DOAJ |
| description | Abstract Aim The current overview on published systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically gather, evaluate, and synthesize solid evidence for using fecal microbiota transplantation (FMT) to treat ulcerative colitis (UC). Methods Relevant articles published before January 2023 were collected from Web of Science, Embase, PubMed, and Cochrane Library. Two authors used Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, PRISMA checklists, and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system were applied by two authors to independently evaluate the methodological quality, reporting quality, and evidence quality, respectively. Re-meta-analysis on the primary RCTs was conducted after excluding overlapping randomized controlled trials (RCTs). Results Six SRs/MAs involving 12 primary RCTs and 544 participants were included. According to the AMSTAR-2 tool and PRISMA checklist, methodological quality and reporting quality of the included studies was overall satisfactory. The evidence quality of a great majority of outcomes was rated as moderate to high according to the GRADE system. Compared to placebo, the re-meta-analysis found a great advantage of use FMT in inducing combined clinical and endoscopic remission (OR 3.83 [2.31, 6.34]), clinical remission (3.31 [2.09, 5.25]), endoscopic remission (OR 3.75 [2.20, 6.39]), clinical response (OR 2.56 [1.64, 4.00]), and endoscopic response (OR 2.18 [1.12, 4.26]). Pooled data showed no significant difference in serious adverse events between patients receiving FMT and those receiving placebo (OR 1.53 [0.74, 3.19]). Evidence quality of the outcomes derived from re-meta-analysis was significantly higher after overcoming the limitations of previous SRs/MAs. Conclusion In conclusion, moderate- to high-quality evidence supported a promising use of FMT to safely induce remission in UC. However, further trials with larger sample size are still required to comprehensively analyze the delivery route, total dosage, frequency, and donor selection in FMT. |
| first_indexed | 2024-03-09T05:55:10Z |
| format | Article |
| id | doaj.art-41c1a5c8538944de8f759594fbd80527 |
| institution | Directory Open Access Journal |
| issn | 1471-2180 |
| language | English |
| last_indexed | 2024-03-09T05:55:10Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Microbiology |
| spelling | doaj.art-41c1a5c8538944de8f759594fbd805272023-12-03T12:14:10ZengBMCBMC Microbiology1471-21802023-11-0123111810.1186/s12866-023-03107-1Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviewsHaixia Liu0Jing Li1Jiaxin Yuan2Jinke Huang3Youqi Xu4The Second Affiliated Hospital of Nanjing University of Chinese MedicineGuang’an Hospital of Traditional Chinese MedicineTianjin University of Traditional Chinese MedicineXiyuan Hospital of China Academy of Chinese Medical SciencesThe Second Affiliated Hospital of Nanjing University of Chinese MedicineAbstract Aim The current overview on published systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically gather, evaluate, and synthesize solid evidence for using fecal microbiota transplantation (FMT) to treat ulcerative colitis (UC). Methods Relevant articles published before January 2023 were collected from Web of Science, Embase, PubMed, and Cochrane Library. Two authors used Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, PRISMA checklists, and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system were applied by two authors to independently evaluate the methodological quality, reporting quality, and evidence quality, respectively. Re-meta-analysis on the primary RCTs was conducted after excluding overlapping randomized controlled trials (RCTs). Results Six SRs/MAs involving 12 primary RCTs and 544 participants were included. According to the AMSTAR-2 tool and PRISMA checklist, methodological quality and reporting quality of the included studies was overall satisfactory. The evidence quality of a great majority of outcomes was rated as moderate to high according to the GRADE system. Compared to placebo, the re-meta-analysis found a great advantage of use FMT in inducing combined clinical and endoscopic remission (OR 3.83 [2.31, 6.34]), clinical remission (3.31 [2.09, 5.25]), endoscopic remission (OR 3.75 [2.20, 6.39]), clinical response (OR 2.56 [1.64, 4.00]), and endoscopic response (OR 2.18 [1.12, 4.26]). Pooled data showed no significant difference in serious adverse events between patients receiving FMT and those receiving placebo (OR 1.53 [0.74, 3.19]). Evidence quality of the outcomes derived from re-meta-analysis was significantly higher after overcoming the limitations of previous SRs/MAs. Conclusion In conclusion, moderate- to high-quality evidence supported a promising use of FMT to safely induce remission in UC. However, further trials with larger sample size are still required to comprehensively analyze the delivery route, total dosage, frequency, and donor selection in FMT.https://doi.org/10.1186/s12866-023-03107-1Fecal microbiota transplantationUlcerative colitisEvidenceRemission |
| spellingShingle | Haixia Liu Jing Li Jiaxin Yuan Jinke Huang Youqi Xu Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews BMC Microbiology Fecal microbiota transplantation Ulcerative colitis Evidence Remission |
| title | Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews |
| title_full | Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews |
| title_fullStr | Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews |
| title_full_unstemmed | Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews |
| title_short | Fecal microbiota transplantation as a therapy for treating ulcerative colitis: an overview of systematic reviews |
| title_sort | fecal microbiota transplantation as a therapy for treating ulcerative colitis an overview of systematic reviews |
| topic | Fecal microbiota transplantation Ulcerative colitis Evidence Remission |
| url | https://doi.org/10.1186/s12866-023-03107-1 |
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