Faecal Microbiota Transplantation [FMT] in the Treatment of Chronic Refractory Pouchitis: A Systematic Review and Meta-analysis.
Zaman, Szaman Akingboye, Akingboye Mohamedahmed, Ali Yasen Y Bhattacharya, Pratik El-Asrag, Mohammed E Iqbal, Tariq H Quraishi, Mohammed N Beggs, Andrew D
Zaman, Szaman
Akingboye, Akingboye
Mohamedahmed, Ali Yasen Y
Bhattacharya, Pratik
El-Asrag, Mohammed E
Iqbal, Tariq H
Quraishi, Mohammed N
Beggs, Andrew D
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Affiliation
University of Birmingham; The Dudley Group NHS Foundation Trust; Royal Wolverhampton NHS Trust; Sandwell and West Birmingham Hospitals et al
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Publication date
2024-01-27
Subject
Research Projects
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Abstract
The aim of this systematic review and meta-analysis is to assess the efficacy and safety of faecal microbiota transplantation (FMT) in the treatment of chronic pouchitis. A PRISMA-compliant systematic review and meta-analysis was conducted using the following databases and clinical trial registers: Medline, Embase, Scopus, Cochrane Database of Systematic Reviews [CENTRAL], clinical trials.gov, ScienceDirect, and VHL [virtual health library]. The primary outcome was clinical response/remission in patients treated with FMT. Secondary outcomes included safety profile, quality of life, and changes in the gut microbiome. Seven observational cohort studies/case series and two randomised, controlled trials with a total of 103 patients were included. The route, preparation, and quantity of FMT administered varied among the included studies. Clinical response of 42.6% with a remission rate of 29.8% was estimated in our cohort following FMT therapy. Minor, self-limiting, adverse events were reported, and the treatment was well tolerated with good short- and long-term safety profiles. Successful FMT engraftment in recipients varied and, on average, microbial richness and diversity was lower in patients with pouchitis. In some instances, shifts with specific changes towards abundance of species, suggestive of a 'healthier' pouch microbiota, were observed following treatment with FMT. The evidence for FMT in the treatment of chronic pouchitis is sparse, which limits any recommendations being made for its use in clinical practice. Current evidence from low-quality studies suggests a variable clinical response and remission rate, but the treatment is well tolerated, with a good safety profile. This review emphasises the need for rationally designed, well-powered, randomised, placebo-controlled trials to understand the efficacy of FMT for the treatment of pouchitis. The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn�s and Colitis Organisation.
Citation
Zaman S, Akingboye A, Mohamedahmed AYY, Peterknecht E, Bhattacharya P, El-Asrag ME, Iqbal TH, Quraishi MN, Beggs AD. Faecal Microbiota Transplantation [FMT] in the Treatment of Chronic Refractory Pouchitis: A Systematic Review and Meta-analysis. J Crohns Colitis. 2024 Jan 27;18(1):144-161. doi: 10.1093/ecco-jcc/jjad120. PMID: 37450947; PMCID: PMC10821709.
Type
Article