The Efficacy And Safety Of Fecal Microbiota Transplantation For Ulcerative Colitis:A Systematic Review And Single-rate Metaanalysis

Objective: To evaluate the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of ulcerative colitis(UC).And provide some reference for clinical trials and clinical application of FMT in the future.Methods: 1.Pubmed,Embase,Medline,CNKI,and Wanfang data knowledge service platforms,etc.were searched for reports,which were started from January 1990 and ended in December 2017.2.According to the inclusion criteria to select the documents and organize the data,then use R software to perform meta-analysis.Results: 1.A total of 14 nonrandomized experimental studies,3 randomized controlled trials(RCT),and 1 non-randomized controlled study were included.The single rate results of FMTfor UC showed that the clinical remission rate(including 17 studies,a total of 292 patients)was 27%(95% CI: 13% to 43%);the clinical response rate(including 18 studies,a total of302 cases)was 53%(95% CI: 39% to 66%).The subgroup analysis showed that nodifference in clinical remission rate was detected between upper gastrointestinal deliveryversus lower gastrointestinal delivery.The same was true for the pretreatment group versusthe non-pretreatment group,the kinship donor group versus the non-relative volunteer donorgroup.But there was a significant difference in clinical remission rate between singleinfusion versus multiple infusions(>1)of FMT.2.FMT for UC was relatively safe.The adverse reactions of it were mostly self-relievedfever,abdominal pain,nausea,etc.,and rarely serious adverse reactions.Results: 1.A total of 14 nonrandomized experimental studies,3 randomized controlled trials(RCT),and 1 non-randomized controlled study were included.The single rate results of FMT for UC showed that the clinical remission rate(including 17 studies,a total of 292 patients)was 27%(95% CI: 13% to 43%);the clinical response rate(including 18 studies,a total of 302 cases)was 53%(95% CI: 39% to 66%).The subgroup analysis showed that no difference in clinical remission rate was detected between upper gastrointestinal delivery versus lower gastrointestinal delivery.The same was true for the pretreatment group versus the non-pretreatment group,the kinship donor group versus the non-relative volunteer donor group.But there was a significant difference in clinical remission rate between single infusion versus multiple infusions(>1)of FMT.2.FMT for UC was relatively safe.The adverse reactions of it were mostly self-relieved fever,abdominal pain,nausea,etc.,and rarely serious adverse reactions.Conclusion: The results of this analysis suggest that FMT was safe and effective in the treatment of UC.But before it was widely used in the clinic,it still needed to be verified by a large number of high-quality RCTs.