Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials
INTRODUCTION: Fecal microbiota transplantation (FMT) has been proposed as a potential treatment for irritable bowel syndrome (IBS); however, the consensus regarding its efficacy and safety is limited. MATERIALS AND METHODS: We performed a systematic search of the literature using PubMed, EMBASE, Ovi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669599/ https://www.ncbi.nlm.nih.gov/pubmed/36405622 http://dx.doi.org/10.3389/fmed.2022.1039284 |
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author | Samuthpongtorn, Chatpol Kantagowit, Piyawat Pittayanon, Rapat Patcharatrakul, Tanisa Gonlachanvit, Sutep |
author_facet | Samuthpongtorn, Chatpol Kantagowit, Piyawat Pittayanon, Rapat Patcharatrakul, Tanisa Gonlachanvit, Sutep |
author_sort | Samuthpongtorn, Chatpol |
collection | PubMed |
description | INTRODUCTION: Fecal microbiota transplantation (FMT) has been proposed as a potential treatment for irritable bowel syndrome (IBS); however, the consensus regarding its efficacy and safety is limited. MATERIALS AND METHODS: We performed a systematic search of the literature using PubMed, EMBASE, Ovid MEDLINE, and Cochrane. Meta-analyses were conducted in relative risk (RR) or standard mean difference (SMD) using 95% confidence intervals (CI). Cochrane risk-of-bias 2 tool (RoB2) was employed to evaluate the study quality. RESULT: Of 2,589 potential records, 7 studies with 9 cohorts involving 505 participants were included. Meta-analyses showed no significant difference in the short-term (12 weeks) and long-term (12 months) global improvement of IBS symptoms of FMT vs. placebo (RR 0.63, 95% CI 0.39–1.00 and RR 0.88, 95% CI 0.53–1.45, respectively). There were statistically significant differences of short-term IBS-SSS improvement (SMD –0.58, 95% CI –1.09 to –0.88) and short-term IBS-QoL improvement (SMD 0.67, 95% CI 0.43–0.91). Eight from 9 studies (88.9%) had a low risk of bias. The subgroup analysis revealed the short-term global symptoms improvement in studies with low-risk of bias (RR 0.53, 95% CI 0.35–0.81), studies with well-defined donors (RR 0.31, 95% CI 0.14–0.72), and studies with FMT using colonoscopy (RR 0.66, 95% CI 0.47–0.92). Major FMT adverse events are transient and rapidly self-limiting. CONCLUSION: FMT significantly improved IBS-SSS and IBS-QoL in the short-term period in IBS patients. However, global symptom improvement showed no significance. Well-defined donors and appropriate fecal administration routes appear to be important factors for the successful outcomes of FMT in IBS. SYSTEMATIC REVIEW REGISTRATION: [www.crd.york.ac.uk/prospero], identifier [CRD42021246101]. |
format | Online Article Text |
id | pubmed-9669599 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96695992022-11-18 Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials Samuthpongtorn, Chatpol Kantagowit, Piyawat Pittayanon, Rapat Patcharatrakul, Tanisa Gonlachanvit, Sutep Front Med (Lausanne) Medicine INTRODUCTION: Fecal microbiota transplantation (FMT) has been proposed as a potential treatment for irritable bowel syndrome (IBS); however, the consensus regarding its efficacy and safety is limited. MATERIALS AND METHODS: We performed a systematic search of the literature using PubMed, EMBASE, Ovid MEDLINE, and Cochrane. Meta-analyses were conducted in relative risk (RR) or standard mean difference (SMD) using 95% confidence intervals (CI). Cochrane risk-of-bias 2 tool (RoB2) was employed to evaluate the study quality. RESULT: Of 2,589 potential records, 7 studies with 9 cohorts involving 505 participants were included. Meta-analyses showed no significant difference in the short-term (12 weeks) and long-term (12 months) global improvement of IBS symptoms of FMT vs. placebo (RR 0.63, 95% CI 0.39–1.00 and RR 0.88, 95% CI 0.53–1.45, respectively). There were statistically significant differences of short-term IBS-SSS improvement (SMD –0.58, 95% CI –1.09 to –0.88) and short-term IBS-QoL improvement (SMD 0.67, 95% CI 0.43–0.91). Eight from 9 studies (88.9%) had a low risk of bias. The subgroup analysis revealed the short-term global symptoms improvement in studies with low-risk of bias (RR 0.53, 95% CI 0.35–0.81), studies with well-defined donors (RR 0.31, 95% CI 0.14–0.72), and studies with FMT using colonoscopy (RR 0.66, 95% CI 0.47–0.92). Major FMT adverse events are transient and rapidly self-limiting. CONCLUSION: FMT significantly improved IBS-SSS and IBS-QoL in the short-term period in IBS patients. However, global symptom improvement showed no significance. Well-defined donors and appropriate fecal administration routes appear to be important factors for the successful outcomes of FMT in IBS. SYSTEMATIC REVIEW REGISTRATION: [www.crd.york.ac.uk/prospero], identifier [CRD42021246101]. Frontiers Media S.A. 2022-11-03 /pmc/articles/PMC9669599/ /pubmed/36405622 http://dx.doi.org/10.3389/fmed.2022.1039284 Text en Copyright © 2022 Samuthpongtorn, Kantagowit, Pittayanon, Patcharatrakul and Gonlachanvit. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Samuthpongtorn, Chatpol Kantagowit, Piyawat Pittayanon, Rapat Patcharatrakul, Tanisa Gonlachanvit, Sutep Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title | Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title_full | Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title_fullStr | Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title_full_unstemmed | Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title_short | Fecal microbiota transplantation in irritable bowel syndrome: A meta-analysis of randomized controlled trials |
title_sort | fecal microbiota transplantation in irritable bowel syndrome: a meta-analysis of randomized controlled trials |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669599/ https://www.ncbi.nlm.nih.gov/pubmed/36405622 http://dx.doi.org/10.3389/fmed.2022.1039284 |
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