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...

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Autores principales: Samuthpongtorn, Chatpol, Kantagowit, Piyawat, Pittayanon, Rapat, Patcharatrakul, Tanisa, Gonlachanvit, Sutep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
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].
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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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