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Fecal microbiota transplantation for Crohn’s disease: a systematic review and meta-analysis

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Abstract

Background

Crohn’s disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal microbiota transplantation (FMT) is an emerging treatment approach for CD. But its efficacy and safety remain controversial. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD patients.

Methods

Electronic databases were searched for studies that reported efficacy and/or safety of FMT for CD. Clinical remission was established as the primary outcome. Secondary outcome was clinical response. Odds ratios with 95% confidence intervals (CIs) were reported.

Results

In all, 12 trials were included in our study. Pooled analysis showed that 0.62 (95% CI 0.48, 0.81) of CD patients achieved clinical remission and 0.79 (95% CI 0.71, 0.89) of CD patients achieved clinical response post-FMT. Sub-analyses suggested the rate of clinical remission with fresh stool FMT was higher than with frozen stool FMT (73% vs 43%; p < 0.05). Most adverse events were minor and self-resolving and no major FMT-related adverse event has been reported so far.

Conclusions

The evidence showed that FMT is an effective and safe therapy for CD. FMT may be successful because it increases the overall diversity of enteric microbiome. Additional randomized controlled studies are needed.

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Authors and Affiliations

  1. Division of Gastroenterology, Zigong First People’s Hospital, 42 Shangyihao Road, Zigong, 643000, Sichuan, China

    F. Cheng, Z. Huang, W. Wei & Z. Li

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  1. F. Cheng
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  2. Z. Huang
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  3. W. Wei
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  4. Z. Li
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Correspondence to F. Cheng.

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Cheng, F., Huang, Z., Wei, W. et al. Fecal microbiota transplantation for Crohn’s disease: a systematic review and meta-analysis. Tech Coloproctol 25, 495–504 (2021). https://doi.org/10.1007/s10151-020-02395-3

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  • DOI: https://doi.org/10.1007/s10151-020-02395-3

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