NOTICIAS DIARIAS

Ulcerative Colitis: FMT Superior to Placebo for Remission Induction

Anaesthesiology

A meta-analysis states, faecal microbiota transplant ( FMT ) to be more effective than placebo for remission induction in patients with ulcerative colitis ( UC ), in absence of major short-term safety signals.

Till date, most medical treatments for UC targeted the immune response without altering the luminal microbial environment. However, 'immunocentric' treatments had partial effectiveness and were associated with side effects. FMT was more effective for remission in patients with UC, with no major short-term safety signs.

Using the multiple electronic databases, we conducted a meta-analysis of the cohort studies and randomized controlled trials (RCTs) to assess the remission rates following FMT for active UC. Data were assessed for bias using the Cochrane risk of bias tool.

The study included 14 cohort studies and 4 RCTs which showed that the FMT groups had a higher rate of clinical remission than the placebo groups (28% vs 9%). The UC patients who received FMT were 3.67 (95% CI, 1.82 to 7.39) times as likely as those who received placebo to achieve clinical remission.

The percentage of individuals with clinical response was also higher in the FMT group than in the placebo group (49% vs 28%). Records from cohort studies showed that 55% of patients who received FMT had a clinical response and among responders, 24% achieved clinical remission.

Till date, most medical treatments targeted the immune response without altering the luminal microbial environment. But such ' immunocentric ' treatments had partial effectiveness and were sometimes restricted due to side effects such as allergy, intolerance, serious infection, increased risk of malignancy, drug antibody formation and cost.

FMT was more effective for remission induction in UC, with no major short-term safety signs. More studies are required to explain the rate and preparation techniques. In addition, to explore its feasibility, efficiency, and safety as maintenance agent, more research has been carried out. The study reported the efficiency and safety of FMT for the remission induction in UC individuals.

FMT provides a promising effect for UC with few adverse events. Successful FMT may be associated with an increase in microbiota diversity and richness, similarity, and some change of bacterial composition.