A0346 - Efficacy and Safety of Fecal Microbiota Transplantation in the Treatment of Active Inflammatory Bowel Disease - An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

MH

Murtaza Hussain, MD

Hurley Medical Center at Michigan State University
Flint, Michigan

Murtaza Hussain, MD¹, Smit Deliwala, MD², Justine Chinnapan, MD¹, Samuel A. Schueler, MD³
¹Hurley Medical Center at Michigan State University, Flint, MI; ²Michigan State University at Hurley Medical Center, Flint, MI; ³George Washington University, Washington, DC

Introduction: In active inflammatory bowel disease (IBD) patients refractory to standard medical therapy, fecal microbiota transplantation (FMT) has shown to be efficacious. The current literature presents compelling evidence for its use. Herein we performed an updated systematic review and meta-analysis to provide a more robust understanding of the effectiveness and safety of FMT on active IBD patients versus placebo.

Methods: We performed a comprehensive literature search on multiple databases in May 2022. Only randomized controlled trials (RCTs) concerning active IBD patients treated with FMT versus placebo were included. Analysis was done using CMA software to compute Odds Ratio, 95% confidence interval. I² was used to define heterogeneity.

Results: Ten RCTs with the desired study outcomes were included. We had a total of 437 patients in our study in which each patient met a baseline severity of their ulcerative colitis (UC) or Crohn’s Disease (CD) based on Mayo Score and Harvey Bradshaw Index respectively. Moreover improvement was standardized by the same scales. Our results are consistent with previous meta-analyses demonstrating reassuring efficacy of FMT in IBD patients when compared to placebo. Clinical (OR 1.506, (95% CI 1.259-1.803), P < 0.0001), endoscopic (OR 2.335, (95% CI 1.577-3.457), P < 0.0001), and histologic (OR 3.764, (95% CI 1.986-7.136), P < 0.001) remission were consistent with the aforementioned. Adverse events (OR 0.745, (95% CI 0.537-1.033), P = 0.077) in FMT patients were also as expected.

Discussion: FMT continues to demonstrates superior efficacy when compared to placebo in terms of active IBD treatment. Likewise, its adverse events compared to placebo display no statistical significance; equating to an analogous safety profile. Larger RCTs with longer follow up and more CD patients are necessary to strengthen the validity of FMT as an IBD therapeutic modality.

Figure: The clinical remission among active IBD patients treated with FMT versus placebo.

Outcomes	Number of Studies	OR & 95% CI	P Value (I2)
Clinical Remission	10	1.506 & 1.259-1.803	P < 0.001
Endoscopic Remission	6	2.335 & 1.577-3.457	P < 0.001
Histologic Remission	5	3.764 & 1.986-7.136	P < 0.001
Adverse Events	9	0.745 & 0.537-1.033	P = 0.077

Table: Various outcomes of meta-analysis

Disclosures:

Murtaza Hussain indicated no relevant financial relationships.

Smit Deliwala indicated no relevant financial relationships.

Justine Chinnapan indicated no relevant financial relationships.

Samuel Schueler indicated no relevant financial relationships.

Murtaza Hussain, MD¹, Smit Deliwala, MD², Justine Chinnapan, MD¹, Samuel A. Schueler, MD³. A0346 - Efficacy and Safety of Fecal Microbiota Transplantation in the Treatment of Active Inflammatory Bowel Disease - An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.