PDF(Pubmed)
Abstract：
UNASSIGNED: Pouchitis is the most common long-term complication after ileal-pouch anal anastomosis in patients with ulcerative colitis. We conducted a systematic review and meta-analysis evaluating the safety and efficacy of fecal microbiota transplant (FMT) in chronic antibiotic dependent and refractory pouchitis.
UNASSIGNED: Multiple databases were searched through April 2022 for studies that reported the efficacy and safety of FMT in patients with chronic pouchitis. Meta-analysis using random effects model was performed to calculate pooled rates.
UNASSIGNED: Eight studies with a total of 89 patients were included in our review, with 74 patients having received FMT and 15 patients having received placebo. The mean age ranged from 32.6 to 51.5 years. In patients that received FMT, the pooled rates of overall remission was (Pouchitis Disease Activity Index score < 7) 22% (95% CI, 9%-43%; I2, 29%), clinical remission was 20% (95% CI, 6%-49%; I2, 25%), clinical response rate was 42% (95% CI, 30%-54%; I2, 7%), and the relapse rate 60% (95% CI, 40%-77%, I2 16%) over the mean follow up of 4.67 months (range 1-12 months). The pooled proportion of patients with adverse events was 54% (95% CI, 21%-84%; I2, 73%). There were no serious adverse events or deaths.
UNASSIGNED: In patients with chronic pouchitis, FMT is safe though there are mixed results in terms of its long-term efficacy. Future Randomized Controlled Trials with larger sample sizes and greater standardization in terms of preparation, delivery, and length of treatment of FMT are needed to determine efficacy.
UNASSIGNED: Multiple databases were searched through April 2022 for studies that reported the efficacy and safety of FMT in patients with chronic pouchitis. Meta-analysis using random effects model was performed to calculate pooled rates.
UNASSIGNED: Eight studies with a total of 89 patients were included in our review, with 74 patients having received FMT and 15 patients having received placebo. The mean age ranged from 32.6 to 51.5 years. In patients that received FMT, the pooled rates of overall remission was (Pouchitis Disease Activity Index score < 7) 22% (95% CI, 9%-43%; I2, 29%), clinical remission was 20% (95% CI, 6%-49%; I2, 25%), clinical response rate was 42% (95% CI, 30%-54%; I2, 7%), and the relapse rate 60% (95% CI, 40%-77%, I2 16%) over the mean follow up of 4.67 months (range 1-12 months). The pooled proportion of patients with adverse events was 54% (95% CI, 21%-84%; I2, 73%). There were no serious adverse events or deaths.
UNASSIGNED: In patients with chronic pouchitis, FMT is safe though there are mixed results in terms of its long-term efficacy. Future Randomized Controlled Trials with larger sample sizes and greater standardization in terms of preparation, delivery, and length of treatment of FMT are needed to determine efficacy.
摘要：
■囊炎是溃疡性结肠炎患者回肠-袋肛门吻合术后最常见的长期并发症。我们进行了系统评价和荟萃分析，评估了粪便微生物群移植（FMT）在慢性抗生素依赖性和难治性囊炎中的安全性和有效性。
■在2022年4月搜索了多个数据库，以研究报道FMT在慢性囊炎患者中的疗效和安全性。使用随机效应模型进行Meta分析以计算合并率。
■我们的综述中纳入了8项研究，共89名患者，其中74例患者接受FMT治疗，15例患者接受安慰剂治疗。平均年龄为32.6至51.5岁。在接受FMT的患者中，总体缓解的合并率为（囊炎疾病活动指数评分<7）22％（95％CI，9％-43％；I2，29％），临床缓解为20％（95％CI，6％-49％；I2，25％），临床反应率为42%（95%CI，30%-54%；I2，7%），复发率为60%(95%CI，40%-77%，I216％）平均随访4.67个月（范围1-12个月）。合并不良事件的患者比例为54％（95％CI，21％-84％；I2，73％）。无严重不良事件或死亡。
■在慢性囊炎患者中，FMT是安全的，尽管在其长期疗效方面存在混合结果。未来的随机对照试验具有更大的样本量和更高的标准化准备，delivery,和FMT的治疗长度需要确定疗效。
■在2022年4月搜索了多个数据库，以研究报道FMT在慢性囊炎患者中的疗效和安全性。使用随机效应模型进行Meta分析以计算合并率。
■我们的综述中纳入了8项研究，共89名患者，其中74例患者接受FMT治疗，15例患者接受安慰剂治疗。平均年龄为32.6至51.5岁。在接受FMT的患者中，总体缓解的合并率为（囊炎疾病活动指数评分<7）22％（95％CI，9％-43％；I2，29％），临床缓解为20％（95％CI，6％-49％；I2，25％），临床反应率为42%（95%CI，30%-54%；I2，7%），复发率为60%(95%CI，40%-77%，I216％）平均随访4.67个月（范围1-12个月）。合并不良事件的患者比例为54％（95％CI，21％-84％；I2，73％）。无严重不良事件或死亡。
■在慢性囊炎患者中，FMT是安全的，尽管在其长期疗效方面存在混合结果。未来的随机对照试验具有更大的样本量和更高的标准化准备，delivery,和FMT的治疗长度需要确定疗效。
