- Fecal microbiota transplantation (FMT) from healthy people to the gastrointestinal tract of children or adults with inflammatory bowel disease (IBD) is of uncertain efficacy and safety, according to a Cochrane review.
Why this matters
- The evidence is insufficient for the introduction of FMT for IBD into clinical practice.
- Pooled analysis of 4 randomized controlled trials or nonrandomized trials with a control group (n=277) that met eligibility criteria after search included Medline, EMBASE, Cochrane Library, and Cochrane IBD Group Specialized Register.
- The quality of the evidence was rated by GRADE criteria.
- Funding: None.
- For ulcerative colitis (UC), FMT may increase the rate of clinical remission at 8 weeks (37% vs 18% with control intervention; risk ratio [RR], 2.03; 95% CI, 1.07-3.86; low-certainty evidence).
- For UC, FMT may increase rate of endoscopic remission (30% vs 10%; RR, 2.96; 95% CI, 1.60-5.48; low-certainty evidence).
- FMT nonsignificantly increased severe adverse events (AEs; 7% vs 5%; RR, 1.40; 95% CI, 0.55-3.58; low-certainty evidence), most commonly with Clostridium difficile and cytomegalovirus infections, small bowel perforation, pneumonia.
- FMT did not increase rate of AEs (78% vs 75%; RR, 1.03; 95% CI, 0.81-1.31; moderate certainty of evidence).
- Small number of studies.
- No studies of Crohn's disease.