Efficacy and safety of fecal transplantation versus targeted therapies in ulcerative colitis: network meta-analysis

We conducted this network meta-analysis to compare the efficacy and safety of targeted pharmacotherapies and fecal microbial transplantation (FMT). Nineteen studies were included and there was only one head-to-head randomized controlled trial (adalimumab vs vedolizumab). All interventions, including...

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Bibliographic Details
Published in:Future microbiology 2021-10, Vol.16 (15), p.1215-1227
Main Authors: Vuyyuru, Sudheer K, Kedia, Saurabh, Kalaivani, Mani, Sahu, Pabitra, Kante, Bhaskar, Kumar, Peeyush, Ranjan, Mukesh K, Makharia, Govind, Ananthakrishnan, Ashwin, Ahuja, Vineet
Format: Article
Language:English
Subjects:
Adalimumab - therapeutic use
anti-TNF
Antibodies, Monoclonal, Humanized - therapeutic use
biologicals
Colitis, Ulcerative - therapy
fecal microbial transplantation
Fecal Microbiota Transplantation
Humans
Network Meta-Analysis
Randomized Controlled Trials as Topic
ulcerative colitis
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Summary:We conducted this network meta-analysis to compare the efficacy and safety of targeted pharmacotherapies and fecal microbial transplantation (FMT). Nineteen studies were included and there was only one head-to-head randomized controlled trial (adalimumab vs vedolizumab). All interventions, including FMT, were superior to a placebo in inducing clinical remission (except adalimumab – odds ratio 1.66; 95% CI: 0.97–2.85), clinical response and endoscopic remission. FMT was comparable with other agents in achieving all efficacy outcomes. Infliximab was ranked highest in inducing clinical remission (surface under the cumulative ranking, 0.8). There was no difference in safety outcomes between FMT and other targeted therapies. FMT is as efficacious and as safe as other targeted therapies in inducing clinical remission, clinical response and endoscopic remission. Further studies to assess the long-term benefits are needed in order to reach a definitive conclusion.
ISSN:1746-0913
1746-0921
DOI:10.2217/fmb-2020-0242