S1576 Effectiveness and Safety of Fecal Microbiota Transplantation for Ulcerative Colitis Treatment: A Systematic Review and Meta-Analysis

Introduction: Despite progress in developing effective pharmaceutical regimens, the management of ulcerative colitis (UC) remains a challenge. There is a growing interest in utilizing fecal microbiota transplantation (FMT) as a potential treatment for UC however, due to the different formulations and endpoints in the existing studies, the safety and efficacy remain challenging. In this systematic review and meta-analysis, we provide an up-to-date and scientifically validated overview of the efficacy and safety profile of FMT in UC. Methods: We searched 4 electronic databases and analyzed only randomized clinical trials (RCT) that investigated the clinical and endoscopic efficacy of FMT in UC, regardless of administration route or dose. Clinical and endoscopic remission was assessed by comparing the odds ratio (OR) and 95% confidence interval (CI). Results: The initial search revealed 6737 studies. After removing the duplicates and applying our inclusion criteria, 15 articles were included in our analysis. The meta-analysis showed clinical remission in 54% receiving FMT vs 33.5% in controls (OR 4.11; 3.12, 5.42). The endoscopic response was 30% in the FMT group vs 18% in controls (OR 2.05; 1.28, 3.29). Heterogeneity was assessed low (by Cochran's Q and I2 index) in both clinical and endoscopic remission. Conclusion: Our data indicate that FMT can significantly improve clinical and endoscopic remission rates, suggesting a promising non-pharmacological therapeutic approach for patients with UC who fail conventional treatments. Further prospective studies are needed to determine the most effective formulation and dose while also addressing the safety profile to reinforce the utility of FMT in managing UC.