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Date of Award
Spring 2020
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
ToriAnne Yetter
Abstract
Abstract
Introduction: UC is a chronic, idiopathic disease of the colon with current treatment including immunomodulating medications with severe side effects or curative total proctocolectomy with lifestyle implications. Intestinal dysbiosis has been considered as a component in UC progression and FMT has been shown to restore intestinal dysbiosis in patients with refractory C. difficile infections. Therefore, this review investigates, in adults (18 years+) with ulcerative colitis (P), does Fecal Microbiota Transplantation (I) reduce the symptoms or initiate remission of ulcerative colitis (O) compared to placebo treatment (C ) in patients where standard of care treatment fails to induce remission?
Methods: From an investigation in November 2018 in using PubMed, Academic Search Ultimate, and Biomedical Reference Collection, a total of 6 articles including RTCs and open label studies were selected as the best articles currently available based on publication date, method of treatment delivery, and sample population. The selected articles were then evaluated on the basis of their study design and reported results and compared.
Results: Three of the analyzed studies were RTCs and compared a control placebo or autologous FMTs to an experimental group of donor FMTs who had been previously diagnosed with UC. Three studies were open-label studies and therefore reported the results of FMT on participants without comparing the results to a control group. Some studies found statistically significant results of the FMT on participants’ Mayo scores or in inducing remission. The included studies provided study follow-up of less than or equal to 12 weeks.
Discussion: Statistically significant results showed FMT had a positive influence on participants Mayo scores. However, outcome measures varied between studies. In addition, the use of RCT and open label studies limits the ability to directly compare FMT as the variable responsible for disease improvement in this analysis. Therefore, the efficacy of FMT in treating UC cannot be confirmed by this analysis despite positive findings with statistical significance. Further investigation is warranted into the efficacy of FMT to treat UC.
Conclusion: Although this analysis shows some statistically significant results, the treatment effect of FMT needs to be further investigated. It is clinically important to continue to research the efficacy of using FMT as the current treatment modalities present a multitude of complications and quality of life considerations. Therefore, further RTCs are warranted to address the efficacy of FMT while addressing the weaknesses of the current research.
Recommended Citation
Chenault, Courtney, "The efficacy of Fecal Microbiota Transplantation in the treatment of ulcerative colitis" (2020). Capstone Showcase. 1.
https://scholarworks.arcadia.edu/showcase/2020/pa/1
Additional Files
Courtney Chenault PICO Poster Final.pptx (1 kB)Poster
Courtney Chenault PICO references for Poster Presentation.pdf (82 kB)
Reference List
The efficacy of Fecal Microbiota Transplantation in the treatment of ulcerative colitis
Abstract
Introduction: UC is a chronic, idiopathic disease of the colon with current treatment including immunomodulating medications with severe side effects or curative total proctocolectomy with lifestyle implications. Intestinal dysbiosis has been considered as a component in UC progression and FMT has been shown to restore intestinal dysbiosis in patients with refractory C. difficile infections. Therefore, this review investigates, in adults (18 years+) with ulcerative colitis (P), does Fecal Microbiota Transplantation (I) reduce the symptoms or initiate remission of ulcerative colitis (O) compared to placebo treatment (C ) in patients where standard of care treatment fails to induce remission?
Methods: From an investigation in November 2018 in using PubMed, Academic Search Ultimate, and Biomedical Reference Collection, a total of 6 articles including RTCs and open label studies were selected as the best articles currently available based on publication date, method of treatment delivery, and sample population. The selected articles were then evaluated on the basis of their study design and reported results and compared.
Results: Three of the analyzed studies were RTCs and compared a control placebo or autologous FMTs to an experimental group of donor FMTs who had been previously diagnosed with UC. Three studies were open-label studies and therefore reported the results of FMT on participants without comparing the results to a control group. Some studies found statistically significant results of the FMT on participants’ Mayo scores or in inducing remission. The included studies provided study follow-up of less than or equal to 12 weeks.
Discussion: Statistically significant results showed FMT had a positive influence on participants Mayo scores. However, outcome measures varied between studies. In addition, the use of RCT and open label studies limits the ability to directly compare FMT as the variable responsible for disease improvement in this analysis. Therefore, the efficacy of FMT in treating UC cannot be confirmed by this analysis despite positive findings with statistical significance. Further investigation is warranted into the efficacy of FMT to treat UC.
Conclusion: Although this analysis shows some statistically significant results, the treatment effect of FMT needs to be further investigated. It is clinically important to continue to research the efficacy of using FMT as the current treatment modalities present a multitude of complications and quality of life considerations. Therefore, further RTCs are warranted to address the efficacy of FMT while addressing the weaknesses of the current research.