Living Evidence Synthesis Baseline Report. Hospital Universitario Ramón y Cajal. LE-IHD.
Creators: name: Rojas- Reyes, María
name: Bendersky, Josefina
name: Comas, David
name: Gil, Andrea
name: Plana, Maria
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Continuos update
subject: Evidence-based medicine
subject: Evidence Synthesis
subject: fecal microbiota transplant
subject: Inform Health Decisions
subject: Living Evidence
subject: Ulcerative colitis

description: Tittle: Effectiveness and safety of Fecal Microbiota Transplant in the Treatment of ulcerative colitis: A living overview. Authors: Andrea Correa-Pérez Afilliation: Clinical Biostatistics Unit. Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain. Faculty of Medicine. Universidad Francisco de Vitoria, Madrid, Spain Jorge de Vicente Guijarro Afilliation: Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal (IRYCIS) Madrid, Spain Andrea Gaetano Gil Afilliation: Clinical Biostatistics Unit. Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain Juan Ocaña Jiménez Afilliation: Servicio de Cirugía General y del Aparato Digestivo. Unidad de Coloproctología. Hospital Universitario Ramón y Cajal, Madrid, Spain Raquel Luengo González Afilliation: Department of Nursing and Physiotherapy. University of Alcalá, Madrid, Spain David Rigau Comas Afilliation: Iberoamerican Cochrane Centre. C/ Sant Antoni Maria Claret, 167. Pavelló 18, planta 0, 08025 Barcelona, Spain. CIBER de Epidemiología Clínica y Salud Pública (CIBERESP). Josefina Bendersky Afilliation: Institut d'Recerca-Servei d'Epidemiologia Clínica i Salut Pública. Hospital de la Santa Creu i Sant Pau. Carrer de Sant Quintí, 89, 08041 Barcelona, Spain María Ximena Rojas Reyes Afilliation: Institut d'Recerca-Servei d'Epidemiologia Clínica i Salut Pública. Hospital de la Santa Creu i Sant Pau. Carrer de Sant Quintí, 89, 08041 Barcelona, Spain María N Plana Farrás ORCID: 0000-0003-0921-7954 Afilliation: Unidad de Evaluación de Tecnologías Sanitarias, Ramón y Cajal University Hospital (IRYCIS), Madrid, Spain. CIBER Epidemiology and Public Health (CIBERESP) Corresponding author: Maria N Plana Farrás. Email address: nieves.plana@salud.madrid.org Postal address: Unidad de Evaluación de Tecnologías Sanitarias, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España. CIBER de Epidemiología y Salud Pública (CIBERESP). Funding sources/sponsors: This work is part of a project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No MSCA-IF-EF-ST #894990 (to María Ximena Rojas). This work is also supported by the Health Tecnology Assesment Unit of the Hospital Universitario Ramón y Cajal. The funders and institutions did not take any part in the development of this study. Conflicts of interest: Authors have declared no conflict of interest. ABSTRACT: Objective This living overview bring together all the evidence from systematic reviews assessing the effectiveness and safety of fecal microbiota transplantation (FMT) in patients with ulcerative colitis (UC). Particularly, in patients with moderate to severe UC refractary to corticosteroids treatment. Is in these patients where TMF has been proposed as a therapeutic alternative to improve the inflammation control. Design Living overview of reviews. Database The Epistemonikos-L.OVE platform was used for evidence identification, screening, and selection. This platform has been validated as a repository for COVID-19, and proved to be a highly comprehensive source of evidence. The main search source for the L.OVE platform is the Epistemonikos database (https://www.epistemonikos.org), a comprehensive database that collates information from multiple sources to identify systematic reviews and their included primary studies, including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, DARE, HTA Database, Campbell database, JBI Database of Systematic Reviews and Implementation Reports, EPPI-Centre Evidence Library. The team maintaining the Epistemonikos-L·OVE platform devised the literature search, using the following approach: i) Identification of terms relevant to the population and intervention components of the search strategy, using Word2vec technology to the corpus of documents available in Epistemonikos Database; ii) Discussion of search terms with methods experts to identify relevant, irrelevant and missing terms, iii) Creation of a sensitive boolean strategy encompassing all the relevant terms. The results of the literature searches were automatically incorporated into the L·OVE platform (automated retrieval) and organized in the corresponding L.OVE of “Fecal microbiota transplant for ulcerative colitis”. Methods We conducted a rapid overview and generated an structured evidence summary following a pre-established format that includes key messages, a summary of the body of evidence (presented as an evidence matrix in Epistemonikos), a meta-analysis of all studies (when possible), a summary table of results with the method GRADE (Grades of Recommendation, Assessment, Development and Evaluation) and a section of other considerations for decision making. Results We identified 16 systematic reviews that together included 79 primary studies, five of which were randomized clinical trials comparing FMT with placebo thefore were considered for analysis. Fecal microbiota transplant compared to placebo in patients with moderate to severe UC could increase the proportion of patients with clinical remission (RR 1.80, 95% CI (1.24 to 2.61)) and clinical remission with endoscopic response/remission ( RR 2.89, 95% CI (1.63 to 5.14)). There is uncertainty about the risk of serious adverse events associated with fecal microbiota transplant (RR 1.40, 95% CI (0.55 to 3.58)) very low certainty of the evidence due to inconsistency and impresicion. Conclusions This summary results are partially consistent with the identified systematic reviews . Fecal microbiota transplant showed to increase the proportion of patients with clinical remission and/or endoscopic response. There is uncertainty about the risk of serious adverse events related to the intervention. The certainty of the evidence is low or very low. © 2022 Hospital Universitario Ramón y Cajal, Spain/ EU H2020, Living Evidence to Inform Health Decisions Project. All rights reserved.