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Probiotics may be beneficial for Ulcerative Colitis, but not Crohn’s Disease

Probiotics may be beneficial for Ulcerative Colitis, but not Crohn’s Disease

According to findings from a new systematic review and meta-analysis, a probiotic called VSL#3 may be effective in inducing remission in active ulcerative colitis (UC), but it has not been found to be effective  in treating active Crohn’s disease (CD) or preventing relapse after its remission.The original article by  Y. Derwa et al. was a technically  checked  by Dr Y Yuan and the Handling Editor for this article was Professor Jonathan Rhodes, and it was accepted for publication after full peer-review.

Ulcerative colitis (UC) and Crohn’s disease (CD) are inflammatory bowel diseases (IBD). Evidence implicates disturbances of the gastrointestinal microbiota in their pathogenesis.

The present study was conducted to perform a systematic review and meta-analysis to examine the efficacy of probiotics in IBD.
MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (until November 2016). Eligible randomised controlled trials (RCTs) recruited adults with ulcerative colitis (UC) or CD, and compared probiotics with 5-aminosalicylates (5-ASAs) or placebo. Dichotomous symptom data were pooled to obtain a relative risk (RR) of failure to achieve remission in active IBD, or RR of relapse of disease activity in quiescent IBD, with 95% confidence intervals (CIs).
The search identified 12 253 citations out of which  Twenty-two RCTs were eligible. There was no benefit of probiotics over placebo in inducing remission in active UC (RR of failure to achieve remission=0.86; 95% CI=0.68-1.08). However, when only trials of VSL#3 were considered there appeared to be a benefit (RR=0.74; 95% CI=0.63-0.87). Probiotics appeared equivalent to 5-ASAs in preventing UC relapse (RR=1.02; 95% CI=0.85-1.23). There was no benefit of probiotics in inducing remission of active CD, in preventing relapse of quiescent Crohn’s disease (CD), or in preventing relapse of Crohn’s disease (CD) after surgically induced remission.

It was concluded that probiotic VSL#3 may be effective in inducing remission in active ulcerative colitis (UC). Probiotics may be as effective as 5-ASAs in preventing relapse of quiescent ulcerative colitis (UC). The efficacy of probiotics in Crohn’s disease (CD) remains uncertain, and more evidence from RCTs is required before their utility is known. Therefore use of probiotics and other “microflora-altering products” to manipulate the gut microbiome holds promise for preventing and treating mild forms of inflammatory and metabolic disorders, but “a rational development” of these products that includes in-depth research into their protective mechanisms is needed,

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Source: self

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