Meta-analysis: probiotic may prevent childhood asthma

  • Du X & al.
  • Allergy Asthma Proc
  • 1 Jul 2019

  • International Clinical Digest
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Takeaway

  • A meta-analysis finds that, in a subgroup of randomized controlled trials, the probiotic Lactobacillus rhamnosus GG given pre- and postnatally may reduce asthma by 25% in mostly high-risk children.

Why this matters

  • Results need confirmation in larger, higher-quality studies.

Study design

  • Meta-analysis of 17 randomized controlled trials (RCTs; n=5246 children) after search of PubMed, Web of Science, the Cochrane Library, Scopus, and Chinese databases.
  • The primary outcome was clinically diagnosed asthma in children.
  • 14 of the 17 trials were of high-risk children.
  • 11 of the 17 trials had both pre- and postnatal exposure.
  • 8 of the 17 trials were of L rhamnosus GG.
  • Funding: National Science Foundation of China; others.

Key results

  • The pooled data revealed no reduction in childhood asthma (risk ratio [RR], 0.86; P=.06).
    • Subgroup analysis by strain found that L rhamnosus GG cut childhood asthma risk by 25% (RR, 0.75; P=.04; I2=11%).
    • Subgroup analysis by period of intervention found that postnatal exposure cut childhood asthma risk by 37% (RR, 0.63; P=.03; I2=0%).
  • The pooled data found no reduction in childhood allergic rhinitis (RR, 1.03; 95% CI, 0.77-1.39), wheeze (RR, 0.94; 95% CI, 0.81-1.08), or positive aeroallergen skin-prick test result (RR, 0.74; 95% CI, 0.50-1.09).

Limitations

  • High-risk children were not defined.
  • Missing data on type/dose of placebo.