Probiotics may reduce intestinal inflammation in patients with ulcerative colitis

Takeaway

• Multi-strain probiotics may be associated with reduced intestinal inflammation in patients with ulcerative colitis (UC), but not in Crohn’s disease (CD) and is well tolerated.

Why this matters

• There is considerable interest in the role of gut microflora in the pathophysiology of the inflammatory bowel diseases (IBD) UC and CD, and probiotics may be useful as a potential adjuvant therapy in these patients, but reports of their efficacy are conflicting.

Study design

• 143 patients with asymptomatic IBD (81 with UC and 62 with CD) who were randomly assigned to receive the probiotics and placebo (1 mL/kg/day) for 4 weeks.
• Primary outcome: difference in the overall IBD Quality of Life (IBD-QoL) scores between 2 groups.
• Secondary outcome: difference in clinical disease activity scores and laboratory findings, including faecal calprotectin (FCAL) level between 2 groups.
• Funding: Symprove Limited.

Key results

• In patients with UC and CD, probiotic vs placebo groups did not differ in IBD-QoL scores.
• There was no significant difference in the clinical disease activity scores and laboratory findings in patients with UC and CD who received probiotics vs placebo.
• In patients with UC, no significant difference was seen in FCAL level before and after probiotics vs placebo (P=.076).
• Post hoc analyses showed a significant reduction in FCAL level in the patients with UC who received probiotic vs placebo (P=.011), and no significant difference was seen in FCAL level in patients with CD.
• No serious adverse events were reported.

Limitations

• Exploratory nature of study.