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Probiotics not superior for maintaining ulcerative colitis remission
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ORLANDO — A systematic review showed no significant difference in efficacy between probiotics and placebo or mesalazine for maintenance of remission in ulcerative colitis, according to a poster presentation at the 2015 Advances in IBD Meeting.
“Five years ago, a Cochrane review found only four studies and no evidence regarding the efficacy of probiotics [for preventing UC relapse], but much work has been published in recent years,” Morris Gordon, PhD, from University of Central Lancashire and Blackpool Victoria Hospital in the UK, and colleagues wrote. They therefore performed an updated Cochrane systematic review of data published up to January 2015 to evaluate the safety and efficacy of probiotics for the maintenance of remission in UC.
The review included seven randomized controlled trials (n = 887), ranging in duration from 3 to 12 months and comparing probiotics to placebo or mesalazine. They found the efficacy of probiotics was not significantly different from placebo based on two small studies involving 92 patients, which had some risk of bias (OR = 0.56; 95% CI, 0.22-1.4).
They also found the efficacy of probiotics was not significantly different from mesalazine, based on four studies involving 638 patients (OR = 1.29; 95% CI, 0.92-1.8). Incidence of adverse events was also statistically comparable (OR = 1.16; 95% CI, 0.79-1.71).
“There is a trend in favor of mesalazine, but this is not statistically significant,” Morris said during his poster presentation. “It seems very hard to draw any strong conclusions. … There is some evidence to suggest there may be a trend towards effectiveness [of probiotics] when compared to placebo, but this is not statistically significant. … It therefore appears that — for the moment — probiotics cannot be supported as a superior intervention either compared to placebo or mesalazine for the maintenance of remission in ulcerative colitis.”
The investigators concluded that further research on the role of probiotics in maintaining remission in UC is warranted. – by Adam Leitenberger
Reference: Gordon M, Farrell M. Abstract P-054. Presented at Advances in Inflammatory Bowel Diseases; Dec. 10-12, 2015; Orlando, Fla.
Disclosures: Healio Gastroenterology was unable to confirm relevant financial disclosures at the time of publication.