CoChat
Sign Up
Cited by 339Liver Disease and TransplantationProbiotics and Fermented FoodsGut microbiota and health

Probiotic VSL#3 Reduces Liver Disease Severity and Hospitalization in Patients With Cirrhosis: A Randomized, Controlled Trial

Dhiman, Radha K., Rana, Baldev, Agrawal, Swastik, Garg, Ashish, Chopra, Madhu, Thumburu, Kiran K., Khattri, Amit, Malhotra, Samir +2 more·2014·Gastroenterology
DOI 10.1053/j.gastro.2014.08.031
Open this paper in CoChat — free account

Abstract

Background & aims Little is known about whether probiotics can affect outcomes of patients with cirrhosis and hepatic encephalopathy (HE). We assessed the efficacy of a probiotic preparation in preventing the recurrence of HE (primary outcome) and reducing the number of hospitalizations and severity of liver disease in patients with cirrhosis.Methods We performed a double-blind trial at a tertiary care hospital in India. Patients with cirrhosis who had recovered from an episode of HE during the previous month were assigned randomly (using computer-generated allocation) to groups given a probiotic preparation (VSL#3, 9 × 10(11) bacteria; CD Pharma India Private Limited, New Delhi, India) (n = 66) or placebo (n = 64) daily for 6 months.Results There was a trend toward a reduction in the development of breakthrough HE among patients receiving the probiotic (34.8% in the probiotic group vs 51.6% in the placebo group; hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.38-1.11; P = .12). Fewer patients in the probiotic group were hospitalized for HE (19.7% vs 42.2%, respectively; HR, 0.45; 95% CI, 0.23-0.87; P = .02) or for complications of cirrhosis (24.2%) than in the placebo group (45.3%) (HR, 0.52; 95% CI, 0.28-0.95; P = .034). Child-Turcotte-Pugh and model for end-stage liver disease scores improved significantly from baseline to 6 months in the probiotic group, but not in the placebo group. There were no adverse events related to VSL#3.Conclusions Over a 6-month period, daily intake of VSL#3 significantly reduced the risk of hospitalization for HE, as well as Child-Turcotte-Pugh and model for end-stage liver disease scores, in patients with cirrhosis. ClinicalTrials.gov number: NCT01110447.

Integrity signals

Registry

Crossref · 10.1053/j.gastro.2014.08.031

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A double-blind trial showed that daily VSL#3 reduced hospitalization risk for hepatic encephalopathy and improved Child-Turcotte-Pugh and MELD scores in cirrhosis patients.

    “A double-blind trial showed that daily intake of VSL#3 reduced the risk of hospitalization for hepatic encephalopathy, as well as Child–Turcotte–Pugh and model for end-stage liver disease (MELD) scores, in patients with cirrhosis121.”

    From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [121]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Dhiman, R. K., Rana, B., Agrawal, S., Garg, A., Chopra, M., Thumburu, K. K., Khattri, A., Malhotra, S., Duseja, A., & Chawla, Y. K.
Affiliations
Post Graduate Institute of Medical Education and Research (IN)
Corresponding author
Dhiman, Radha K.
ORCID
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2014-12
Volume
147
Issue
6
Pages
1327-1337.e3
ISSN
0016-5085 (ISSN-L)
DOI
10.1053/j.gastro.2014.08.031
OpenAlex
W2170666048
Cited by
339
References
39
Citations by year
2026: 12 · 2025: 15 · 2024: 28 · 2023: 37 · 2022: 26 · 2021: 47 · 2020: 33 · 2019: 31 · 2018: 33 · 2017: 30 · 2016: 25 · 2015: 20 · 2014: 2
FWCI
14.38
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
VSL#3, probiotics, liver cirrhosis, hepatic encephalopathy, hospitalization, Child-Pugh score, MELD score, liver disease severity, cirrhosis complications
MeSH terms
Double-Blind Method, Female, Hepatic Encephalopathy, Hospitalization, Humans, Liver Cirrhosis, Male, Middle Aged, Quality of Life, Recurrence, Severity of Illness Index, Biomarkers, Treatment Outcome, Hospital Mortality, Probiotics, Tertiary Care Centers, Microbiota

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review