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Effect of Probiotics on Inducing Remission and Maintaining Therapy in Ulcerative Colitis, Crohnʼs Disease, and Pouchitis: Meta-analysis of Randomized Controlled Trials
Abstract
BACKGROUND: Whether probiotics are beneficial at all stages of treatment in inflammatory bowel disease or superior to placebo remains controversial. METHODS: Two reviewers independently selected randomized controlled trials comparing probiotics with controls in inflammatory bowel disease and extracted data related to remission/response rates, relapse rates, and adverse events. Subanalyses were also performed. RESULTS: Twenty-three randomized controlled trials with a total of 1763 participants met the inclusion criteria. From the meta-analysis, probiotics significantly increase the remission rates in patients with active ulcerative colitis (UC) (P = 0.01, risk ratio [RR] = 1.51). The remission rates were significantly higher in patients with active UC treated with probiotics than placebo (P < 0.0001, RR = 1.80). Unfortunately, subgroup analysis found that only VSL#3 significantly increased the remission rates compared with controls in patients with active UC (P = 0.004, RR = 1.74). Interestingly, VSL#3 (P < 0.00001, RR = 0.18) also significantly reduced the clinical relapse rates for maintaining remission in patients with pouchitis. No significantly different adverse events were detected between probiotics and controls in the treatment of UC (P = 0.94, RR = 0.99) or CD (P = 0.33, RR = 0.87). CONCLUSIONS: Administration of probiotics results in additional benefit in inducing remission of patients with UC. VSL#3 are beneficial for maintaining remission in patients with pouchitis. And, probiotics can provide the similar effect as 5-aminosalicylic acid on maintaining remission of UC, although no additional adverse events presented.
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“A meta-analysis has shown that VSL#3 significantly reduced the clinical relapse rates for maintaining remission in patients with pouchitis.82”
From The gut microbiota and host health: a new clinical frontier (2016) · cites this paper as [82]
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Silva, A. R., Bernardo, A., de Mesquita, M. F., Patto, J. V., Moreira, P. A. M., Padrão, P., & Silva, M. L. (2020) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/978-1-7998-4808-0.ch015 · Cited by 1
Melchert, T. P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.004 · Cited by 1
Probiotics in Inflammatory Bowel Disease
Mardini, H. E., & Grigorian, A. Y. (2014) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000040 · Cited by 1
Lindberg, A. (2015) · Figshare · Cited by 1
Jackson, B. D. (2019) · Minerva Access (University of Melbourne) · Cited by 1
Mother to fetus transfer of probiotic lactobacilli in mice
Hashemi, A. (2017) · TSpace (University of Toronto) · Cited by 1
IsHak, W. W. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108650182.052 · Cited by 2
Therapeutic Modification of the GI Microbiome
Horowitz, S. (2015) · Alternative and Complementary Therapies · doi:10.1089/act.2015.29001.sh
Metadata
- Authors
- Shen, J., Zuo, Z.-X., & Mao, A.-P.
- Affiliations
- Shanghai Jiao Tong University (CN)
- ORCID
- Shen, Jun
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-01
- Volume
- 20
- Issue
- 1
- Pages
- 21-35
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W1997405434
- Cited by
- 364
- References
- 57
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 16 · 2023: 18 · 2022: 22 · 2021: 26 · 2020: 74 · 2019: 18 · 2018: 33 · 2017: 46 · 2016: 38 · 2015: 34 · 2014: 22
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- 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
- probiotics, ulcerative colitis
- MeSH terms
- Colitis, Ulcerative, Crohn Disease, Humans, Prognosis, Remission Induction, Randomized Controlled Trials as Topic, Pouchitis, Probiotics, Maintenance Chemotherapy
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