Effects Of Probiotics On Remission And Relapse In Adult Ulcerative Colitis

OBJECTIVE:Ulcerative colitis (UC) is a chronic intestinal inflammatory disease with increasing prevalence worldwide. Accumulating evidences have suggested that intestinal microbiota play an important role in the pathogenesis of this disorder. Therefore, increasing clinical trials have been carried out to study the effects of different probiotics in treating UC and suggested that probiotics could take beneficial effects to the UC patients. However, many of these studies are either relatively small-sampled or not RCTs. As a result, a meta-analysis based on a large data of RCTs could make the evidence more convincing. This paper summarizes the available literature before October,2012which concerned the probiotic intervention studies for the management of UC, comparing the effects between probiotics and placebo, no additive treatment (NAT) to standard therapy or mesalazine, addressing the clinical outcome parameters in UC subjects.METHODS:Electronic databases including MEDLINE, EMBASE, the Cochrane Controlled Trails Register, ScienceDirect were searched to find relevant randomized controlled trials (RCTs). Trials were reviewed on the efficacy of probiotics with placebo, no additive treatment or mesalazine in treating UC. Statistical analysis was performed using Stata software (version11.0). Pooled relative risk with95%confidence intervals was applied.RESULTS:Twelve RCTs including1250subjects were identified. Meta-analysis showed that when compared with the placebo or no additive treatment, the probiotics can promote the remission rate and decreased the relapse rate (treatment course was≤6months). However, when the treatment course was last for one year, probiotics were not superior to the controls in preventing disease relapse. Interestingly, when compared to mesalazine, probiotics revealed similar efficacy in preventing relapse of UC regardless of the treatment time.CONCLUSIONS:Probiotics have showed their efficacy and safety in treating UC in this study. Additional studies on the different effects between probiotics species, dosages as well as the treatment durations are still warranted before probiotics can routinely be recommended as a treatment option for inducing remission and preventing relapse of UC in adults.