Efficacy of Lactobacillus GG in maintaining remission of ulcerative colitis.
BACKGROUND
Aminosalicylates are the mainstay of therapy to prevent relapse of quiescent ulcerative colitis. The rationale for using probiotics is based on the evidence implicating intestinal bacteria in the pathogenesis of this disorder.


OBJECTIVE
To evaluate the efficacy of Lactobacillus GG alone or in combination with mesalazine vs. mesalazine as maintenance treatment in ulcerative colitis.


METHODS
187 ulcerative colitis patients with quiescent disease were randomized to receive Lactobacillus GG 18 x 10(9) viable bacteria/day (65 patients), mesalazine 2400 mg/day (60 patients) or Lactobacillus GG + mesalazine (62 patients). Disease activity index, endoscopic and histological scores were determined at 0, 6 and 12 months and in case of relapse. The primary end point was to evaluate sustained remission.


RESULTS
Overall analysis showed no difference in relapse rate at 6 (P = 0.44) and 12 months (P = 0.77) among the three treatment groups. However, the treatment with Lactobacillus GG seems to be more effective than standard treatment with mesalazine in prolonging the relapse-free time (P < 0.05).


CONCLUSIONS
Lactobacillus GG seems to be effective and safe for maintaining remission in patients with ulcerative colitis, and it could represent a good therapeutic option for preventing relapse in this group of patients.
Zocco
M A
MA
Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
dal Verme
L Zileri
LZ
Cremonini
F
F
Piscaglia
A C
AC
Nista
E C
EC
Candelli
M
M
Novi
M
M
Rigante
D
D
Cazzato
I A
IA
Ojetti
V
V
Armuzzi
A
A
Gasbarrini
G
G
Gasbarrini
A
A
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007778:Lactobacillus; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use*; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine