A meta-analysis on the efficacy of probiotics for maintenance of remission and prevention of clinical and endoscopic relapse in Crohn's disease.
OBJECTIVE
To evaluate whether probiotics maintain remission in patients with Crohn's disease (CD).


METHODS
A meta-analysis of controlled clinical trials.


METHODS
PUBMED and Cochrane Central Register of Controlled Trials were searched for clinical trial studies investigated the efficacy of probiotics for the maintenance of remission in Crohn's disease. Clinical relapse and endoscopic relapse were the key outcomes of interest. Data were searched within the time period of 1966 through May 2007.


RESULTS
Eight randomized placebo-controlled clinical trials met our criteria and were included in the analysis. Seven determined clinical relapse and three evaluated endoscopic relapse among patients with CD received probiotics for maintenance of remission. Pooling of seven trials for the outcome of clinical relapse yielded an odds ratio of 0.92 (95% confidence interval of 0.52-1.62, P = 0.8853), a nonsignificant odds ratio. The odds ratio for three studies for the outcome of endoscopic relapse was 0.97 (95% confidence interval of 0.54-1.78, P = 0.93), a nonsignificant odds ratio.


CONCLUSIONS
This meta-analysis fails to demonstrate the efficacy of probiotics in maintaining remission and preventing clinical and endoscopic recurrence in CD. It is suggested to use probiotic preparations containing a mixture of lactobacillus with E. coli or Saccharomyces.
Rahimi
Roja
R
Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Nikfar
Shekoufeh
S
Rahimi
Fatemeh
F
Elahi
Behzad
B
Derakhshani
Saeed
S
Vafaie
Mohammad
M
Abdollahi
Mohammad
M
D003424:Crohn Disease / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D007778:Lactobacillus; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D013906:Thoracoscopy; D016896:Treatment Outcome