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Nutrients. 2019 Jan 30;11(2). pii: E293. doi: 10.3390/nu11020293.

The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis.

Author information

1
AB-Biotics, S.A., ESADE Creapolis, Av. Torre Blanca, 57, Sant Cugat del Vallès, E-08172 Barcelona, Spain. asto@ab-biotics.com.
2
AB-Biotics, S.A., ESADE Creapolis, Av. Torre Blanca, 57, Sant Cugat del Vallès, E-08172 Barcelona, Spain. mendez@ab-biotics.com.
3
AB-Biotics, S.A., ESADE Creapolis, Av. Torre Blanca, 57, Sant Cugat del Vallès, E-08172 Barcelona, Spain. sergi@ab-biotics.com.
4
Department of Nutrition, Food Science, and Gastronomy, XaRTA ⁻ INSA, Faculty of Pharmacy, University of Barcelona, Campus de l'Alimentació de Torribera, Av. Prat de la Riba, 171, Santa Coloma de Gramenet, E-08921 Barcelona, Spain. afarran@ub.edu.
5
AB-Biotics, S.A., ESADE Creapolis, Av. Torre Blanca, 57, Sant Cugat del Vallès, E-08172 Barcelona, Spain. espadaler@ab-biotics.com.

Abstract

Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13⁻2.15, p-value = 0.007, I² = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23⁻2.43, p-value = 0.002, I² = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.

KEYWORDS:

prebiotic; probiotic; remission; synbiotic; ulcerative colitis

PMID:
30704039
PMCID:
PMC6412539
DOI:
10.3390/nu11020293
[Indexed for MEDLINE]
Free PMC Article

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