Table 1.
Clinical studies of probiotics in IBD
| Author | Design |
Group (Dose/d) (n) |
Results | |
| Probiotic | Comparator | |||
| Induction of remission of ulcerative colitis | ||||
| Kato 2004 [87] | DB, R, C | Bifidobacterium fermented milk (100 mL) (10) | Placebo (10) | Reduced UCDAI (P < 0.05) |
| Rembacken 1999 [85] | DB, R, C | E. coli Nissle 1917 (1 × 1011 cfu) (57) | Mesalamine (59) | As effective as mesalamine at attaining remission |
| Bibiloni 2005 [88] | Open-label | VSL#3 (3.6 × 109 cfu) (32) | None | 77% remission or response rate |
| Ishikawa 2003 [86] | R, C | Lactobacillus and Bifidobacterium-fermented milk (100 mL) (11) | Placebo (10) | Reduced exacerbation of symptoms (P < 0.01) |
| Borody 2003 [90] | Case reports | Fecal enema (6) | None | 100% remission |
| Maintenance of remission of ulcerative colitis | ||||
| Kruis 2004 [82] | DB, R, C | E. coli Nissle 1917(2.5-25 × 109 cfu) (162) | Mesalamine (165) | As effective as mesalamine at maintaining remission (P = 0.003) |
| Zocco 2006 [83] | Open-label | Lactobacillus GG (1.8 × 1010 cfu) (65) | Mesalamine (60) Mesalamine + LGG (62) | No difference in relapse rates at 12 mo. LGG more effective than mesalamine at prolonging relapse-free time (P < 0.05) |
| Shanahan 2006 [117] | DB, R, C | Lactobacillus salivarius or Bifidobacterium infantus (1 × 109 cfu) (52/group) | Placebo (53) | No improvement of time to relapse |
| Venturi 1999 [84] | Open-label | VSL#3 (1 × 1012 cfu) (20) | None | 75% maintained clinical and endoscopic remission |
| Induction of remission of Crohn’s disease | ||||
| Schultz 2004 [97] | DB, R, C | Lactobacillus GG (2 × 109 cfu) (5) | Placebo (6) | No difference in remission rates |
| McCarthy 2001 [118] | Open-label | Lactobacillus salivarius (1 × 1010 cfu) (25) | None | Reduced disease activity compared with baseline |
| Gupta 2000 [119] | Open-label | Lactobacillus GG (2 × 1010 cfu) (4) | None | Improvement in CDAI scores compared with baseline (P < 0.05) |
| Maintenance of remission of Crohn’s disease | ||||
| Prantera 2002 [95] | DB, R, C | Lactobacillus GG (1.2 × 1010 cfu) (23) | Placebo (22) | No significant difference in remission |
| Campieri 2000 [120] | R, C | VSL#3 (3 × 1011 cfu) (20) | Mesalamine (20) | Equivalent to mesalamine in preventing recurrence |
| Marteau 2006 [94] | DB, R, C | Lactobacillus johnsonii LA1(2 × 109 cfu) (48) | Placebo (50) | No difference in endoscopic recurrence |
| Malchow 1997 [93] | DB, R, C | E. coli Nissle 1917 (5 × 1010 cfu) (16) | Placebo (12) | No difference in remission rates |
| Bousvaros 2005 [96] | DB, R, C | Lactobacillus GG (2 × 1010 cfu) (39) | Placebo (36) | No difference in time to relapse |
| Guslandi 2000 [91] | R, C 6 mo | Saccharomyces boulardii (1 g/d) + mesalamine (2g) (16) | Mesalamine (16) | Significant prolongation of remission (P < 0.05) |
| Induction of remission of pouchitis | ||||
| Kuisma 2003 [80] | DB, R, C | Lactobacillus GG (1 × 1010 cfu) (10) | Placebo (10) | No difference in PDAI |
| Laake 2004 [121] | Open-label | Lactobacillus acidophilus and Bifidobacterium lactis-fermented milk (500 mL) (51) | None | Improved PDAI, no difference in histology |
| Gionchetti 2000 [78] | DB, R, C | VSL#3 (6 g) (20) | Placebo (20) | Increased remission time (P < 0.001) |
| Mimura 2004 [122] | DB, R, C | VSL#3 (6 g) (20 ) | Placebo (16) | Increased remission time (P < 0.0001) |
| Gionchetti 2003 [79] | DB, R, C | VSL#3 (1 × 1011) (20) | Placebo (20) | Increased remission time (P < 0.05) |
DB: Double-blind; R: Randomized; C: Controlled; UCDAI: Ulcerative colitis disease activity index; CDAI: Crohn’s disease activity index; LGG: Lactobacillus GG; PDAI: Pouchitis disease activity index.