Abstract
(1) Background: Inflammatory bowel diseases are pathologies of unknown etiology and auto-immune pathogenia. The use of probiotics is studied in order to increase the arsenal of treatments. The aim was to assess the efficacy of the probiotics in these diseases in the active or quiescent phases; (2) Methods: A systematic review with meta-analysis was performed by an exhaustive bibliographic search in Medline, Cinahl, Embase, Scopus, Web of Science, and Cochrane Library. The inclusion criteria were studies of more than 10 years, English/Spanish, clinical trials, and involving human beings. Relative risk was used to compare efficacy, which was meta-analyzed using a fixed effects model. Heterogeneity was evaluated with the Higgins I2 test; (3) Results: Nineteen studies were included in the systematic review and 17 in the meta-analysis, with a total of 1537 patients (nexperimental group = 762; nplacebo group = 775). There are significant remission differences in ulcerative colitis (relative risk (RR) = 0.81; 95% CI = 0.72–0.91; I2 = 32%; p = 0.16). However, no significant differences were found in the use of probiotics for the prevention of ulcerative colitis, and for the remission of Crohn’s disease; (4) Conclusions: There are data showing an additional beneficial effect of probiotics on active ulcerative colitis. More and better studies are needed which assess its possible therapeutic efficacy for quiescent ulcerative colitis and for Crohn’s disease.
Highlights
Inflammatory bowel diseases (IBDs) are a group of auto-immune pathologies, with Crohn’s disease (CD) and ulcerative colitis (UC) among the most well-known
A total of 1814 articles were identified in the initial literature search, and 83 additional documents that were found in clinical trial specific records were excluded (Clinical Trial Gov and Prospero)
Of the 17 studies included in the meta-analysis, 52.94% (n = 9) of the randomized clinical trials (RCTs) assessed the efficacy of the probiotics to induce remission of active UC, 17.64% (n = 3) studied their efficacy in preventing relapse in quiescent UC, 29.41% (n = 5) analyzed their efficacy in inducing remission in active Crohn’s disease, and no studies were found that assessed the efficacy of probiotics in preventing relapse in quiescent Crohn’s disease
Summary
Inflammatory bowel diseases (IBDs) are a group of auto-immune pathologies, with Crohn’s disease (CD) and ulcerative colitis (UC) among the most well-known. They are both of recurrent clinical course and show a higher incidence in developed countries [1,2]. Environmental factors have been involved, with possible mediators including geo-localization, tobacco, rest disorders, surgical interventions or infections during childhood, and diet—the latter considered a higher risk factor in the development of such pathologies [2,3]. The following have been recommended: quitting tobacco use, specific diet and nutrition, anti-inflammatories such as corticoids (temporary use), immuno-suppressors, biological therapy, and surgery [4].
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