Randomized, Placebo-Controlled Trial of Lactobacillus rhamnosus GG as Treatment of Atopic Dermatitis in Infancy

Abstract

Grüber C, Wendt M, Sulser C, et al. Allergy. 2007;62(11):1270–1276 PURPOSE OF THE STUDY. To investigate the efficacy of Lactobacillus rhamnous GG (LGG) as a food supplement for children with mild-to-moderate atopic dermatitis (AD). STUDY POPULATION. One hundred two children aged 3 to 12 months with mild-to-moderately severe AD who were not taking antiinflammatory medications were included in this German study. METHODS. Subjects were randomly assigned to receive LGG (5 × 109 colony-forming units twice per day) or placebo for 12 weeks. Severity Scoring Atopic Dermatitis (SCORAD) index and use of hydrocortisone 1% ointment as a rescue medication were recorded at 4, 8, and 12 weeks of treatment. RESULTS. One hundred two subjects were randomly assigned and completed the treatment period (54 in the treatment group, 48 in the placebo group). Initial symptom load was similar in both groups (SCORAD index: 24.6 ± 8.8 in the LGG group and 23.6 ± 7.8 in the placebo group) and improved over time. There were no statistically significant differences between the groups at any of the analysis times (SCORAD index for LGG versus placebo: 23.8 ± 12.4 vs 20.6 ± 9.9 at 4 weeks, 22.5 ± 14.6 vs 17.9 ± 13.1 at 8 weeks, and 19.6 ± 15.4 vs 15.1 ± 12.1 at 12 weeks, respectively). No statistically significant differences were found when the data were stratified according to age, eczema severity, or use of rescue medications, and no differences were found in the use of rescue medications, total immunoglobulin E level, or newly developed allergic sensitization to hen's egg or cow's milk. CONCLUSIONS. This study showed no therapeutic effect of LGG for the treatment of mild-to-moderate AD in infancy. REVIEWER COMMENTS. In our practice, parents of children with AD frequently inquire about whether they should supplement their children's diets with lactobacilli. Previous studies had shown some possible benefit of supplementation with lactobacilli for prevention of AD in infants at risk but even less-promising results regarding its use in the treatment of AD. This study adds to the literature, finding no utility of lactobacilli supplementation for the treatment of established AD.