Probiotics for induction of remission in Crohn's Disease

Butterworth, AD; Thomas, AG; Akobeng, Anthony

doi:10.1002/14651858.cd006634

Cited by 33 publications

(31 citation statements)

References 17 publications

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“…Randomised controlled studies in which human adult IBD subjects were treated with herbal therapy were identified. For this systematic review, studies on prebiotics, probiotics fish oils/omega 3‐fatty acids, and moxibustion/acupuncture were excluded as these therapies have been extensively reviewed recently. Studies were included if they were placebo‐controlled or controlled against a conventional treatment.…”

Section: Methodsmentioning

confidence: 99%

Systematic review: the efficacy of herbal therapy in inflammatory bowel disease

Lam

Tsoi

et al. 2013

Aliment Pharmacol Ther

125

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Summary Background Complementary and alternative medicine (CAM), particularly herbal therapy, is widely used by patients with inflammatory bowel disease (IBD) but controlled data are limited. Aim To systematically review the literature on the efficacy of herbal therapy in the treatment of ulcerative colitis (UC) and Crohn's disease (CD). Methods Publications in English and non‐English literatures (MEDLINE, EMBASE, EBM Reviews, AMED, Global Health) were searched from 1947 to 2013 for controlled clinical studies of herbal therapy in IBD. Outcome measures included response and remission rates. Results Twenty‐one randomised controlled trials (14 UC; 7 CD) including a total of 1484 subjects (mean age 41, 50% female) were analysed. In UC, aloe vera gel, Triticum aestivum (wheat grass juice), Andrographis paniculata extract (HMPL‐004) and topical Xilei‐san were superior to placebo in inducing remission or response, and curcumin was superior to placebo in maintaining remission; Boswellia serrata gum resin and Plantago ovata seeds were as effective as mesalazine, whereas Oenothera biennis (evening primrose oil) had similar relapse rates as omega‐3 fatty acids in the treatment of UC. In CD, Artemisia absinthium (wormwood) and Tripterygium wilfordii were superior to placebo in inducing remission, and preventing clinical recurrence of post‐operative CD respectively. Conclusions Randomised controlled trials of herbal therapy for the treatment of IBD show encouraging results but studies remain limited and heterogenous. Larger controlled studies with stricter endpoints and better‐defined patient groups are required to obtain more conclusive results on the use of CAM therapies in IBD.

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Section: Methodsmentioning

confidence: 99%

Systematic review: the efficacy of herbal therapy in inflammatory bowel disease

Lam

Tsoi

et al. 2013

Aliment Pharmacol Ther

125

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“…Finally, 2 Cochrane reviews found that probiotics conferred no advantage over placebo in maintaining or inducing remission of CD . Therefore, probiotics are not suggested in the routine maintenance of remission in patients with CD .…”

Section: Microbiota As a Therapeutic Target In Inflammatory Bowel Dismentioning

confidence: 99%

Review article: the gut microbiome in inflammatory bowel disease—avenues for microbial management

Mcilroy

Ianiro

Mukhopadhya

et al. 2017

Aliment Pharmacol Ther

159

120

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“…No benefit of various probiotic preparations was observed with studies on induction of remission, prevention of recurrence of CD following active disease, or for prevention of post-operative recurrence. [48][49][50] Evidence for extending remission for patients with pouchitis was found, 51,52 but a study by another research group did not find the same product to be effective. 53 A systematic review did not find any benefit to combining probiotics with standard therapy for remission of CD in mild to moderate disease.…”

Section: Use Of Probiotics In Patients With Inflammatory Bowel Diseasementioning

confidence: 99%

Safety assessment of probiotics for human use

et al. 2010

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The safety of probiotics is tied to their intended use, which includes consideration of potential vulnerability of the consumer or patient, dose and duration of consumption, and both the manner and frequency of administration. Unique to probiotics is that they are alive when administered, and unlike other food or drug ingredients, possess the potential for infectivity or in situ toxin production. Since numerous types of microbes are used as probiotics, safety is also intricately tied to the nature of the specific microbe being used. The presence of transferable antibiotic resistance genes, which comprises a theoretical risk of transfer to a less innocuous member of the gut microbial community, must also be considered. Genetic stability of the probiotic over time, deleterious metabolic activities, and the potential for pathogenicity or toxicogenicity must be assessed depending on the characteristics of the genus and species of the microbe being used. Immunological effects must be considered, especially in certain vulnerable populations, including infants with undeveloped immune function. A few reports about negative probiotic effects have surfaced, the significance of which would be better understood with more complete understanding of the mechanisms of probiotic interaction with the host and colonizing microbes. Use of readily available and low cost genomic sequencing technologies to assure the absence of genes of concern is advisable for candidate probiotic strains. The field of probiotic safety is characterized by the scarcity of studies specifically designed to assess safety contrasted with the long history of safe use of many of these microbes in foods.

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Probiotics for induction of remission in Crohn's Disease

Abstract: Editorial group: Cochrane Gut Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 7, 2020.

Cited by 33 publications

References 17 publications

Systematic review: the efficacy of herbal therapy in inflammatory bowel disease

Systematic review: the efficacy of herbal therapy in inflammatory bowel disease

Review article: the gut microbiome in inflammatory bowel disease—avenues for microbial management

Safety assessment of probiotics for human use

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