07/17/06 02:10 PM
Review of Probiotics for IBD


The data on these agents originally suffered from poor study design, limits on generalizability and commercial bias: true 'junk science'. Reviews mentioning them still grossly outnumber studies with primary data, but the application of better study design supports their use. Thus far, there are more data for probiotic use in ulcerative colitis than in Crohn's disease. VSL#3 is a combination of probiotic strains that has been shown to maintain remission and decrease the incidence of pouchitis. Recent open-label data suggest that it may have utility for the induction of remission in patients with ulcerative colitis.[24] In this small study of 34 patients with moderately active ulcerative colitis, there was a 77% response rate, indicating that the VSL#3 probiotic mixture induces remission in patients with active ulcerative colitis. A German study[25] found equivalent efficacy of Escherichia coli Nissle 1917 and mesalazine in maintaining remission in ulcerative colitis. Although interesting, these must be considered grade III data and require more extensive exploration and validation in large-scale clinical trials.


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