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Strain-specific and outcome-specific efficacy of probiotics for the treatment of irritable bowel syndrome: A systematic review and meta-analysis.
McFarland, Lynne V; Karakan, Tarkan; Karatas, Ali.
Affiliation
  • McFarland LV; Department Medicinal Chemistry, School of Pharmacy, University of Washington, 6047 38th Avenue NE, Seattle, WA 98195, United States.
  • Karakan T; Department of Gastroenterology, Gazi University Faculty of Medicine, Besevler, Ankara 06500, Turkey.
  • Karatas A; Department of Gastroenterology, Gazi University Faculty of Medicine, Besevler, Ankara 06500, Turkey.
EClinicalMedicine ; 41: 101154, 2021 Nov.
Article in En | MEDLINE | ID: mdl-34712929
BACKGROUND: Consistent guidance for choosing an appropriate probiotic for the treatment of irritable bowel syndrome is lacking. METHODS: Literature databases searched included: PubMed, Google Scholar and NIH registry of clinical trials from inception to June 2021. Inclusion criteria: randomized controlled trials (RCTs) enrolling adult or pediatric IBS patients comparing probiotics against controls and ≥ 2 RCTs with common IBS outcome measures within each type of probiotic. Five common measures of IBS symptoms (changes in global Irritable Bowel Syndrome Severity Scoring System or IBS-SSS scores, frequency of global responders, changes in bloating or abdominal pain scores and frequency of abdominal pain relief) were used. This study was registered at Prospero (#CRD42018109169). FINDINGS: We screened 521 studies and included 42 randomized controlled trials (45 treatment arms, N = 3856). Four probiotics demonstrated significant reduction in abdominal pain relief: B. coagulans MTCC5260 (RR= 4.9, 95% C.I. 3.3, 7.3), L. plantarum 299v (RR= 4.6, 95% CI 1.9, 11.0), S. boulardii CNCM I-745 (RR= 1.5, 95% C.I. 1.1, 2.1) and S. cerevisiae CNCM I-3856 (RR= 1.3, 95% C.I. 1.04, 1.6). Mild-moderate adverse events were reported in 51% of the trials, none were more associated with the probiotic compared to controls. INTERPRETATION: Although the analysis of probiotic efficacy was limited by the diversity of IBS outcomes used in trials and lack of confirmatory trials for some strains, six single-strain probiotics and three different types of probiotic mixtures showed significant efficacy for at least one IBS outcome measure. These results might be relevant to clinical practice and policy.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Guideline / Systematic_reviews Language: En Journal: EClinicalMedicine Year: 2021 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Clinical_trials / Guideline / Systematic_reviews Language: En Journal: EClinicalMedicine Year: 2021 Document type: Article Affiliation country: Country of publication: