High dose probiotic and prebiotic cotherapy for remission induction of active Crohn’s disease

Abstract

High-dose probiotic and prebiotic cotherapy can be safely and effectively used for the treatment of active CD.

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

“…Además, el uso de simbióticos se asocia con mejoría clínica y disminución de marcadores inflamatorios (47,48).…”

Probiotics and Crohn’s Disease

“…More recently, mucosal healing has emerged as an important and objective treatment endpoint in evaluating the efficacy for the treatments of Crohn's disease [14]. The majority of the studies of probiotics in Crohn's disease have used clinical endpoints, with the exception of the post-operative recurrence studies [15].…”

“…In an open-label trial, Fujimori et al examined the effect of synbiotic therapy (Bifidobacterium breve, Lactobacillus casei, Bifidobacterium longum, and psyllium) in 10 CD patients with active disease, the CDAI significantly improved (255-136, P = 0.009) with only two of the six responders successfully discontinuing steroid therapy in 13 months [15]. In a randomized controlled study of a different synbiotic (Bifidobacterium longum and Synergy 1 [inulin and oligofructose]), the CDAI of 35 patients with active CD also significantly improved at 6 months in the treatment group (219 ± 78 vs. 147 ± 74, p = 0.02) but not in the placebo group (249 ± 78 vs. 233 ± 155, p = 0.81) [16].…”

Responders and non-responders to probiotic interventions

“…For example, in the one study pertaining to responders and non-responders to probiotic therapy, the primary measurement of response was based upon the Crohn's disease activity index and the International Organization for the Study of Inflammatory Bowel Disease score. 1 The conclusion was that the scores were significantly reduced after therapy (255-136, p = 0.009; 3.5-2.1, p = 0.03, respectively), based upon six patients having a complete response, one a partial response and three not responding. If the primary measurement of response had been decreased or discontinuance of prednisone use, then one of the 'non-responders' and the 'partial responder' would have been categorized as 'responders,' and four original responders would have been classified as 'non-responders'.…”