Evidence map›Paper›PMID 39106167›Full record

SynthesisUnited European gastroenterology journal2024

Efficacy and safety of probiotics in IBD: An overview of systematic reviews and updated meta-analysis of randomized controlled trials.

Maria Manuela Estevinho, Yuhong Yuan, Iago Rodríguez-Lago, Mário Sousa-Pimenta, Cláudia Camila Dias, Manuel Barreiro-de Acosta, Vipul Jairath, Fernando Magro

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in United European gastroenterology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  8. Gut microbiota in health and disease.Molecular biomedicine · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Maria Manuela EstevinhoDepartment of Gastroenterology, Unidade Local de Saúde Gaia Espinho (ULSGE), Vila Nova de Gaia, Portugal.ORCID 0000-0001-7171-0139
Yuhong YuanDepartment of Medicine, London Health Science Center, London, Ontario, Canada.
Iago Rodríguez-LagoDepartment of Gastroenterology, Hospital Universitario de Galdakao, Biocruces Bizkaia Health Research Institute, Deusto University, Galdakao, Spain.ORCID 0000-0003-1133-4578
Mário Sousa-PimentaDepartment of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal.
Cláudia Camila DiasKnowledge Management Unit, Faculty of Medicine, University of Porto, Porto, Portugal.
Manuel Barreiro-de AcostaDepartment of Gastroenterology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.ORCID 0000-0001-5915-1477
Vipul JairathDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.ORCID 0000-0002-1092-0033
Fernando MagroCINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveProbiotics show promise in inflammatory bowel disease (IBD), yet knowledge gaps persist. We performed an overview of systematic reviews and an updated metanalysis of randomized controlled trials (RCT) assessing the effect of probiotics on Crohn's disease (CD) and ulcerative colitis (UC).

methodsMEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched up to September 2023. Primary outcomes were clinical remission and recurrence; secondary outcomes included endoscopic response and remission, and adverse events. We calculated odds ratios (OR) using a random-effects model in R. The quality of systematic reviews was assessed using the AMSTAR-2; the trials' risk of bias was evaluated using the Cochrane Collaboration tool. Evidence certainty was rated using the GRADE framework.

resultsOut of 2613 results, 67 studies (22 systematic reviews and 45 RCTs) met the eligibility criteria. In the updated meta-analysis, the OR for clinical remission in UC and CD was 2.00 (95% CI 1.28-3.11) and 1.61 (95% CI 0.21-12.50), respectively. The subgroup analysis suggested that combining 5-ASA and probiotics may be beneficial for inducing remission in mild-to-moderate UC (OR 2.35, 95% CI 1.29-4.28). Probiotics decreased the odds of recurrence in relapsing pouchitis (OR 0.03, 95% CI 0.00-0.25) and trended toward reducing clinical recurrence in inactive UC (OR 0.65, 95% CI 0.42-1.01). No protective effect against recurrence was identified for CD. Multi-strain formulations appear superior in achieving remission and preventing recurrence in UC. The use of probiotics was not associated with better endoscopic outcomes. Adverse events were similar to control. However, the overall certainty of evidence was low.

conclusionProbiotics, particularly multi-strain formulations, appear efficacious for the induction of clinical remission and the prevention of relapse in UC patients as well as for relapsing pouchitis. Notwithstanding, no significant effect was identified for CD. The favorable safety profile of probiotics was also highlighted.

Indexed as

Colitis, UlcerativeCrohn DiseasePouchitisProbioticsRemission InductionHumansRandomized Controlled Trials as TopicRecurrenceSystematic Reviews as TopicTreatment Outcomeclinical outcomesclinical remissionCrohn's diseaseendoscopic responseinflammatory bowel diseasemicrobiome modulationprobioticRCTrecurrenceulcerative colitis

Identifiers

PMID39106167
PMCPMC11497663

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.