Probiotics may not prevent Crohn's disease relapse: RCT data

22-Aug-2013 - Last updated on 23-Aug-2013 at 15:28 GMT

Supplementation with the probiotic Saccharomuces boulardii (S. boulardii) may not prevent clinical relapse in patients with Crohn's disease, according to the findings of a clinical trial.

Despite previous data showing beneficial effects for supplementation with the probiotic strain, the new randomised trial published in Clinical Gastroenterology and Hepatology, suggests that Saccharomuces boulardii (S. boulardii) has no significant effect on the risk of Crohn's disease relapse.

Led by Arnaud Bourreille from the Institut des Maladies de l'Appareil Digestif (IMAD), France, noted that yeast S. boulardii has been shown to have beneficial effects on the intestinal epithelial barrier and digestive immune system - with preliminary evidence that the probiotic yeast could be of benefit to people with Crohn's disease.

The new randomised, double-blind, placebo-controlled trial tested whether use of the probiotic strain was of benefit for the prevention of relapse in people who are in remission from Crohn's disease.

S boulardii is safe and well tolerated, it does not appear to have any beneficial effects for patients with CD in remission after steroid or salicylate therapies," said the researchers.

Commenting on the trial findings in an accompanying editorial experts from the University of Maryland, USA - led by Sandra Quezada - said that the use of probiotics to maintain remission in patients with Crohn's disease "cannot be advocated on the basis of the current study as well as prior meta-analyses."

"Use of probiotics in clinical practice should be limited to prevention of antibiotic-associated diarrhoea, prevention of recurrent Clostridium difficile, and prevention and treatment of pouchitis," they commented.

Study details

The pilot scale randomised, double-blind, placebo-controlled trial, tested the potential of S. boulardii as a preventive therapy in patients with moderately severe Crohn's disease who were currently in remission following steroid or salicylate therapies.

the team found that at the end of a one-year follow-up period, 50% of patients had relapsed, with 47.5% in the S. boulardii group and, similarly, 53.2% in the placebo group - a sinding that was not statistcally significant.

In addition, Bourreille and his team noted that time-to-relapse was not statistically different between patients treated with S. boulardii or placebo.

They noted that while the probiotic yeast showed no positive effects for Crohn's disease patients, further studies are needed to determine the potential therapeutic efficacy of probiotics in other forms of IBD, such as ulcerative colitis, and pouchitis.