The results of several small studies evaluating the use of probiotics in patients with ulcerative colitis have been reported by the Cochrane review to not be associated with the maintenance of a remission or with symptom improvements in patients with ulcerative colitis (UC) this week at a meeting of UC experts.

The study authors had previously conducted a Cochrane review that included only four studies and concluded that there was "insufficient evidence" to draw conclusions about the effectiveness of probiotics for maintenance of remission in UC. But further research has been published, so they have now performed an updated review.

Because alterations in gut bacteria have been implicated in the development of UC, it has been suggested that modifying these bacteria with probiotics may diminish the inflammatory process and prevent relapses. The studies evaluated in the current analyses were all randomized controlled trials that compared the use of probiotics against any intervention or placebo for at least 3 months. Patients could be classified as being in remission according to clinical, histologic, or endoscopic criteria. Overall the studies included 887 patients.

In four studies that directly compared probiotics with mesalazine, the likelihood of clinical or endoscopic relapse did not differ between the two treatments according to Dr. Morris Gordon of the University of Central Lancashire in Preston, England. Dr. Gordon also reported that in two small additional studies including 92 patients, there was no difference in maintenance of remission between probiotics and placebo at the Advances in Inflammatory Bowel Disease Meetings in Orlando FL this week.

Interestingly, and despite no clear difference being seen in these studies, the reviewers called for further research to "explore the potential for probiotics in this context."

References: Gordon M, et al: Probiotics for maintenance of remission in ulcerative colitis: a Cochrane systematic review. AIBD 2015; Abstract P054

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