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Session: Dietary Associations with Gut Microbial Community and Metabolic Changes (Poster Theater Flash Session 22)

(PTFS22-04-24) Lactobacillus and Bifidobacterium Probiotics Outperform Synbiotics and FMT in Inflammatory Bowel Disease Therapy: Current Evidence From Meta-Analysis of RCTs

Tuesday, July 2, 2024
10:12 AM – 10:16 AM CT
Location:  W185A-C
Objectives: Gut microbiota interventions such as probiotics, synbiotics, and fecal microbiota transplantation (FMT) are emerging as potential alternatives to traditional 5-aminosalicylic acid (5-ASA) in Inflammatory Bowel Disease (IBD) management. This study assesses their efficacy against 5-ASA and placebo. We conducted a systematic review and meta-analysis, adhering to PRISMA guidelines and according to a prospectively registered protocol (PROSPERO: CRD42024502577).

Methods: Twelve randomized controlled trials, comprising 498 IBD patients, were included. Studies were selected from six databases, focusing on research from the past ten years. Clinical disease activity was the primary outcome, measured using the Mayo Score and Clinical Disease Activity Index (CDAI). Meta-analysis was performed using the random effects model in Review Manager 5.4, and the risk of bias was assessed using the Cochrane Risk of Bias Tool 2.

Results: Twelve randomized controlled trials (RCTs), comprising 498 IBD patients, were included. Studies were selected from six databases, focusing on research from the past ten years. Clinical disease activity was the primary outcome, measured using the Mayo Score and Clinical Disease Activity Index (CDAI). Meta-analysis was performed using the random effects model in Review Manager 5.4, and the risk of bias was assessed using the Cochrane Risk of Bias Tool 2. Compared to 5-ASA, probiotics significantly reduced CDAI (MD: -2.48, 95%CI: -4.66 to -0.31, p=0.03). Against placebo, probiotics showed a notable decrease in CDAI (MD: -1.69, 95%CI: -3.26 to -0.11, p=0.04). Synbiotics and FMT were effective but less so than probiotics. Side effects were more familiar with FMT, particularly abdominal discomfort and bloating. The heterogeneity of the studies was I2 = 60%, indicating moderate variability.

Conclusions: Probiotics outperform synbiotics and FMT in reducing IBD clinical disease activity, suggesting a viable alternative to 5-ASA. This highlights the potential role of gut microbiota interventions in IBD treatment, warranting further exploration.

Funding Sources: This research/abstract received no external funding.