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Lactobacillus prevents relapse in ulcerative colitis

Bitesize evidence

Q. Can regular treatment with Lactobacillus rhamnosus GG prevent relapse in patients with ulcerative colitis?

These Italian researchers enrolled 187 consecutive patients with ulcerative colitis for an average of eight years into this study of the probiotic Lactobacillus rhamnosus GG (LGG). This species has been used successfully to treat travellers' diarrhoea and antibiotic-associated diarrhoea.

The patients were randomly assigned (allocation concealment uncertain) to receive one of the following regimens for 12 months: LGG 18 billion viable bacteria per day in two doses; mesalazine 2,400mg daily; or the combination.

The primary outcome was the appearance of ulcerative colitis signs or symptoms that required additional treatment. This study did not blind the patients or the investigators, which is a serious limitation because the clinical outcome in this study makes blinding especially important.

Relapse occurred in approximately 17 per cent of patients over the course of the study. Using intention-to-treat analysis, the investigators found similar relapse rates

across the three treatment groups (15 per cent, 20 per cent, and 16 per cent). Similar findings occurred when patients were evaluated by endoscopy for the presence of colitis.

1b- (see www.infopoems.com/levels.html)

Zocco MA et al. Efficacy of Lactobacillus GG in maintaining remission of ulcerative

colitis. Aliment Pharmacol Ther 2006; 23:1567-1574

Bottom line

LGG was as effective as a mesalazine product in preventing recurrence in patients with ulcerative colitis. However, the study was unblinded and a confirmatory study would be helpful.

This Patient Oriented Evidence that Matters (POEMs )is taken from InfoPOEMS/ Inforetriever, a point of care evidence-based medicine tool, published by John Wiley.

For more information, e-mail: freynold@wiley.co.uk

or visit www.infopoems.com

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