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 21 February 2018

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News

Probiotics do no prevent endoscopic recurrence of Crohn's

Probiotics in Crohn's do not prevent early endoscopic recurrence after ileo-cecal resection, reports January's Inflammatory Bowel Diseases.

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About 70% of Crohn's disease patients exhibit anastomotic recurrence within 1 year after ileo-caecal surgery.

Recent clinical trials suggest the beneficial use of probiotics in the control of intestinal inflammation in pouchitis and ulcerative colitis.

Dr Denis Franchimont and colleagues from Belgium conducted a multicenter clinical trial.

The researchers evaluated the efficacy of an oral administration of the probiotic Lactobacillus johnsonii on early postoperative endoscopic recurrence of Crohn's.

The team enrolled 70 patients with Crohn's disease prior to elective ileo-cecal resection.

21% of the Lactobacillus johnsonii had severe recurrence
Inflammatory Bowel Diseases

The researchers then randomized 34 patients after surgery to daily treatment with either Lactobacillus johnsonii or 36 to placebo for 12 weeks.

The primary objective was to assess the effect of Lactobacillus johnsonii on the endoscopic recurrence rate at 12 weeks.

Stratification was performed according to smoking status at randomization.

The researchers excluded 7 and 14 patients in the Lactobacillus johnsonii and placebo groups, respectively.

In intention-to-treat analysis, the team found that the mean endoscopic score was not significantly different between the two treatment groups at 3 months.

The percentage of patients with severe recurrence was 21% and 15% in the Lactobacillus johnsonii and placebo groups, respectively.

The researchers used a per-protocol analysis.

The team noted that the mean endoscopic score was not significantly different between the 2 treatment groups.

The team found severe recurrence in 19% and 9% of the Lactobacillus johnsonii and placebo groups, respectively.

The researchers observed that the clinical relapse rate in the Lactobacillus johnsonii and placebo groups was 15% and 14%, respectively.

Dr Franchimont's team concludes, “Oral administration of the probiotic Lactobacillus johnsonii in patients with Crohn's disease failed to prevent early endoscopic recurrence at 12 weeks after ileo-cecal resection.”

Inflamm Bowel Dis 2007: 13(2): 135-42
29 January 2007

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