Meta-analysis of the safety and efficacy of probiotics in the treatment of Crohn's disease

Background: The aim of this study was to conduct a systematic evaluation of the safety and efficacy of probiotics in patients with Crohn's disease. Methods: A systematic literature search of PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases limited to January 2005 to March 2017 was conducted. We used terms including 'Crohn's Disease' or 'inflammatory bowel disease', and 'probiotics'. Eligible studies were all randomized controlled trials using probiotic agents as the treatment and a placebo as the control. Extracted data were analyzed with RevMan (version 5.1). Results: A total of 9 randomized controlled studies were included, including 358 probiotics-and 355 placebo-treated patients; all studies were of high quality. There were no significant differences between probiotics and placebo in the induced remission rate (RR=0.97; 95% CI=0.70-1.35; P=0.87; I-2=O), relapse rate (RR=1.01; 95% CI=0.78-1.32; P=0.93; I-2=O), recurrence time (SMD=-0.04; 95%CI=0.850.58; P=0.89; 12=0) or the incidence of adverse reactions (RR=0.83; 95% CI=0.62-1.11; P=0.21;I-2=0). Conclusions: Probiotics do not show a therapeutic advantage in the maintenance of remission or remission of Crohn's disease during the active period compared to placebos. Large samples and high-quality clinical trials are required to further determine the efficacy of probiotics in the induction and maintained remission of Crohn's disease.