Barts-MS rose-tinted-odometer: ★★ (Black Friday, Friday the 13th #000000)
The meta-analysis below of probiotics suggests they may help people with MS (pwMS). However, when you drill down into the details you will note that there were only four studies included in the meta-analysis with 213 actively treated subjects compared to 107 controls. Far too small to be confident of an effect. The problem with probiotics is not only their definition but trying to work out what they actually do in terms of MS pathology. The rationale for prescribing probiotics to treat MS is based on the potential for gut bacteria to be anti-inflammatory and to stimulate regulatory cells. This hypothesis is based largely on animal studies and I am yet to be convinced it has any relevance to multiple sclerosis. This is why I don’t recommend probiotics to my patients. If your financial resources are limited I would question spending them on unproven therapies such as probiotics.
I would be interested to know how many of you are taking probiotics, who prescribed them and have you noticed any effect?
Mirashrafi et al. Effect of Probiotics Supplementation on Disease Progression, Depression, General Health and Anthropometric Measurements in Relapsing-Remitting Multiple Sclerosis Patients: A Systematic Review and Meta-analysis of Clinical Trials. Meta-Analysis Int J Clin Pract. 2021 Aug 11;e14724.
Methods: The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through January 2021. Random effect models were used to synthesize quantitative data by STATA14 .
Results: From a total of 152 identified entries, four trials were included in quantitative synthesis (n=213; 106 as intervention, 107 as control). An additional six studies with the same structure and different markers were also systematically reviewed. The pooled effect size showed that Expanded Disability Status Scale (EDSS) (WMD=-0.43; 95% CI=-0.65, -0.20; P<0.001), Beck Depression Inventory-Ⅱ (BDI-Ⅱ) (WMD=-3.22; 95% CI=-4.38, -2.06; P<0.001) and General Health Questionnaire (GHQ) (WMD=-4.37; 95% CI=-6.43, -2.31; P<0.001) were improved following probiotics supplementation. However, body weight and body mass index did not statistically change.
Conclusion: Our findings revealed that probiotics supplementation can improve disease progression, suppress depression, and general health in MS patients; although, further investigations may be needed.
General Disclaimer: Please note that the opinions expressed here are those of Professor Giovannoni and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust and are not meant to be interpreted as personal clinical advice.
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