scholarly journals Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
pp. 13 ◽  
Author(s):  
Mohammad Z. Asha ◽  
Sundos F. H. Khalil
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Adverse Events ◽  
Meta Analysis ◽  
Group Differences ◽  
Significant Heterogeneity ◽  
Efficacy And Safety ◽  
Gastrointestinal Microbiome ◽  
Irritable Bowel

Treatments that target alterations in gut microbiota may be beneficial for patients with irritable bowel syndrome (IBS). A systematic review and meta-analysis was conducted of randomised clinical trials (RCTs) evaluating the efficacy and safety of probiotics, prebiotics and synbiotics. Factors considered in the analysis included global IBS symptoms and/or abdominal pain, secondary symptoms and the frequency of adverse events. A total of 33 RCTs involving 4,321 patients were identified. Overall, probiotics significantly improved global IBS symptoms compared to placebos (standardised mean difference = −0.32, 95% confidence interval: −0.48 to −0.15; P <0.001), with significant heterogeneity between studies (I2 = 72%; P <0.001). This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations. However, evidence regarding prebiotics was scarce. There were no significant inter-group differences in terms of the frequency of adverse events. Future RCTs should address methodological limitations, including short follow-up periods and patient adherence.Keywords: Irritable Bowel Syndrome; Gastrointestinal Microbiome; Dietary Supplements; Probiotics; Prebiotics; Synbiotics; Meta-Analysis; Systematic Review.

The Efficacy and Safety of Rifaximin for the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 107 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Stacy B Menees ◽  
Monthira Maneerattannaporn ◽  
Hyungjin Myra Kim ◽  
William D Chey
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Irritable Bowel

scholarly journals Efficacy and safety of rituximab in adult frequent-relapsing or steroid-dependent minimal change disease or focal segmental glomerulosclerosis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Cheng Xue ◽  
Bo Yang ◽  
Jing Xu ◽  
Chenchen Zhou ◽  
Liming Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Focal Segmental Glomerulosclerosis ◽  
Minimal Change Disease ◽  
Meta Analysis ◽  
Minimal Change ◽  
Efficacy And Safety ◽  
Segmental Glomerulosclerosis ◽  
Steroid Dependent

Abstract Background The efficacy and safety of rituximab (RTX) in adult frequent-relapsing (FR) or steroid-dependent (SD) nephrotic syndrome (NS), including minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS), are still inconclusive. Methods We performed a systematic review and meta-analysis registered in  PROSPERO (CRD42019148102) by pooling data of cohort studies or case series on adult patients with difficult-to-treat NS. Steroid-resistant NS was excluded. The primary outcomes were the complete remission (CR) rate and the relapse rate. Partial remission (PR) rate, no response (NR) rate and adverse events were the secondary outcomes. A random-effects model was performed for all the outcomes. Results We included 21 studies involving 382 adult MCD/FSGS subjects with a median follow-up duration from 12 to 43 months. RTX treatment induced a pooled 84.2% CR rate [95% confidence interval (CI): 67.7–96.3%], while MCD patients had a high 91.6% CR rate and FSGS patients a moderate 43% CR rate. However, 27.4% (95% CI 20.7–34.5%) of the patients relapsed during the follow-up. The pooled PR and NR rates were 5.8% (95% CI 1.2–12.5%) and 5.2% (95% CI 0.0–15.0%), respectively. RTX was associated with trivial adverse events and good tolerance. Conclusions In summary, by pooling results of current pilot studies, RTX may be an effective and relatively safe alternative for most adult FR or SD MCD/FSGS to displace calcineurin inhibitors or prednisone in the hierarchy of treatment. More clinical trials comparing RTX with other immunosuppressants and concerning the long-term adverse events are needed.

scholarly journals Comparative efficacy and safety of probiotics for the treatment of irritable bowel syndrome: a systematic review and network meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027376
Author(s):  
Man Yang ◽  
Yuanyuan Yu ◽  
Ping-Guang Lei ◽  
Jinqiu Yuan
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Meta Analysis ◽  
Absolute Difference ◽  
Individual Species ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Comparative Efficacy ◽  
Irritable Bowel

IntroductionIrritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder affecting approximately 10% to 25% of the adult population. A large number of clinical trials have been conducted to evaluate the efficacy of probiotics for IBS but the results were inconsistent. Previous meta-analyses have shown that probiotics are effective for IBS, but the comparative efficacy of individual species is unclear. In addition, evidence regarding the superiority of combination over single probiotic is still lacking. We, therefore, perform this study to evaluate the comparative efficacy and safety of various species of probiotics, and combination regimens for the treatment of IBS.Methods and analysisThis study is a systematic review with network meta-analysis. We will search PubMed, Scopus, The Cochrane Central Register of Controlled Trials and CINAHL for randomised controlled trials comparing probiotics with placebo or comparing different probiotics for IBS, with no language restrictions. The primary outcomes will be treatment response and global IBS-symptom score. We will initially combine included studies with traditional pairwise meta-analysis and then with random-effects network meta-analysis. We will quantify the effect of potential effect modifiers by meta-regression if appropriate. We will check the consistency assumption by testing the absolute difference between direct and indirect estimates for comparisons in closed loops. The quality of evidence will be evaluated according to the GRADE framework.Ethics and disseminationEthical approval is not required for literature-based studies. We will disseminate the findings through publications in peer-reviewed journals and relevant conferences.PROSPERO registration numberCRD42018102101

scholarly journals Efficacy and safety of probiotics in irritable bowel syndrome: A systematic review and meta-analysis

2019 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Li-Qun Jia ◽  
Jian-Rong Sun ◽  
Chen-Fan Kong ◽  
Xiang-Ke Qu ◽  
Chao Deng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Irritable Bowel
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