Probiotics (VSL#3) in arthralgia in patients with ulcerative colitis and Crohn's disease: A pilot study

VU University Medical Center, Amsterdamo, North Holland, Netherlands
Drugs of today (Barcelona, Spain: 1998) (Impact Factor: 1.2). 08/2005; 41(7):453-9. DOI: 10.1358/dot.2005.41.7.917341
Source: PubMed


Arthralgia is a common extraintestinal manifestation of inflammatory bowel disease (IBD). Alterations of the immunologic regulation in the gut may contribute to the pathogenesis of arthralgia. Probiotics (VSL#3) have proven effective in the treatment of pouchitis in patients with ileal pouch anal anastomosis after panproctocolectomy for ulcerative colitis both in maintaining remission and in preventing a flare-up without side effects. The aim of this study was to determine the safety and efficacy of VSL#3 in patients with quiescent IBD who suffered from arthralgia for more than two weeks. An open-label trial was conducted using VSL#3. Pre- and post-treatment joint pain intensity were measured on the Ritchie Articular Index and visual analog scale. Disease activity of the bowel was assessed by the Truelove-Witts and the Harvey-Bradshaw scores. Sixteen of 29 patients completed the trial; in 10 of the 16 patients a statistically significant improvement was documented by the Ritchie Articular Index. No one of the patients had a relapse of intestinal disease while on probiotics. These preliminary results suggest that the probiotic mixture VSL#3 may be an alternative treatment for arthralgia in patients with IBD without inducing exacerbation of the disease. Because probiotics may be effective in the treatment of IBD as well, our results suggest that patients with active disease and arthralgia may also derive benefit from this treatment. Proper randomized controlled studies are indicated.

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    • "Yeast S. boulardii was shown to be more effective than melsalazine in maintaining remission of CD (Guslandi et al., 2000) and improving intestinal permeability in CD patients (Van Gossum et al., 2007). Probiotic mixture VSL#3 was successful in the treatment of CD-induced arthralgia (Karimi et al., 2005) and in the prevention of postoperative recurrence of CD (Madsen et al., 2008). These studies offer support for the commonly asserted claim that further trials are justified. "

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    • "Our chosen intervention was probiotics in spondyloarthropathy (SpA a group of related disorders) as probiotics have an excellent safety profile [7] and are considered a food supplement. There is considerable evidence from clinical and epidemiological studies that inflammation of the gut is involved in triggering spondyloarthropathy [8-11] and in the severity of the resultant joint inflammation [12,13] Probiotics may help in treating this bowel inflammation [14-16] and are advertised for ankylosing spondylitis, the prototypic SpA on several commercial internet sites, despite the absence of any published clinical trials. "
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