A Cochrane review [Abstract] 1 included 4 studies with a total of 244 subjects. A formal meta-analysis was not preformed due to differences in probiotics, outcomes and trial methodology. Three studies measured proportion of patients achieving remission. Probiotics (bifidobacteria) + 5-ASA compared to placebo + 5-ASA (OR 0.64, 95% CI 0.10 to 4.10, n=20), probiotics (VSL#3) + balsalazide compared to placebo + balsalazide (OR 0.58, 95% CI 0.18 to 1.91, n=60) and probiotics (E.coli Nissle 1917) + steroids compared to Mesalazine + steroids (OR 1.35, 95% CI 0.6 to 3.04, n=116) didn't show any statistically significant differences in induction of remission.
Comment:The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding), by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison). Most of the included studies were small in size and may have lacked power to detect a statistically significant difference between the groups should one exist.
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