AB0113 Efficacy of treatment with probiotics in the inflammatory activity of patients with rheumatoid arthritis. systematic review of the literature

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1251
• Main Authors: Fuego, C., Mena-Vazquez, N., Caparrós-Ruiz, R., Ureña-Garnica, I., Diaz-Cordovés, G., Jimenez-Nuñez, F.G., Ordoñez-Cañizares, M.C., Rojas-Gimenez, M., Redondo-Rodríguez, R., Cano-Garcia, L., Irigoyen-Oyarzábal, M.V., Romero-Barco, C.M., Belmonte, A., Manrique-Arija, S., Fernández-Nebro, A.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: C-reactive protein; Clinical trials; Erythrocyte sedimentation rate; Inflammation; Insulin; Joint diseases; Literature reviews; Metabolism; NAD; Patients; Probiotics; Rheumatoid arthritis; Systematic review
• DOI: 10.1136/annrheumdis-2018-eular.4676
• ISSN: 0003-4967

ObjectivesTo study the effectiveness of the use of probiotics in the control of inflammatory activity of patients with rheumatoid arthritis and analyse its effect on their metabolic profile.MethodsA bibliographic search was carried out in Medline and Embase. The search strategy included the terms MeSH and the free text of ”lactobacillus”, ”bacillus”, ”probiotics” and ”rheumatoid arthritis.” The search strategies were carried out by two authors, which were included according to the type of studies: meta-analysis, systematic reviews and clinical trials, depending on the type of participant: adults with RA who have received probiotics, the main outcome measures: changes in the Disease Activity Score (DAS28), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI)), as well as each of the parameters that constitute them: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), visual analogue scale of the doctor and the patient (EVA), number of painful joints (NAD) and inflamed (NAI) and functional status by Health Assessment Questionnaire (HAQ) Secondary variables: number of adverse events and parameters of metabolic activity. The quality of the evidence was analysed following the guidelines of the Scottish Network of Intercollegiate Guidelines (SIGN).ResultsAfter the selection of 34 articles, 9 articles were finally included. All were randomised, double-blind, placebo-controlled clinical trials (RCTs) with a level of evidence between 1+and 1++and a recommendation grade of A and B. Seven CDs showed improvement in arthritis measurements. In Peltonen et al. observed a high rate of improvement in the experimental group than in the control group (3.1 vs 2, p=0.027). Mandel et al. they described improvement of the EVA in the experimental group (p=0.046). Zamani the al. they described an improvement in DAS28 (−0.3±0.4 versus −0.1±0.4, p=0.01). Vaghef-Mehrabany et al defined this improvement (p<0.01). Pineda et al. showed an improvement in HAQ at 3 months in the experimental group (from 0.97 to 0.80, p=0.02), although not in ACR20 (p=0.33). Allipour et al. found improvements in CRP between the two groups (mean [95% CI]=2.03 [0.54–3.51], p=0.009); NAD: (mean [95% CI]=0.72 [0.25, 1.19], p=0.003); NAI: (mean [95% CI]=0.351 [0.13, 0.58], p=0.003); EVA: (mean [95% CI]=16.71 [8.91, 24.50] p<0.001; DAS-28: (average [CI] 95%]=0.31 [0.02, 0.61], p=0.039) and in cytokine levels, Hatakka et al observed no significant improvement in the experimental group in HAQ, NAD and NAI, and Nenonent et al. Did not observe differences in DAS28. In the last, EC of Vaghef-Mehrabany of 2017 metabolic measures were evaluated without finding significant improvements If an improvement in insulin resistance was observed as measured by the HOMA B index in the study by Zamani et al.ConclusionsTreatment with probiotics seems to be effective in controlling the inflammatory activity of rheumatoid arthritis.Disclosure of InterestNone declared