Table 3.

Probiotics in ulcerative colitis maintenance and induction + maintenance

Publication (year, country)	First author	Type of intervention	Agent used	N	Control group	Intervention group	Primary end point	Statistical benefit (P-value)	Trend toward clinical benefit or harm
1997, Germany	Kruis49	Probiotic	Escherichia coli Nissle 1917	103	53	50	Remission and relapse rate	No (>0.05)	None
1999, UK	Rembacken50	Probiotic	Nonpathogenic strain of Escherichia coli (serotype O6:K5:H1) Nissle 1917	116	59	57	Remission and relapse rate	No (>0.05) and yes (0.0059)	Benefit
2003, Japan	Ishikawa51	Probiotic	Bifidobacteria-fermented milk	21	10	11	Clinical relapse and duration of remission	Yes (0.0059 and 0.0174)	Benefit
2004, Germany	Kruis52	Probiotic	Escherichia coli Nissle 1917	327	165	162	Rate of relapse	Yes (0.003)	Benefit
2004, People’s Republic of China	Cui53	Probiotic	Bifid Triple Viable capsule	30	15	15	Rate of relapse and fecal/mucosal response	Yes (<0.01 and <0.05)	Benefit
2006, Italy	Zocco54	Probiotic	LGG LGG + mesalazine	187	62	65,* 60**	Maintenance of clinical remission	No (>0.05)	Benefit
2009, Japan	Fujimori55	Probiotic, prebiotic, synbiotic	Bifidobacterium longum, psyllium, combined	120	0	40,a 40,b 40c	Improvement in quality of life: IBDQ score	Yes (0.03)	Benefit
2009, Italy	Miele56	Probiotic	VSL#3	29	15	14	Maintenance of remission and relapse rate	Yes (<0.01 and 0.014)	Benefit
2009, Denmark	Wildt57	Probiotic	Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. Lactis BB-12	32	12	20	Maintenance of clinical remission	No (0.37)	Benefit
2010, Egypt	Hegazy58	Probiotic	Lactobacillus delbruekii and Lactobacillus fermentum	30	15	15	Decrease in colonic inflammation	Yes (<0.05)	Not applicable
2011, Japan	Ishikawa59	Synbiotic	Bifidobacterium breve Yakult and galacto-oligosaccharide	41	20	21	Endoscopic score: Matt’s Classification	Yes (<0.05)	Benefit
2012, Italy	Oliva60	Probiotic	Lactobacillus reuteri ATCC 55730	31	15	16	Clinical and endoscopic remission: Mayo Score and inflammatory markers	Yes (<0.01)	Benefit

Notes: Randomized controlled trials that have studied the use of various probiotic/prebiotic/synbiotic agents in the treatment of either induction, maintenance, or induction + maintenance of ulcerative colitis with primary end points, number of patients involved in the study, and outcomes as shown.

^*LGG agent used.

^**LGG + mesalazine agent used.

^aProbiotic type of intervention.

^bPrebiotic type of intervention.

^cSynbiotic type of intervention.

Abbreviations: ATCC, American Type Culture Collection; IBDQ, Inflammatory Bowel Disease Questionnaire; LGG, Lactobacillus GG; N, total number of patients enrolled in the study at the beginning of the study.