Systematic review and meta-analysis: Efficacy of patented probiotic, VSL#3, in irritable bowel syndrome

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5 Citations (Scopus)

Abstract

Background: VSL#3 is a patented probiotic for which several clinical trials suggest benefits on motor function, bloating, and symptoms of irritable bowel syndrome (IBS). Objectives: To quantify effects of VSL#3 on abdominal pain, stool consistency, overall response, abdominal bloating, and quality of life (QOL) in IBS through meta-analysis. Methods: MEDLINE (OvidSP and PubMed), EMBASE, Web of Science, and Scopus were searched up to May 2017. Using a fixed effects model, we pooled data from intention-to-treat analyses of randomized trials (RCTs) comparing VSL#3 to placebo in IBS. Data were reported as relative risk (RR), overall mean difference (MD), or standardized MD (SMD) with 95% confidence intervals (CI). Quality of evidence was rated using the GRADE approach. Key Results: Among 236 citations, 5 RCTs (243 patients) were included. No significant differences were observed for abdominal pain (SMD = −0.03; 95% CI −0.29 to 0.22), bloating (SMD = −0.15; 95% CI −0.40 to 0.11), proportion of bowel movements with normal consistency (overall MD = 0; 95% CI −0.09 to 0.08), or IBS-QOL (SMD = 0.08; 95% CI −0.22 to 0.39). VSL#3 was associated with a nearly statistically significant increase in overall response (RR = 1.39; 95% CI 0.99-1.98). Conclusions & Inferences: In this systematic review and meta-analysis, there was a trend toward improvement in overall response with VSL#3, but no clear evidence effectiveness for IBS. However, the number and sample sizes of the trials are small and the overall quality of evidence for 3 of the 5 outcomes was low. Larger trials evaluating validated endpoints in well-defined IBS patients are warranted.

Original languageEnglish (US)
JournalNeurogastroenterology and Motility
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Irritable Bowel Syndrome
Probiotics
Meta-Analysis
Confidence Intervals
Abdominal Pain
Quality of Life
Intention to Treat Analysis
PubMed
MEDLINE
Sample Size
Placebos
Clinical Trials

Keywords

  • irritable bowel syndrome
  • probiotic
  • systematic review
  • VSL#3

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

@article{8c8cc422fe134c48b9709675b11bdf4f,
title = "Systematic review and meta-analysis: Efficacy of patented probiotic, VSL#3, in irritable bowel syndrome",
abstract = "Background: VSL#3 is a patented probiotic for which several clinical trials suggest benefits on motor function, bloating, and symptoms of irritable bowel syndrome (IBS). Objectives: To quantify effects of VSL#3 on abdominal pain, stool consistency, overall response, abdominal bloating, and quality of life (QOL) in IBS through meta-analysis. Methods: MEDLINE (OvidSP and PubMed), EMBASE, Web of Science, and Scopus were searched up to May 2017. Using a fixed effects model, we pooled data from intention-to-treat analyses of randomized trials (RCTs) comparing VSL#3 to placebo in IBS. Data were reported as relative risk (RR), overall mean difference (MD), or standardized MD (SMD) with 95{\%} confidence intervals (CI). Quality of evidence was rated using the GRADE approach. Key Results: Among 236 citations, 5 RCTs (243 patients) were included. No significant differences were observed for abdominal pain (SMD = −0.03; 95{\%} CI −0.29 to 0.22), bloating (SMD = −0.15; 95{\%} CI −0.40 to 0.11), proportion of bowel movements with normal consistency (overall MD = 0; 95{\%} CI −0.09 to 0.08), or IBS-QOL (SMD = 0.08; 95{\%} CI −0.22 to 0.39). VSL#3 was associated with a nearly statistically significant increase in overall response (RR = 1.39; 95{\%} CI 0.99-1.98). Conclusions & Inferences: In this systematic review and meta-analysis, there was a trend toward improvement in overall response with VSL#3, but no clear evidence effectiveness for IBS. However, the number and sample sizes of the trials are small and the overall quality of evidence for 3 of the 5 outcomes was low. Larger trials evaluating validated endpoints in well-defined IBS patients are warranted.",
keywords = "irritable bowel syndrome, probiotic, systematic review, VSL#3",
author = "M. Connell and Andrea Shin and Toyia James-Stevenson and Huiping Xu and Thomas Imperiale and J. Herron",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/nmo.13427",
language = "English (US)",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",

}

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T1 - Systematic review and meta-analysis

T2 - Efficacy of patented probiotic, VSL#3, in irritable bowel syndrome

AU - Connell, M.

AU - Shin, Andrea

AU - James-Stevenson, Toyia

AU - Xu, Huiping

AU - Imperiale, Thomas

AU - Herron, J.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: VSL#3 is a patented probiotic for which several clinical trials suggest benefits on motor function, bloating, and symptoms of irritable bowel syndrome (IBS). Objectives: To quantify effects of VSL#3 on abdominal pain, stool consistency, overall response, abdominal bloating, and quality of life (QOL) in IBS through meta-analysis. Methods: MEDLINE (OvidSP and PubMed), EMBASE, Web of Science, and Scopus were searched up to May 2017. Using a fixed effects model, we pooled data from intention-to-treat analyses of randomized trials (RCTs) comparing VSL#3 to placebo in IBS. Data were reported as relative risk (RR), overall mean difference (MD), or standardized MD (SMD) with 95% confidence intervals (CI). Quality of evidence was rated using the GRADE approach. Key Results: Among 236 citations, 5 RCTs (243 patients) were included. No significant differences were observed for abdominal pain (SMD = −0.03; 95% CI −0.29 to 0.22), bloating (SMD = −0.15; 95% CI −0.40 to 0.11), proportion of bowel movements with normal consistency (overall MD = 0; 95% CI −0.09 to 0.08), or IBS-QOL (SMD = 0.08; 95% CI −0.22 to 0.39). VSL#3 was associated with a nearly statistically significant increase in overall response (RR = 1.39; 95% CI 0.99-1.98). Conclusions & Inferences: In this systematic review and meta-analysis, there was a trend toward improvement in overall response with VSL#3, but no clear evidence effectiveness for IBS. However, the number and sample sizes of the trials are small and the overall quality of evidence for 3 of the 5 outcomes was low. Larger trials evaluating validated endpoints in well-defined IBS patients are warranted.

AB - Background: VSL#3 is a patented probiotic for which several clinical trials suggest benefits on motor function, bloating, and symptoms of irritable bowel syndrome (IBS). Objectives: To quantify effects of VSL#3 on abdominal pain, stool consistency, overall response, abdominal bloating, and quality of life (QOL) in IBS through meta-analysis. Methods: MEDLINE (OvidSP and PubMed), EMBASE, Web of Science, and Scopus were searched up to May 2017. Using a fixed effects model, we pooled data from intention-to-treat analyses of randomized trials (RCTs) comparing VSL#3 to placebo in IBS. Data were reported as relative risk (RR), overall mean difference (MD), or standardized MD (SMD) with 95% confidence intervals (CI). Quality of evidence was rated using the GRADE approach. Key Results: Among 236 citations, 5 RCTs (243 patients) were included. No significant differences were observed for abdominal pain (SMD = −0.03; 95% CI −0.29 to 0.22), bloating (SMD = −0.15; 95% CI −0.40 to 0.11), proportion of bowel movements with normal consistency (overall MD = 0; 95% CI −0.09 to 0.08), or IBS-QOL (SMD = 0.08; 95% CI −0.22 to 0.39). VSL#3 was associated with a nearly statistically significant increase in overall response (RR = 1.39; 95% CI 0.99-1.98). Conclusions & Inferences: In this systematic review and meta-analysis, there was a trend toward improvement in overall response with VSL#3, but no clear evidence effectiveness for IBS. However, the number and sample sizes of the trials are small and the overall quality of evidence for 3 of the 5 outcomes was low. Larger trials evaluating validated endpoints in well-defined IBS patients are warranted.

KW - irritable bowel syndrome

KW - probiotic

KW - systematic review

KW - VSL#3

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