Probiotics Likely To Be of Help With RRMS, Meta-analysis Finds

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by Marisa Wexler MS |

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Probiotic supplements could ease disability, lessen depression, and improve overall health in people with relapsing-remitting multiple sclerosis (MS), according to an analysis of four randomized clinical trials.

Physicians working with these patients might recommend “confirmed probiotic supplements” to help manage “MS concerns,” its scientists wrote, while noting that studies into their use were limited.

Findings were in the paper “Effect of Probiotics Supplementation on Disease Progression, Depression, General Health and Anthropometric Measurements in Relapsing-Remitting Multiple Sclerosis Patients: A Systematic Review and Meta-analysis of Clinical Trials,” published in the International Journal of Clinical Practice.

The human body is home to billions of bacteria, many of which live in the digestive tract. These bacteria — collectively called the gut microbiome — play vital roles in both health and disease, many of which are only beginning to be understood.

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Emerging research suggests that regulation of gut microbiome can be affected by autoimmune diseases like MS, raising the possibility that steps to normalize this microbiome could be a treatment approach. One such way is taking probiotics, which are specific bacterial strains thought to be beneficial for the health of the microbiome, as a supplement.

Whether and how probiotic supplements might benefit MS patients has been investigated in clinical trials, though most have been small and of short duration, limiting their ability to draw robust conclusions.

A team of researchers in Iran conducted a meta-analysis of clinical trials of probiotic supplements in people with relapsing-remitting MS (RRMS). In this type of analysis, researchers pool data from multiple published studies and analyze them collectively. Because of their varied study data, meta-analyses generally have more power to find meaningful conclusions than do individual studies.

“The current study was designed to collect and reanalyze the available data and reach a conclusion on the effectiveness of probiotics supplementation in RRMS patients, focusing on disease progression, depression, general health, and anthropometric indices,” the researchers wrote.

Their meta-analysis included data from four clinical trials, results of which were published between 2017 and 2020. In all four trials, people with RRMS were randomly given either probiotics or a placebo for 12 to 24 weeks. In total, the analysis included 213 patients — 106 given probiotics and 107 on placebo. Most participants were 30 to 40 years old.

Researchers assessed the impact of probiotic supplements on patient outcomes, mainly using a mathematical test called weighted mean differences (WMDs), which reflects differences in average values between probiotic and placebo groups in each trial. Of note, not all trials reported data for every outcome assessed.

Results showed that probiotic supplementation led to a significant decrease in Expanded Disability Status Scale (EDSS) scores, with a WMD of -0.43, reflecting lesser disability among patients given probiotics.

Probiotics also led to significant improvements on the Beck Depression Inventory-Ⅱ, a measure of depression severity, and on the 28-item General Health Questionnaire, which assesses overall health, including mental well-being. WMDs were -3.22 and -4.37, respectively.

By contrast, probiotic supplement use showed no significant effect on anthropometric measures of body weight or body mass index (a measure of body fat based on height and weight).

“The current meta-analysis found a significant improvement in disease disability, depression, and general health after probiotic supplementation [in] MS patients,” the team concluded.

Based on the results, the researchers suggested that probiotic supplements might benefit some MS patients. However, they stressed that their analysis was limited by the small amount of data published, and more research is needed.

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