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Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

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Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

Abstract

Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

참고문헌 (40)

  1. Ramos GP, "Mechanisms of disease : inflammatory bowel diseases", Mayo Clin Proc, 94, pp.155~165 (2019)
  2. Emiko Mizoguchi, "Recent updates on the basic mechanisms and pathogenesis of inflammatory bowel diseases in experimental animal models", Intestinal research, 18(2), pp.151~167 (2020), 대한장연구학회[DOI]
  3. Khor B, "Genetics and pathogenesis of inflammatory bowel disease", Nature, 474, pp.307~317 (2011)
  4. Elson CO, "Experimental models of inflammatory bowel disease reveal innate, adaptive, and regulatory mechanisms of host dialogue with the microbiota", Immunol Rev, 206, pp.260~276 (2005)
  5. Norouzinia M, "Biomarkers in inflammatory bowel diseases : insight into diagnosis, prognosis and treatment", Gastroenterol Hepatol Bed Bench, 10, pp.155~167 (2017)
  6. Mow WS, "Association of antibody responses to microbial antigens and complications of small bowel Crohn’s disease", Gastroenterology, 126, pp.414~424 (2004)
  7. Jakubczyk D, "The effectiveness of probiotics in the treatment of inflammatory bowel disease(IBD) : a critical review", Nutrients, 12, pp.1973~ (2020)
  8. 최창환, "Second Korean guidelines for the management of ulcerative colitis", Intestinal research, 15(1), pp.7~37 (2017), 대한장연구학회
  9. 박재준, "Second Korean guidelines for the management of Crohn’s disease", Intestinal research, 15(1), pp.38~67 (2017), 대한장연구학회
  10. Maaser C, "ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1 : initial diagnosis, monitoring of known IBD, detection of complications", J Crohns Colitis, 13, pp.144~164 (2019)
  11. Sutherland LR, "5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis", Gastroenterology, 92, pp.1894~1898 (1987)
  12. 김성배, "Vaccination and Complementary and Alternative Medicine in Patients with Inflammatory Bowel Disease", Intestinal research, 12(2), pp.124~130 (2014), 대한장연구학회
  13. Irving P, "Prevalence of depression and anxiety in people with inflammatory bowel disease and associated healthcare use : population-based cohort study", Evid Based Ment Health, 24, pp.102~109 (2021)
  14. Opheim R, "Complementary and alternative medicine in patients with inflammatory bowel disease : the results of a population-based inception cohort study(IBSEN)", J Crohns Colitis, 6, pp.345~353 (2012)
  15. Tamaki H, "Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis : a randomized, double-blinded, placebo-controlled multicenter trial", Dig Endosc, 28, pp.67~74 (2016)
  16. Tursi A, "Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment : a double-blind, randomized, placebo-controlled study", Am J Gastroenterol, 105, pp.2218~2227 (2010)
  17. van der Waal MB, "Probiotics for improving quality of life in ulcerative colitis : exploring the patient perspective", Pharmanutrition, 7, pp.100139~ (2019)
  18. Palumbo VD, "The long-term effects of probiotics in the therapy of ulcerative colitis : a clinical study", Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 160, pp.372~377 (2016)
  19. Plein K, "Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn’s disease with special respect to chronic diarrhea : a pilot study", Z Gastroenterol, 31, pp.129~134 (1993)
  20. Fujimori S, "High dose probiotic and prebiotic cotherapy for remission induction of active Crohn’s disease", J Gastroenterol Hepatol, 22, pp.1199~1204 (2007)
  21. Matsuoka K, "Efficacy of bifidobacterium breve fermented milk in maintaining remission of ulcerative colitis", Dig Dis Sci, 63, pp.1910~1919 (2018)
  22. Dore MP, "Side effects associated with probiotic use in adult patients with inflammatory bowel disease : a systematic review and meta-analysis of randomized controlled trials", Nutrients, 11, pp.2913~ (2019)
  23. Jitsumura M, "Remission endpoints in ulcerative colitis : a systematic review", World J Metaanal, 5, pp.85~102 (2017)
  24. Frolkis AD, "Risk of surgery for inflammatory bowel diseases has decreased over time : a systematic review and meta-analysis of population-based studies", Gastroenterology, 145, pp.996~1006 (2013)
  25. Ueno F, "Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan", J Gastroenterol, 48, pp.31~72 (2013)
  26. Fedorak RN, "The probiotic VSL#3 has anti-inflammatory effects and could reduce endoscopic recurrence after surgery for Crohn's disease", Clin Gastroenterol Hepatol, 13, pp.928~935 (2015)
  27. Campieri M, "Combination of antibiotic and probiotic treatment is efficacious in prophylaxis of post-operative recurrence of Crohn’s disease : a randomized controlled study vs mesalamine", Gastroenterology, 118, pp.A781~ (2000)
  28. Prantera C, "Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn’s disease : a randomised controlled trial with Lactobacillus GG", Gut, 51, pp.405~409 (2002)
  29. Marteau P, "Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn’s disease : a randomised, double blind, placebo controlled GETAID trial", Gut, 55, pp.842~847 (2006)
  30. Gao X, "Symptoms of anxiety", depression is associated with more aggressive inflammatory bowel disease, 2021, pp.11, 1440~
  31. Maconi G, "Perianal disease is associated with psychiatric co-morbidity in Crohn’s disease in remission", Int J Colorectal Dis, 29, pp.1285~1290 (2014)
  32. McDonald JW, "Methotrexate for induction of remission in refractory Crohn’s disease", Cochrane Database Syst Rev, 2014, pp.CD003459~ (2014)
  33. Southcott E, "Yoghurts containing probiotics reduce disruption of the small intestinal barrier in methotrexate-treated rats", Dig Dis Sci, 53, pp.1837~1841 (2008)
  34. Kulnigg S, "Systematic review : managing anaemia in Crohn’s disease", Aliment Pharmacol Ther, 24, pp.1507~1523 (2006)
  35. Constante M, "Iron supplements modulate colon microbiota composition and potentiate the protective effects of probiotics in dextran sodium sulfate-induced colitis", Inflamm Bowel Dis, 23, pp.753~766 (2017)
  36. Hoppe M, "Freeze-dried Lactobacillus plantarum 299v increases iron absorption in young females : double isotope sequential single-blind studies in menstruating women", PLoS One, 12, pp.e0189141~ (2017)
  37. Dignass AU, "European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases", J Crohns Colitis, 9, pp.211~222 (2015)
  38. Rupa Banerjee, "Efficacy and safety of vedolizumab in Crohn’s disease in patients from Asian countries in the GEMINI 2 study", Intestinal research, 19(1), pp.83~94 (2021), 대한장연구학회[DOI]
  39. Feagan BG, "Ustekinumab as induction and maintenance therapy for Crohn’s disease", N Engl J Med, 375, pp.1946~1960 (2016)
  40. Norton BA, "Patient perspectives on the impact of Crohn’s disease : results from group interviews", Patient Prefer Adherence, 6, pp.509~520 (2012)

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