In the Journals

Certain probiotics improve H. pylori eradication rates, prevent adverse events

Some multi-strain probiotics are effective for improving Helicobacter pylori eradication rates and preventing adverse events associated with eradication therapy, according to the results of a systematic review and meta-analysis published in the United European Gastroenterology Journal.

“Although our meta-analysis of pooled data found that, in general, probiotics were effective for improving the cure rate (H. pylori eradication) and reducing the incidence of adverse reactions associated with the standard therapy, it is necessary to recognize that efficacy for probiotics are strain-specific,” Lynne V. McFarland, PhD, from the department of medicinal chemistry at University of Washington, Seattle, told Healio Gastroenterology. “This became apparent once we separated the mixtures and did a sub-group analysis so that identical strain mixtures were analyzed together.”

Lynne V. McFarland

McFarland and colleagues reviewed relevant literature published up to June 2015, and included 19 randomized controlled trials in their meta-analysis (n = 2,730). All trials evaluated one of six multi-strain probiotics in combination with standard H. pylori eradication therapy (75% of trials used triple therapy) vs. controls. Eradication rates and frequencies of adverse events and antibiotic-associated diarrhea served as primary endpoints.

They found that four of the six probiotic mixtures evaluated were effective as adjuncts to standard therapy for improving H. pylori eradication rates, while two were ineffective. Moreover, five of the six mixtures were effective in reducing adverse events associated with standard eradication therapy, and only three of five mixtures were effective in reducing antibiotic-associated diarrhea.

“Only two multi-strain probiotic mixtures were effective for all three outcomes. These two mixtures were ‘AB Yogurt’ (Lactobacillus acidophilus La5 and Bifido. lactis Bb12) and ‘Pb Probinul’ (mixture of 8 different strains: 6 different Lactobacilli strains and 2 Bifidobacteri strains),” McFarland said. “This shows a promising therapeutic strategy to improve the cure rates for H. pylori disease, but studies need to assess the efficacy by strain type. More RCTs are needed to test if combining multi-strain probiotics added to the newer quadruple therapies will improve the cure rate even further.” – by Adam Leitenberger

Disclosures: McFarland reports she has received fees as a speaker for Biocodex, France and Lallemand, France, and is on the scientific advisory board of BioK+, Canada. Please see the full study for a list of all other researchers’ relevant financial disclosures.