The efficacy of probiotics supplementation for the treatment of atopic dermatitis in adults: a systematic review and meta-analysis
What this study found
Probiotic supplementation improved adult atopic dermatitis severity overall, and the Lactobacillus salivarius LS01 plus Bifidobacterium BR03 mixture appeared to be the most effective formulation. Short-term disease severity improved versus control (SMD 0.63, 95% CI 0.02-1.25; p=.04; I2=85%), and long-term severity also improved (SMD 1.57, 95% CI 0.66-2.49; p<.001; I2=93%). Quality-of-life findings were mixed across instruments: one pooled DLQI estimate favored probiotics (SMD 1.93, 95% CI 1.36-2.51; p=.01; I2=95%), whereas another pooled estimate was null (0.01, -0.44 to 0.46; p=.97;…
- Study & population
- Systematic review and meta-analysis of randomized or controlled trials in adults with atopic dermatitis from multiple countries, including Japan, Italy, and Sweden.
- Intervention
- Across the included adult atopic dermatitis trials, probiotic regimens were mostly oral, with one study using a topical probiotic ointment.
- Key limitation
- The evidence was limited by very high heterogeneity, small and diverse trials, and major variation in probiotic strains, doses, routes, and follow-up duration.
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Open PDFOriginal abstract
Abstract Background There is a lack of certain evidence for the therapeutic efficacy of probiotics for adult atopic dermatitis (AD). Methods PubMed, EMBASE, and the Cochrane Database were searched for relevant studies, and randomized controlled trials of AD describing treatment with single/mixed probiotic therapy were included. Changes in outcomes were calculated by standard mean difference (SMD) and 95% confidence interval (CI). Relative efficacies of the probiotics were ranked by the surface under the cumulative ranking (SUCRA). Results Nine studies with a total of 402 participants, including 208 AD patients who received probiotic treatments and 194 controls, were considered during the current analysis. A reduction in disease severity for probiotic supplementation compared to controls in both the short term (SMD: 0.63; 95% CI: 0.02–1.25) and the long term (SMD: 1.57; 95% CI: 0.66–2.49). There was a significant improvement in long-term quality of life after probiotic supplementation compared with controls (SMD: 0.74; 95% CI: 0.39–1.09). A mixture of L. salivarius (LS01) and Bifidobacterium (BR03) was found the highest probability of the best supplementation. Conclusions Probiotic supplementation decreases clinical severity and improves the quality of life among adult AD patients. The mixture of LS01 and BR03 appeared optimal.