Cochrane · systematic review · CD015084
Prebiotics for induction and maintenance of remission in ulcerative colitis
Sinopoulou, V, Gordon, M, Gregory, V, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
30
current version
GRADE rated
18
No studies
12
Included studies
NR
No studies 12 · 40%Ungraded 0 · 0%Very low 16 · 53.3%Low 2 · 6.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Prebiotics compared to placebo for induction of remission
Population: people with mild‐to‐moderate disease (Rachmilewitz index) or active disease (SCCAI score of 4 to 10)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission (14 days) Prebiotics vs placebo | RR 1.05 [0.57, 1.94] | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Clinical improvement (Rachmilewitz index) (14 days) Prebiotics vs placebo | no estimate extracted | 1 study · 15 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (IBDQ) (2 or 3 months) Prebiotics vs placebo | no estimate extracted | 1 study · 8 participants | Very low Downgraded: risk of bias, imprecision |
Total adverse events Prebiotics vs placebo | no estimate extracted | NR | No studies |
Withdrawals due to adverse events (14 days to 2 or 3 months) Prebiotics vs placebo | RR 2.73 [0.51, 14.55] | 2 studies · 31 participants | Very low Downgraded: risk of bias, imprecision |
Inulin and oligofructose 15 g compared to inulin and oligofructose 7.5 g daily for induction of remission
Population: people with mild to moderately active ulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission (9 weeks) Inulin and oligofructose 15 g vs inulin and oligofructose 7.5 g daily | RR 4.27 [1.07, 16.96] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Clinical improvement (Mayo score) (9 weeks) Inulin and oligofructose 15 g vs inulin and oligofructose 7.5 g daily | RR 2.67 [1.06, 6.7] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Inulin and oligofructose 15 g vs inulin and oligofructose 7.5 g daily | no estimate extracted | NR | No studies |
Total adverse events (9 weeks) Inulin and oligofructose 15 g vs inulin and oligofructose 7.5 g daily | RR 1.71 [0.72, 4.06] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events (9 weeks) Inulin and oligofructose 15 g vs inulin and oligofructose 7.5 g daily | RR 0.53 [0.11, 2.5] | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision |
Prebiotics and anti‐inflammatory therapy compared to anti‐inflammatory therapy for induction of remission
Population: people with mild‐to‐moderate ulcerative colitis based on Truelove and Witts criteria
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission Prebiotics and anti‐inflammatory therapy vs anti‐inflammatory therapy | no estimate extracted | NR | No studies |
Clinical improvement (Lichtiger index) (4 weeks) Prebiotics and anti‐inflammatory therapy vs anti‐inflammatory therapy | no estimate extracted | 1 study · 18 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life Prebiotics and anti‐inflammatory therapy vs anti‐inflammatory therapy | no estimate extracted | NR | No studies |
Total adverse events Prebiotics and anti‐inflammatory therapy vs anti‐inflammatory therapy | no estimate extracted | NR | No studies |
Withdrawals due to adverse events Prebiotics and anti‐inflammatory therapy vs anti‐inflammatory therapy | no estimate extracted | NR | No studies |
Prebiotics compared to placebo for maintenance of remission
Population: people with histologically confirmed diagnosis of ulcerative colitis in remission
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse (6 months) Prebiotics vs placebo | RR 1.36 [0.79, 2.31] | 1 study · 89 participants | Low Downgraded: imprecision |
Clinical improvement (partial Mayo score) (60 days) Prebiotics vs placebo | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Quality of life (IBDQ) (60 days) Prebiotics vs placebo | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Total adverse events (6 months) Prebiotics vs placebo | RR 1.68 [1.18, 2.4] | 1 study · 89 participants | Low Downgraded: imprecision |
Withdrawals due to adverse events (60 days to 6 months) Prebiotics vs placebo | RR 2.57 [1.15, 5.73] | 2 studies · 125 participants | Very low Downgraded: risk of bias, imprecision |
Prebiotics compared to probiotics for maintenance of remission
Population: people in remission or with mildly activeulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse (4 weeks) Prebiotics vs probiotics | no estimate extracted | NR | No studies |
Clinical improvement Prebiotics vs probiotics | no estimate extracted | NR | No studies |
Quality of life (IBDQ) (4 weeks) Prebiotics vs probiotics | no estimate extracted | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Total adverse events Prebiotics vs probiotics | no estimate extracted | NR | No studies |
Withdrawals due to adverse events (4 weeks) Prebiotics vs probiotics | RR 1 [0.44, 2.26] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Prebiotics compared to synbiotics for maintenance of remission
Population: people in remission or with mildly activeulcerative colitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical relapse (4 weeks) Prebiotics vs synbiotics | no estimate extracted | NR | No studies |
Clinical improvement Prebiotics vs synbiotics | no estimate extracted | NR | No studies |
Quality of life (IBDQ) (4 weeks) Prebiotics vs synbiotics | no estimate extracted | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision |
Total adverse events Prebiotics vs synbiotics | no estimate extracted | NR | No studies |
Withdrawals due to adverse events (4 weeks) Prebiotics vs synbiotics | RR 1.13 [0.48, 2.62] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |