Effect of probiotic supplementation on disease activity in rheumatoid arthritis patients

Abstract

Background

Rheumatoid arthritis (RA) is the most prevalent inflammatory arthritis. Alterations in the typical gastrointestinal microflora and dysregulation of the mucosal immune response to these pathogens may contribute to autoimmune diseases like RA. Aim of the work: To assess the effects of probiotic supplementation on the clinical status and disease activity of patients with RA.

Patients and methods

This randomized clinical trial was conducted on 60 RA patients receiving methotrexate (MTX); 30 patients also received 1 daily capsule of probiotic (Group A), and the other 30 were on MTX only (Group B). Disease activity score (DAS28), clinical disease activity index (CDAI); and simplified disease activity index (SDAI) were assessed.

Results

The mean age of the patients was 44.7 ± 9.3 years; they were 51 females and 9 males with a median disease duration of 7 (4.5–14.5) years. Following an eight-week intervention, the ESR significantly decreased in both groups (Group A: 48.6 ± 21.7 to 42.9 ± 23.2; p = 0.01 and (Group B: 45.5 ± 17.1 to 37.6 ± 15.3; p < 0.0001). The median tender joint count (TJC) and swollen joint count significantly decreased in group A (10 to 8; p < 0.0001 and 4 to 2; p < 0.0001, respectively). The reduction in median TJC was significantly greater in group A compared to group B (−2 vs 0; p = 0.01). No significant changes in activity scores were observed in either group following the intervention.

Conclusion

The use of probiotic therapy has no clear benefit as an add-on therapy to the standard of care in patients with RA. However, a notable improvement in TJC was observed, suggesting a potential avenue for future research.