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Unravelling the Ameliorative Effects of Probiotics in Rheumatoid Arthritis: A Meta-analysis of Randomized, Controlled Trials


 Background: Recent studies have shown that rational regulation of the gut microbiota, known as probiotic supplements, have beneficial consequences on rheumatoid arthritis (RA). However, their efficacy as an adjunct therapy remains controversial. Methods: PubMed, Embase, Scopus, Web of science and Cochrane Library was performed to retrieve the existing data from the published randomized, controlled trials (RCTs) comparing probiotics with placebo in RA through August 2021. Among eight RCTs were eligible for inclusion in this meta-analysis, and all data were analyzed by StataSE 12.1 software. Results: The probiotic has achieved significant improvement in visual analogue scales (VAS), high sensitive C-reactive protein (hs-CRP), tumor necrosis factor (TNF-α) and interleukin (IL-1β). Probiotic may have a beneficial role in disease activity score in 28 joints (DAS28). However, probiotic does not have a significant effect on tender joint, swollen joint and lipid levels and not yet achieve obvious improvement in American College of Rheumatology 20% improvement criteria (ACR20). Conclusion: Probiotics have a beneficial effect on improving RA to some extent, especially on alleviating joint inflammation. However, the number of studies was too small to determine if a strain-, dose-, or duration-response effect was present. More multi-centered, large-sample RCTs are needed to explore the benefits of probiotic to RA patients in the future.