CONCLUSIONS VSL#3 , when added to conventional therapy at a daily dose of 3.6 × 10 CFU/d , is safe and more effective than conventional therapy alone in achieving higher response and remission rates in mild to moderately active ulcerative colitis
BACKGROUND VSL#3 is a probiotic mix preparation reported to be effective in the treatment of mild to moderately active ulcerative colitis .
We aim ed to perform a systematic review of the literature and a meta- analysis of studies on its efficacy .
Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis.
BACKGROUND Balsalazide is well tolerated and effective in treating acute ulcerative colitis .  VSL#3 is a probiotic cocktail proven to be effective in preventing flare-ups of chronic pouchitis . We compared the efficacy and safety of low-dose balsalazide ( 2.25 g/day ) plus 3 g/day VLS#3 ( group A ) with medium-dose balsalazide alone ( group B ) and with mesalazine ( group C ) in the treatment of mild-to-moderate active ulcerative colitis . MATERIAL / METHODS Ninety patients ( 30 per group ) were r and omly enrolled , with a treatment duration of 8 weeks .  Efficacy was assessed by symptoms assessment , endoscopic appearance , and histological evaluation . RESULTS Balsalazide/VSL#3 was significantly superior to balsalazide alone and to mesalazine in obtaining remission : 24 patients of group A were in remission [ per- protocol : 85.71 % ( C.I.95 % : 62 - 96 ) , on intention-to-treat : 80 % ( C.I.95 % : 59 - 91 ) ] , while 21 group B [ per- protocol : 80.77 % ( C.I. 95 % : 51 - 82 ) , on intention-to-treat : 77 % ( C.I.95 % : 43 - 81 ) ] and 16 group C patients [ per- protocol : 72.73 % ( C.I. 95 % : 30 - 75 ) , on intention-to-treat : 53.33 % ( C.I.95 % : 42 - 62 ) ] were in remission ( p<0.02 ) . Balsalazide with or without VSL#3 was better tolerated than mesalazine : two group C patients were withdrawn from the study because of severe side-effects ; 1 group A ( 3.33 % ) , 3 group B ( 10 % ) and 4 group C ( 13.33 % ) patients experienced slight side-effects . The balsalazide/VSL#3 combination was faster in obtaining remission than balsalazide alone or mesalazine ( 4 , 7.5 , and 13 days in groups A , B and C , respectively ) and also better in improving all parameters evaluated . CONCLUSIONS Balsalazide/VSL#3 may be a very good choice in the treatment of active mild-to-moderate active ulcerative colitis instead of balsalazide alone or mesalazine
CONCLUSIONS VSL#3 , when added to conventional therapy at a daily dose of 3.6 × 10 CFU/d , is safe and more effective than conventional therapy alone in achieving higher response and remission rates in mild to moderately active ulcerative colitis
BACKGROUND VSL#3 is a probiotic mix preparation reported to be effective in the treatment of mild to moderately active ulcerative colitis .
We aim ed to perform a systematic review of the literature and a meta- analysis of studies on its efficacy .