Lactobacillus GG in inducing and maintaining remission of Crohn's disease

Background: Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders such as Crohn's disease and ulcerative colitis. Alteration of the intestinal microflora by antibiotic or probiotic therapy may induce and maintain remission. The aim of this randomized, placebo-controlled trial was to determine the effect of oral Lactobacillus GG (L. GG) to induce or maintain medically induced remission. Methods: Eleven patients with moderate to active Crohn's disease were enrolled in this trial to receive either L. GG (2x10(9) CFU/day) or placebo for six months. All patients were started on a tapering steroid regime and received antibiotics for the week before the probiotic/placebo medication was initiated. The primary end point was sustained remission, defined as freedom from relapse at the 6 months follow-up visit. Relapse was defined as an increase in CDAI of >100 points. Results: 5/11 patients finished the study, with 2 patients in each group in sustained remission. The median time to relapse was 16+/-4 weeks in the L. GG group and 12+/-4.3 weeks in the placebo group (p=0.5). Conclusion: In this study we could not demonstrate a benefit of L. GG in inducing or maintaining medically induced remission in CD.