Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis - a pilot study

Objective: To study the effects of Lactobacillus rhamnosus GG (LGG) on rheumatoid arthritis (RA). Methods: Twenty-one RA patients were randomised to receive 2 capsules of LGG or a placebo twice daily in double-blind fashion for 12 months. Arthritis activity was evaluated by clinical examination, HAQ index, and laboratory tests (e.g. ESR, CRP, pro- and anti-inflammatory cytokines). Results: There were no statistical differences in the clinical parameters, biochemical variables and HAQ index between the study groups over the intervention period. The mean number of tender and swollen joints decreased from 8.3 to 4.6 in the Lactobacillus group and from 5.5 to 4.8 in the placebo group (p = 0.41). According to the global assessment the RA activity was reduced in 71% (LGG group) vs. 30% (controls) (p=0.15). Serum IL-1beta increased slightly in the LGG group (p=0.07), but no differences were seen in IL-6, TNF-alpha, MPO, IL-10 or 1L-12. Conclusions: Although there were no statistical significant differences in the activity of RA, more subjects in the LGG group reported subjective well being. More studies on the effects of probiotic bacteria in RA are needed.