TY - JOUR
T1 - Probiotics and prebiotic fiber for constipation associated with Parkinson disease
AU - Barichella, Michela
AU - Pacchetti, Claudio
AU - Bolliri, Carlotta
AU - Cassani, Erica
AU - Iorio, Laura
AU - Pusani, Chiara
AU - Pinelli, Giovanna
AU - Privitera, Giulia
AU - Cesari, Ilaria
AU - Faierman, Samanta Andrea
AU - Caccialanza, Riccardo
AU - Pezzoli, Gianni
AU - Cereda, Emanuele
PY - 2016/9/20
Y1 - 2016/9/20
N2 - Objectives: Our objective was to evaluate the efficacy of probiotics and prebiotics in patients with Parkinson disease (PD) and constipation. Methods: We conducted a tertiary setting, randomized, double-blind, placebo-controlled trial in patients with PD with Rome III-confirmed constipation based on 2-week stool diary data at baseline. Patients (n 120) were randomly assigned (2:1) to either a fermented milk, containing multiple probiotic strains and prebiotic fiber, or placebo, once daily for 4 weeks. The primary efficacy endpoint was the increase in the number of complete bowel movements (CBMs) per week. The key secondary endpoints were 3 or more CBMs and an increase by one or more CBMs per week during weeks 3 and 4. Results: For the primary endpoint, the consumption of a fermented milk containing probiotics and prebiotics resulted in a higher increase in the number of CBMs (mean 1.2, 95% confidence interval [CI] 0.8-1.6) than placebo (0.1, 95% CI -0.4% to 0.6%) (mean difference 1.1, 95% CI 0.4-1.8; p 0.002). For the key secondary endpoints, a higher number of patients in the probiotics-prebiotics group vs the placebo group reported 3 or more CBMs (p 0.030; 58.8% vs 37.5%; odds ratio 2.4, 95% CI 1.1-5.2) and an increase by one or more CBMs (p 0.004; 53.8% vs 25.0%; odds ratio 3.5, 95% CI 1.8-8.1) during weeks 3 and 4. Conclusions: The consumption of a fermented milk containing multiple probiotic strains and prebiotic fiber was superior to placebo in improving constipation in patients with PD. ClinicalTrials.gov identifier: NCT02459717. Classification of evidence: This study provides Class I evidence that for patients with PD who have constipation, fermented milk containing probiotics and prebiotics increases the frequency of CBMs.
AB - Objectives: Our objective was to evaluate the efficacy of probiotics and prebiotics in patients with Parkinson disease (PD) and constipation. Methods: We conducted a tertiary setting, randomized, double-blind, placebo-controlled trial in patients with PD with Rome III-confirmed constipation based on 2-week stool diary data at baseline. Patients (n 120) were randomly assigned (2:1) to either a fermented milk, containing multiple probiotic strains and prebiotic fiber, or placebo, once daily for 4 weeks. The primary efficacy endpoint was the increase in the number of complete bowel movements (CBMs) per week. The key secondary endpoints were 3 or more CBMs and an increase by one or more CBMs per week during weeks 3 and 4. Results: For the primary endpoint, the consumption of a fermented milk containing probiotics and prebiotics resulted in a higher increase in the number of CBMs (mean 1.2, 95% confidence interval [CI] 0.8-1.6) than placebo (0.1, 95% CI -0.4% to 0.6%) (mean difference 1.1, 95% CI 0.4-1.8; p 0.002). For the key secondary endpoints, a higher number of patients in the probiotics-prebiotics group vs the placebo group reported 3 or more CBMs (p 0.030; 58.8% vs 37.5%; odds ratio 2.4, 95% CI 1.1-5.2) and an increase by one or more CBMs (p 0.004; 53.8% vs 25.0%; odds ratio 3.5, 95% CI 1.8-8.1) during weeks 3 and 4. Conclusions: The consumption of a fermented milk containing multiple probiotic strains and prebiotic fiber was superior to placebo in improving constipation in patients with PD. ClinicalTrials.gov identifier: NCT02459717. Classification of evidence: This study provides Class I evidence that for patients with PD who have constipation, fermented milk containing probiotics and prebiotics increases the frequency of CBMs.
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U2 - 10.1212/WNL.0000000000003127
DO - 10.1212/WNL.0000000000003127
M3 - Article
AN - SCOPUS:84988531129
VL - 87
SP - 1274
EP - 1280
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 12
ER -