VSL#3 Probiotic Mixture in Chronic Inflammatory Bowel Diseases.

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BioDrugs 2007

Spotlight on VSL#3 Probiotic Mixture in Chronic Inflammatory Bowel Diseases.

Chapman TM, Plosker GL, Figgitt DP.

Wolters Kluwer Health | Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USA.

VSL#3 (VSL#3(®)) is a high-concentration probiotic

preparation of eight live freeze-dried bacterial species that are normal

components of the human gastrointestinal microflora,

including four strains of lactobacilli (Lactobacillus casei,

L. plantarum, L. acidophilus, and L. delbrueckii subsp. bulgaricus), three strains of bifidobacteria

(Bifidobacterium longum, B.

breve, and B. infantis),

and Streptococcus salivarius subsp.

thermophilus. Data from noncomparative trials suggest that VSL#3 has clinical

potential in the treatment of active mild to moderate ulcerative colitis and as

maintenance therapy for patients with ulcerative colitis in remission. In addition, a randomized, open-label, multicenter

trial showed that VSL#3 in combination with low-dose balsalazide

(a prodrug of mesalazine [mesalamine; 5-aminosalicylic acid]) was more effective than

standard doses of basalazide or mesalazine

monotherapy in the treatment of acute mild to

moderate ulcerative colitis. Randomized, double-blind,

placebo-controlled studies have shown VSL#3 is effective in preventing the

onset of acute pouchitis in patients with newly

formed surgical pouches, and in maintaining remission following antibacterial

treatment of acute pouchitis in patients with a

history of refractory or recurrent pouchitis. Treatment guidelines from the US

and the UK

include VSL#3 as a therapeutic option for the prevention of pouchitis

relapse in patients with chronic pouchitis. In general, VSL#3 was well tolerated in clinical trials. Large, well designed, controlled confirmatory clinical

trials will further determine the place of VSL#3 in the treatment of ulcerative

colitis.

PMID: 17263590 [PubMed - in process]

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