van den Nieuwboer M, Claassen E, Morelli L, Guarner F, Brummer R J
Athena Institute, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands Swammerdam Institute for Life Sciences, University of Amsterdam, Kruislaan 318, 1098 SM Amsterdam, the Netherlands.
Athena Institute, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands Department of Viroscience, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
Benef Microbes. 2014 Mar;5(1):45-60. doi: 10.3920/BM2013.0046.
In this study, we systematically evaluated safety aspects in clinical trials with probiotics and synbiotics in young infants (0-2 years of age). This study is an update of earlier reports and covers the recent literature from 2008-2013. The safety evaluation is performed along the Common Terminology Clinical Adverse Events (CTCAE) version 4.0 scale, hereby also providing guidance for future studies. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. The results show a deficiency in the precise reporting and classification of adverse events in most studies. Analysis of 57 clinical trials with probiotics and synbiotics in combination with eight follow-up studies indicate that probiotic administration to infants between 0 and 24 months is safe with regard to the evaluated strains in infants with a particular health status or susceptibility. Most adverse events and serious adverse events were considered unrelated to the study product, and there were no major safety concerns. Almost all studies concluded that none of the adverse effects were related to the study product; the study products are generally well tolerated. Finally, inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes, greatly limit the generalizability of conclusions and argue convincingly for obligatory and standardised behaviour on adverse events (CTCAE) reporting in 'food' studies.
在本研究中,我们系统评估了益生菌和合生元用于低龄婴儿(0至2岁)的临床试验中的安全性。本研究是早期报告的更新,涵盖了2008年至2013年的最新文献。安全性评估按照通用术语临床不良事件(CTCAE)第4.0版量表进行,同时也为未来研究提供指导。安全性相关内容体现为每种益生菌菌株/培养物的参与者数量、研究持续时间、剂量、临床状况和选定的疾病。结果显示,大多数研究在不良事件的精确报告和分类方面存在不足。对57项益生菌和合生元联合使用的临床试验以及八项随访研究的分析表明,对于特定健康状况或易感性的婴儿,给予0至24个月婴儿所评估的菌株的益生菌是安全的。大多数不良事件和严重不良事件被认为与研究产品无关,且不存在重大安全问题。几乎所有研究都得出结论,没有任何不良反应与研究产品相关;研究产品总体耐受性良好。最后,报告的不一致、不精确和可能不完整,以及益生菌菌株、剂量、给药方案、研究人群和报告结果的差异,极大地限制了结论的普遍性,并有力地表明在“食品”研究中对不良事件(CTCAE)报告采取强制性和标准化行为的必要性。
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