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支持益生菌在类风湿关节炎中作用的证据质量:系统评价概述。

Quality of evidence supporting the role of probiotics for rheumatoid arthritis: an overview of systematic reviews.

机构信息

Gansu Provincial Hospital of TCM, Lanzhou, China.

The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.

出版信息

Front Immunol. 2024 May 30;15:1397716. doi: 10.3389/fimmu.2024.1397716. eCollection 2024.


DOI:10.3389/fimmu.2024.1397716
PMID:38873605
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11169672/
Abstract

BACKGROUND: To evaluate the methodological quality, report quality, and evidence quality of meta-analysis (MA) and systematic review (SR) on the efficacy of probiotics in the treatment of rheumatoid arthritis (RA). METHODS: Databases were used to identify eligible SRs/MAs until February 12, 2024. The methodological quality of the studies was assessed using AMSTAR-2 tool, the quality of the literature reports was scored using PRISMA checklists, and the quality of the evidence was graded using GRADE system. RESULTS: Seven reviews including 21 outcomes were included. Methodological quality of the included reviews was of general low, and the entries with poor scores were 2, 4, and 7. By PRISMA checklists, there were some reporting deficiencies, and quality problems were mainly reflected in the reporting registration and protocol, comprehensive search strategy and additional analysis. GRADE results elevated the quality of evidence to be low or very low overall. CONCLUSIONS: Probiotics may have a therapeutic effect on RA, based on the evidence provided by the SRs/MAs in this overview. Nevertheless, there is still a lack of conclusive evidence due to methodological limitations in the included research. To make trustworthy judgments regarding the efficacy of probiotics in the treatment of RA, more large-scale, high-quality randomized controlled trials are still required.

摘要

背景:评估益生菌治疗类风湿关节炎(RA)疗效的荟萃分析(MA)和系统评价(SR)的方法学质量、报告质量和证据质量。

方法:检索数据库以确定合格的 SR/MA,截至 2024 年 2 月 12 日。使用 AMSTAR-2 工具评估研究的方法学质量,使用 PRISMA 清单对文献报告的质量进行评分,使用 GRADE 系统对证据质量进行分级。

结果:纳入了 7 项综述,共包含 21 个结局。纳入综述的方法学质量总体较低,评分较差的条目为 2、4 和 7。根据 PRISMA 清单,存在一些报告缺陷,质量问题主要体现在报告注册和方案、全面的搜索策略和额外的分析上。GRADE 结果总体上提高了证据质量为低或极低。

结论:根据本综述中的 SR/MA 提供的证据,益生菌可能对 RA 具有治疗作用。然而,由于纳入研究的方法学限制,仍然缺乏确凿的证据。要对益生菌治疗 RA 的疗效做出可靠的判断,仍需要更多大规模、高质量的随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00ab/11169672/c8e920af7d52/fimmu-15-1397716-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00ab/11169672/c8e920af7d52/fimmu-15-1397716-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00ab/11169672/c8e920af7d52/fimmu-15-1397716-g001.jpg

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Acupunct Herb Med. 2022-9

[2]
Safety and efficacy of probiotic supplementation in 8 types of inflammatory arthritis: A systematic review and meta-analysis of 34 randomized controlled trials.

Front Immunol. 2022

[3]
Gut microbiota and rheumatoid arthritis: From pathogenesis to novel therapeutic opportunities.

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[4]
Scientific Evidence of Chinese Herbal Medicine (Gegen Qinlian Decoction) in the Treatment of Ulcerative Colitis.

Gastroenterol Res Pract. 2022-3-14

[5]
What Is Rheumatoid Arthritis?

JAMA. 2022-3-22

[6]
Efficacy of Probiotics in Rheumatoid Arthritis and Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Nutrients. 2022-1-14

[7]
Quality of Evidence Supporting the Role of Acupuncture for the Treatment of Irritable Bowel Syndrome.

Pain Res Manag. 2021-12-15

[8]
Molecular and Cellular Heterogeneity in Rheumatoid Arthritis: Mechanisms and Clinical Implications.

Front Immunol. 2021

[9]
Targeting Probiotics in Rheumatoid Arthritis.

Nutrients. 2021-9-26

[10]
Probiotic Supplementation for Rheumatoid Arthritis: A Promising Adjuvant Therapy in the Gut Microbiome Era.

Front Pharmacol. 2021-7-23

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