Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not probiotics are effective in reducing symptoms of atopic dermatitis.
STUDY DESIGN: Selective EBM review of three randomized, double-blind, placebo-controlled trials published after 2009, all English language.
DATA SOURCES: All three studies were published in peer-reviewed journals found on PubMed and selected based on relevance to the proposed clinical question.
OUTCOMES MEASURED: The main outcome measured was the percentage change in SCORAD index to determine severity of atopic dermatitis before and after trial through objective and subjective findings. Additional outcomes included DLQ index which was evaluated via 10 questions scored on a scale of 0-3, IDQOL and DFI questionnaires directed towards evaluating quality of life through 10 questions scored from 0-3, and frequency and amount of corticosteroid used.
RESULTS: Each study assessed the change in SCORAD when comparing the probiotic with the placebo group in those with moderate-to-severe atopic dermatitis. Gerasimov et al. found a SCORAD decrease of 33.7% in the probiotic group in comparison to a decrease of 19.4% in the placebo group and no statistically significant decrease in corticosteroid use (p=0.130). IDQOL and DFI decreased by 33% and 35.2% in the probiotic group and only by 19% and 23.8% in the placebo group, respectively. Iemoli et al. found that SCORAD and DLQ at the end of the trial was significantly reduced in the probiotic group (p = 0.001, p = 0.024, respectively). The study done by Navarro-Lopez et al. found a SCORAD change of -83% (95% CI, -95% to -70%) in the probiotic group and a change of -24% (95% CI, -36% to -11%) in the placebo group. Topical steroid use in the probiotic arm (7.7%) was significantly less compared to the placebo arm (10.8%).
CONCLUSION: This systematic review suggests that probiotics are effective only as an adjunctive therapy in the reduction of clinical symptoms and topical corticosteroid use in atopic dermatitis. However, further research is needed to assess exclusive reduction in subjective symptoms.
Kim, Samuel H., "Are Probiotics Effective in Reducing Symptoms of Atopic Dermatitis?" (2019). PCOM Physician Assistant Studies Student Scholarship. 475.