Effect of probiotics supplementation on disease progression, depression, general health, and anthropometric measurements in relapsing-remitting multiple sclerosis patients: A systematic review and meta-analysis of clinical trials.

BACKGROUND Probiotics may have a promising role in chronic autoinflammatory diseases. The current systematic review and meta-analysis investigated the effects of probiotics on disease progression, depression, general health, and anthropometric measurements in Relapsing-Remitting Multiple Sclerosis (RRMS) patients. METHODS The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through January 2021. Random effect models were used to synthesise quantitative data by STATA14 . RESULTS From a total of 152 identified entries, four trials were included in quantitative synthesis (n = 213; 106 as intervention, 107 as control). An additional six studies with the same structure and different markers were also systematically reviewed. The pooled effect size showed that Expanded Disability Status Scale (EDSS) (WMD = -0.43; 95% CI = -0.65, -0.20; P < .001), Beck Depression Inventory-Ⅱ (BDI-Ⅱ) (WMD = -3.22; 95% CI = -4.38, -2.06; P < .001) and General Health Questionnaire (GHQ) (WMD = -4.37; 95% CI = -6.43, -2.31; P < .001) were improved following probiotics supplementation. However, body weight and body mass index did not statistically change. CONCLUSION Our findings revealed that probiotics supplementation can improve disease progression, suppress depression, and general health in MS patients; although, further investigations may be needed.