Effectiveness of Probiotics and Standard Therapy Versus Standard Therapy Alone in Patients of Mild to Moderate Rheumatoid Arthritis

Probiotics and Standard Therapy Vs Standard Therapy Alone in Rheumatoid Arthritis

Abstract

Analgesics, steroids and disease modifying anti-rheumatic drugs (DMARDs) are the cornerstone of treatment in rheumatoid arthritis (RA). Objective: To determine effectiveness of probiotics, introduced to standard treatment, in improving Disease Activity Score 28 (DAS-28) in patients with mild to moderate rheumatoid arthritis, when given for a period of three months. Methods: This randomized controlled trial registered under ClinicalTrials.gov ID:  NCT06594822, was conducted on diagnosed cases of rheumatoid arthritis presenting to Mayo hospital, Lahore from 24^th August 2023 till 23^rd February 2024. Eighty-eight patients were recruited employing simple random sampling techniques and were categorized into two groups. Group A received standard therapy along with probiotics whereas Group B received standard therapy alone. DAS-28 score was assessed at baseline, at 45 and 90 days. Results: Patients in Group A showed an effective reduction in DAS-28 of 22.7% compared to 6.8% in group B (p=0.035). DAS-28 score in group A and B at baseline was 3.67 ± 0.61 vs 3.63 ± 0.52, p=0.708, after 45 days was 3.15 ± 0.63 vs 3.49 ± 0.56, p=0.010 and after 90 days was 2.93 ± 0.75 vs 3.27 ± 0.52, p=0.015. During treatment at days 45 and 90, group A patients showed a greater decrease from baseline i.e., -0.52 ± 0.63 vs -0.14 ± 0.56, p<0.010 and -0.74 ± 0.75 vs 0.36 ± 0.52, p<0.015 than group B patients. Group A also had a significant improvement in mean DAS-28 score at days 45 and 90 (p<0.05). Conclusion: Daily supplementation of probiotics with standard treatment is effective for the alleviation of symptoms and disease severity in patients having mild to moderate rheumatoid arthritis.