Meta-Analysis
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2017; 23(2): 336-344
Published online Jan 14, 2017. doi: 10.3748/wjg.v23.i2.336
Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: An individual subject meta-analysis
Amélie Cayzeele-Decherf, Fanny Pélerin, Sébastien Leuillet, Benoit Douillard, Béatrice Housez, Murielle Cazaubiel, Gunnard K Jacobson, Peter Jüsten, Pierre Desreumaux
Amélie Cayzeele-Decherf, Fanny Pélerin, Peter Jüsten, Lesaffre Human Care, Lesaffre Group, 59700 Marcq en Baroeul, France
Sébastien Leuillet, Benoit Douillard, Béatrice Housez, Murielle Cazaubiel, Biofortis - Mérieux NutriSciences, 44800 Saint Herblain, France
Gunnard K Jacobson, Lesaffre Yeast Corporation, Lesaffre Group, Milwaukee, WI 53214, United States
Pierre Desreumaux, CHU Lille, Department of Gastroenterology, Claude Huriez Hospital, 59000 Lille, France
Pierre Desreumaux, Lille University North of France, 59000 Lille, France
Pierre Desreumaux, INSERM U995, 59000 Lille, France
Author contributions: All authors have made substantial contributions to conception and design of the study, acquisition of data, analysis and interpretation of data; Cayzeele-Decherf A, Leuillet S and Housez B have drafted the article and other authors have made critical revisions related to important intellectual content of the manuscript; All authors have been involved for final approval of the version of the article to be published.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amélie Cayzeele-Decherf, Clinical Study Manager, Lesaffre Human Care, Lesaffre Group, 59700 Marcq en Baroeul, France. ace@lesaffre.fr
Telephone: +33-3-20148320
Received: August 2, 2016
Peer-review started: August 3, 2016
First decision: September 12, 2016
Revised: October 3, 2016
Accepted: October 19, 2016
Article in press: October 19, 2016
Published online: January 14, 2017
Processing time: 162 Days and 20 Hours
Abstract
AIM

To confirm previous conclusions on Saccharomyces cerevisiae (S. cerevisiae) CNCM I-3856 for irritable bowel syndrome (IBS) management.

METHODS

An individual patient data meta-analysis was performed on two randomized clinical trials studying the effect of S. cerevisiae CNCM I-3856 supplementation on gastrointestinal (GI) symptoms in IBS subjects. A total of 579 IBS subjects were included. Outcomes were the daily Likert scale scores of abdominal pain/discomfort and bloating [area under the curve (AUC) and weekly means], responder status, and bowel movements (stool frequency and consistency). Statistical analyses were conducted in Intent to Treat (ITT) population, IBS-C subjects and IBS-C subjects with an abdominal pain/discomfort score higher than or equal to 2 at baseline (“IBS-C ≥ 2 subpopulation”).

RESULTS

S. cerevisiae CNCM I-3856 significantly improved abdominal pain/discomfort and bloating during the second month of supplementation [AUC (W5-W8)] with improvement up to the minimal clinically relevant threshold of 10%: a 12.3% reduction of abdominal pain/discomfort in the ITT population compared to the Placebo group (P = 0.0134) has been observed. In the IBS-C ≥ 2 subpopulation, there were a 13.1% reduction of abdominal pain/discomfort and a 14.9% reduction of bloating compared to the Placebo group (P = 0.0194 and P = 0.0145, respectively). GI symptoms significantly decreased during supplementation but no statistical differences were reported between groups at the end of the supplementation period. Responder status was defined as a subject who experienced a decrease of 1 arbitrary unit (a.u.) or 50% of the abdominal discomfort score from baseline for at least 2 wk out of the last 4 wk of the study. A significant difference between groups was reported in the ITT population, when considering the first definition: subjects in the Active group had 1.510 higher odds to be a responder (reduction of 1 a.u. of abdominal pain/discomfort) compared with subjects in the Placebo group (P = 0.0240). At the end of supplementation period, stool consistency in the Active group of the ITT population was significantly improved and classified as “normal” compared to Placebo (respectively 3.13 ± 1.197 a.u. vs 2.58 ± 1.020 a.u., P = 0.0003). Similar results were seen in the IBS-C ≥ 2 subpopulation (Active group: 3.14 ± 1.219 a.u. vs Placebo group: 2.59 ± 1.017 a.u., P = 0.0009).

CONCLUSION

This meta-analysis supports previous data linking S. cerevisiae I-3856 and improvement of GI symptoms, in IBS overall population and in the IBS-C and IBS-C ≥ 2 subpopulations.

Keywords: Irritable bowel syndrome; Saccharomyces cerevisiae; Constipation; Abdominal pain; Probiotics

Core tip: Since the gut microbiota is considered to play a role in the pathophysiology of Irritable Bowel Syndrome, the use of probiotics has gained interest for the management of gastrointestinal symptoms of irritable bowel syndrome (IBS). However, the properties of probiotics are strain-dependent. We performed an individual patient data meta-analysis to assess the effectiveness of Saccharomyces cerevisiae CNCM I-3856 on the management of IBS symptoms.