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Saccharomyces boulardii improves clinical and paraclinical indices in overweight/obese knee osteoarthritis patients: a randomized triple-blind placebo-controlled trial

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to determine the effect of the probiotic Saccharomyces boulardii (S. boulardii) in patients with knee osteoarthritis (KOA).

Methods

In this study, 70 patients with KOA were recruited via outpatient clinics between 2020 and 2021 and randomly assigned to receive probiotics or placebo supplements for 12 weeks. The primary outcome was a change in pain intensity according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score.

Results

Sixty-three patients completed the trial. A linear mixed analysis of covariance (ANCOVA) model analysis showed that probiotic was better than placebo in decreasing the pain intensity measured by visual analogue scale (VAS) [−2.11 (−2.59, −1.62) in probiotic group and −0.90 (−1.32, −0.48) in placebo group, p = 0.002] and WOMAC pain score [−3.57 (−4.66, −2.49) in probiotic group and −1.43 (−2.33, −0.53) in placebo group, p < 0.001]. The daily intake of acetaminophen for pain management significantly decreased in the probiotic group [−267.18 (−400.47, −133.89) mg, p < 0.001] that was significantly better than placebo (p = 0.006). Probiotic significantly decreased the serum levels of high-sensitivity C-reactive protein (hs-CRP) inflammatory index [−2.72 (−3.24, −2.20) µg/ml] and malondialdehyde (MDA) oxidative stress index [−1.61 (−2.11, −1.11) nmol/ml] compared to the placebo (p = 0.002 and p < 0.001, respectively). Probiotic was better than placebo in increasing the scores of role disorder due to physical health (p = 0.023), pain (p = 0.048) and physical health (p = 0.031).

Conclusion

Probiotic S. boulardii supplementation in patients with KOA significantly improved pain intensity, some dimensions of QoL, and inflammatory and oxidative stress biomarkers with no severe side effects.

Trial registry

Registered on the Iranian clinical trial website (http://www.irct.ir: IRCT20161022030424N4) on 2019-09-02.

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Data availability

All the necessary data are presented herewith. However, if needed, raw data on excel format can be availed on reasonable request from the corresponding author. The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful to all contributors and the Physical Medicine and Rehabilitation Research Center academic staff who assisted us with this study. The results provided in this article were a part of the thesis by Alireza Jafari.

Funding

Funding was received from the Deputy of Research, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran (NO. 62858). The funding body had no role in the design of the study, collection, analysis, interpretation of the data, or writing of the manuscript.

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Authors and Affiliations

  1. Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Neda Dolatkhah

  2. Department pf Physical Medicine and Rehabilitation, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Alireza Jafari

  3. Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Fariba Eslamian & Vahideh Toopchizadeh

  4. Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Parviz Saleh

  5. Department of Biology, School of Arts and Sciences, Utica University, Utica, NY, USA

    Maryam Hashemian

Authors
  1. Neda Dolatkhah
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  2. Alireza Jafari
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  3. Fariba Eslamian
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  4. Vahideh Toopchizadeh
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  5. Parviz Saleh
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  6. Maryam Hashemian
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Corresponding author

Correspondence to Neda Dolatkhah.

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Conflict of interests

All authors declare that they have no competing interests regarding the research conducted and reported in this article.

Ethics approval and consent to participate

All participants were provided written informed consent and endorsement has been acknowledged by the Ethics Committee of the Research Vice-Chancellor of Tabriz University of Medical Sciences (IR.TBZMED.REC.1398.506). Patients’ data were conserved in a secured database to keep patients’ security. The study was also registered on the Iranian clinical trial website (http://www.irct.ir: IRCT20161022030424N4).

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Dolatkhah, N., Jafari, A., Eslamian, F. et al. Saccharomyces boulardii improves clinical and paraclinical indices in overweight/obese knee osteoarthritis patients: a randomized triple-blind placebo-controlled trial. Eur J Nutr (2024). https://doi.org/10.1007/s00394-024-03428-5

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