Early probiotic supplementation for eczema and asthma prevention: A randomized controlled trial

Michael D. Cabana, Michelle McKean, Aaron B. Caughey, Lawrence Fong, Susan Lynch, Angela Wong, Russell Leong, Homer A. Boushey, Joan F. Hilton

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVES: To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema. METHODS: We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants (n = 92) received a daily dose of 10 billion colonyforming units of LGG and 225 mg of inulin (Amerifit Brands, Cromwell, CT), and control infants (n = 92) received 325 mg of inulin alone. We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases. RESULTS: Infants were accrued over a 6-year period (median follow-up: 4.6 years; 95% retention rate at 2 years). At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25). CONCLUSIONS: For high-risk infants, early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age.

Original languageEnglish (US)
Article numbere20163000
JournalPediatrics
Volume140
Issue number3
DOIs
StatePublished - Sep 2017
Externally publishedYes

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Lactobacillus rhamnosus
Eczema
Probiotics
Asthma
Randomized Controlled Trials
Confidence Intervals
Inulin
Incidence
Rhinitis
Survival Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Cabana, M. D., McKean, M., Caughey, A. B., Fong, L., Lynch, S., Wong, A., ... Hilton, J. F. (2017). Early probiotic supplementation for eczema and asthma prevention: A randomized controlled trial. Pediatrics, 140(3), [e20163000]. https://doi.org/10.1542/peds.2016-3000

Early probiotic supplementation for eczema and asthma prevention : A randomized controlled trial. / Cabana, Michael D.; McKean, Michelle; Caughey, Aaron B.; Fong, Lawrence; Lynch, Susan; Wong, Angela; Leong, Russell; Boushey, Homer A.; Hilton, Joan F.

In: Pediatrics, Vol. 140, No. 3, e20163000, 09.2017.

Research output: Contribution to journalArticle

Cabana, MD, McKean, M, Caughey, AB, Fong, L, Lynch, S, Wong, A, Leong, R, Boushey, HA & Hilton, JF 2017, 'Early probiotic supplementation for eczema and asthma prevention: A randomized controlled trial', Pediatrics, vol. 140, no. 3, e20163000. https://doi.org/10.1542/peds.2016-3000
Cabana, Michael D. ; McKean, Michelle ; Caughey, Aaron B. ; Fong, Lawrence ; Lynch, Susan ; Wong, Angela ; Leong, Russell ; Boushey, Homer A. ; Hilton, Joan F. / Early probiotic supplementation for eczema and asthma prevention : A randomized controlled trial. In: Pediatrics. 2017 ; Vol. 140, No. 3.
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AU - Cabana, Michael D.

AU - McKean, Michelle

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AU - Fong, Lawrence

AU - Lynch, Susan

AU - Wong, Angela

AU - Leong, Russell

AU - Boushey, Homer A.

AU - Hilton, Joan F.

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N2 - OBJECTIVES: To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema. METHODS: We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants (n = 92) received a daily dose of 10 billion colonyforming units of LGG and 225 mg of inulin (Amerifit Brands, Cromwell, CT), and control infants (n = 92) received 325 mg of inulin alone. We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases. RESULTS: Infants were accrued over a 6-year period (median follow-up: 4.6 years; 95% retention rate at 2 years). At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25). CONCLUSIONS: For high-risk infants, early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age.

AB - OBJECTIVES: To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema. METHODS: We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants (n = 92) received a daily dose of 10 billion colonyforming units of LGG and 225 mg of inulin (Amerifit Brands, Cromwell, CT), and control infants (n = 92) received 325 mg of inulin alone. We used survival analysis methods to estimate disease incidences in the presence or absence of LGG and to estimate the efficacy of LGG in delaying or preventing these diseases. RESULTS: Infants were accrued over a 6-year period (median follow-up: 4.6 years; 95% retention rate at 2 years). At 2 years of age, the estimated cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25). CONCLUSIONS: For high-risk infants, early LGG supplementation for the first 6 months of life does not appear to prevent the development of eczema or asthma at 2 years of age.

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