Efficacy and safety of probiotics as a complementary treatment for urticaria: a systematic review and meta-analysis
Abstract
Objective The potential of probiotics in the treatment of urticaria has garnered significant attention. However, a systematic assessment of their benefits and risks is lacking. This meta-analysis and trial sequential analysis (TSA) aim to evaluate the efficacy and safety of probiotics as a complementary treatment for urticaria. Methods Relevant studies published before April 30, 2025, were retrieved and screened from eight public databases. The basic characteristics, outcome data, and risk of bias of the included studies were recorded. Meta-analysis and TSA were conducted using Review Manager 5.3 and TSA 0.9.5.10 Beta, respectively. Funnel plots and Egger’s test were employed to assess publication bias, while the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to evaluate the certainty of evidence. Results A total of 11 clinical trials involving 1,014 participants were included in this study. The meta-analysis revealed that, compared to antihistamines alone, the combination of probiotics and antihistamines significantly improved the urticaria relief rate (URR) (odds ratio [OR] 2.90, 95% confidence interval [CI] 1.97 to 4.28, p < 0.00001) and interferon-gamma (IFN-γ) levels (mean difference [MD] 8.12, 95% CI 6.95 to 9.30, p < 0.00001). Additionally, it reduced the urticaria activity score over 7 days (UAS7) (MD −3.29, 95% CI −3.28 to −2.75, p < 0.00001), the dermatology life quality index (DLQI) (MD −2.95, 95% CI −3.21 to −2.69, p <…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,014 participants or records.
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