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P377. Effect of oligofructose enriched inulin (OF-IN) on bacterial composition and disease activity of Crohn's disease patients: Results from a double-blind randomized controlled trial

M. Joossens, V. De Preter, V. Ballet, K. Verbeke, K. Machiels, P. Rutgeerts, S. Vermeire

Catholic University Leuven, Leuven, Belgium

Background and Aim: The presence of intestinal dysbiosis is well-established in Crohn's disease (CD) patients. Hence improving the disease course by modulation of the intestinal microbiota is an appealing therapeutic approach. Prebiotics are food ingredients that can improve health by modulating the colonic microbiota. Although some small open-label studies with prebiotics in CD already showed promising results, we aimed to study the effect of oligofructose enriched inulin (OF-IN) on the microbiota composition in a double blind placebo-controlled trial.

Methods: We performed a single centre, randomized controlled trial in inactive and mild to moderately active CD patients to study the impact of a 4-week supplementation with OF-IN on the predominant microbiota using denaturing gradient gel electrophoresis (DGGE) and real time PCR. The disease activity was measured with the Harvey-Bradshaw index (HBI) and statistical analyses were performed with SPSS 17.0. In total 67 patients were randomized, 34 to OF-IN treatment, 33 to placebo.

Results: In patients receiving OF-IN, the median number of B. longum increased from 8.3 to 8.7 log10/g (ITT: p = 0.03) and the median number of R. gnavus decreased after treatment from 8.8 to 8.1 log10/g (PP: p = 0.03). Furthermore a positive correlation between improvement in disease-activity and increase in number of B. longum was found in patients with active disease receiving OF-IN (p = 0.02). (Figure 1) In patients randomized to placebo, no significant changes in microbiota composition or clinical activity were found after 4-weeks intervention.

Figure 1. Correlation between reduction in HBI and increase in number of B. longum in active CD patients (n = 5) receiving OF-IN.

Conclusion: In this first double-blind randomized controlled trial with OF-IN in inactive and mild to moderately active CD patients we demonstrated that OF-IN intake increased the number of B. longum and decreased the number of R. gnavus. The positive correlation between improvement in disease activity and increase of number of B. longum is encouraging for longer follow-up studies in CD patients with this prebiotic.