“OA, a progressive joint degeneration, significantly impairs people's ability to perform everyday tasks. Currently, there are no treatment options to cure OA,” explain study authors Karim et al., who sought to explore the potential of probiotics to improve functional performance in OA patients.

Using computer-based randomization, the authors assigned 115 OA patients randomly into placebo (n = 55) and probiotics (n = 60) groups. The probiotics group received Vivomix 112 billion, one capsule daily, to assess probiotic efficacy within a 16-week timeframe. The study analysis included measurements of pain intensity with a visual analog scale, the Oxford knee score (OKS), the knee flexion range of movement (ROM), short physical performance battery (SPPB), gait speed, handgrip strength (HGS), and zonulin as a marker of intestinal permeability, along with c-reactive protein (CRP) level to indicate inflammation and 8-isoprostane level to suggest oxidative stress. Measurements were performed at baseline and after 16 weeks.

A total of 95 patients in the placebo (n = 49) and probiotics (n = 46) groups were finally analyzed. According to the authors, probiotics significantly reduced plasma zonulin levels and pain intensity during walking, along with CRP levels. Further, notable improvements were achieved in the OKS score, ROM, gait speed, HGS, and SPPB score compared to baseline in the probiotics group. Correlation analysis demonstrated a robust association of the percent change in plasma zonulin with OKS score, SPPB total, and HGS.

“Multistrain probiotics enhances functional ability in OA patients; changes in zonulin suggest a possible link to intestinal permeability, though causality remains to be established,” conclude the authors.

Reference

1. Karim A, Khan HA, Ahmad F, Qaisar R. Probiotics improve functional performance in patients with osteoarthritis: a randomized placebo-controlled clinical trial. Eur J Nutr. 2025;64(7):290.

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