Oral intake of Streptococcus thermophilus improves knee osteoarthritis degeneration: A randomized, double-blind, placebo-controlled clinical study

Lyu JL, Wang TM, Chen YH, Chang ST, Wu MS, Lin YH, Lin YH, Kuan CM · Heliyon

Both arms moved, and the paper never compares them. Serum CTX-II, a type II collagen breakdown marker, fell 41.6% on the probiotic and 28.6% on placebo; CRP fell 39.6% on the probiotic and 43.3% on placebo, so on that marker placebo finished ahead. Every p value reported is a group against its own baseline, and the share of participants improving is the same in both arms — 54% against 53% for CTX-II at twelve weeks. The results section describes the WOMAC scores as showing no obvious difference in the probiotic group while pain and function improved in the placebo group after week 8; the abstract says the questionnaire shows the probiotic might retard progression. The authors call the improvement indistinct against placebo and attribute that to the uneven Kellgren-Lawrence distribution, the short period and the small sample.

Population

80 adults with knee osteoarthritis randomised, 67 analysed, over 12 weeks

Intervention

TCI633, a Streptococcus thermophilus strain isolated from human breast milk that produces hyaluronate in the gut

Comparator

Placebo

Limitations

Preliminary by its own description, and no between-group test is reported anywhere in it. 80 randomised and 67 analysed, with drop-out of 23.1% on placebo against 9.8% on the probiotic. Two-thirds of the placebo group sat at Kellgren-Lawrence grade 1, which the authors say made a fair comparison difficult. Twelve weeks is short for a radiographic grade to move, and the K/L shift the paper reports is a within-group count carrying no test. Six of the eight authors work for the company that owns the strain and a seventh for its sister company; the paper declares no conflict of interest and no funding.