PRO-RRMS

Treatment tested

• Probiotic dietary supplement

Placebo or sham

• Standard medical treatment

Other measures (1)

Inclusion Criteria: * Clinically definite MS patients with a diagnosis of relapsing remitting multiple sclerosis according to revised McDonald criteria 2017. * EDSS score of ≤ 4 Exclusion Criteria: * Progressive MS either; primary progressive MS or secondary progressive MS * Patients who had relapses and glucocorticoid therapy within the past 30 days. * Pregnancy and women who were lactating within the prior six month * Patients taking antibiotics * History of gastroenteritis and bowel surgery over the past month, inflammatory bowel disease * Presence of diabetes (type I \& type II) or diseases causing significant nutritional status impairment (malignancy, chronic infections) * Patients who have changed their disease modifying drugs in the past 6 months prior to study * Impaired cognition that limited ability to complete the questionnaires. Addiction to drugs or alcohol.

This study aimed to assess the effect of probiotic supplementation on fatigue, quality of life, disability, depression and inflammatory markers in patients with relapsing-remitting multiple sclerosis (RRMS). Patients were randomized to receive probiotics plus standard therapy The study sought to determine whether modulation of gut microbiota could provide additional clinical and immunological benefits in RRMS management.