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The follow-on open-label extension published by Steven Grinspoon and colleagues in 2010 and 2012 confirmed that the VAT reduction was maintained through 52 weeks of continuous dosing and that patients who switched from placebo to active compound at week 26 caught up to the original treatment arm by week 52

Both studies showed that the combined therapy had a synergistic impact, significantly reducing hepatic inflammatory markers such as leptin, TNF- , and IL-1, more than either intervention alone

10.1016/j.biochi.2011.09.008 Falentin H, Deutsch SM, Jan G, Loux V, Thierry A, Parayre S, Maillard MB, Dherbcourt J, Cousin FJ, Jardin J: The complete genome of Propionibacterium freudenreichii CIRM-BIA1T, a hardy actinobacterium with food and probiotic applications