PT  - JOURNAL ARTICLE
AU  - Maria Chiara Ditto
AU  - Simone Parisi
AU  - Gianpiero Landolfi
AU  - Richard Borrelli
AU  - Cristina Realmuto
AU  - Annacarla Finucci
AU  - Gian Paolo Caviglia
AU  - Davide Giuseppe Ribaldone
AU  - Marco Astegiano
AU  - Anna Zanetti
AU  - Greta Carrara
AU  - Carlo Alberto Scirè
AU  - Marco Antivalle
AU  - Piercarlo Sarzi-Puttini
AU  - Enrico Fusaro
TI  - Intestinal microbiota changes induced by TNF-inhibitors in IBD-related spondyloarthritis
AID  - 10.1136/rmdopen-2021-001755
DP  - 2021 Sep 01
TA  - RMD Open
PG  - e001755
VI  - 7
IP  - 3
4099  - http://rmdopen.bmj.com/content/7/3/e001755.short
4100  - http://rmdopen.bmj.com/content/7/3/e001755.full
SO  - RMD Open2021 Sep 01; 7
AB  - Background The close relationship between joints and gut inflammation has long been known and several data suggest that dysbiosis could link spondyloarthritis (SpA) to inflammatory bowel diseases (IBD). The introduction of biological drugs, in particular tumour necrosis factor inhibitors (TNFi), revolutionised the management of both these diseases. While the impact of conventional drugs on gut microbiota is well known, poor data are available about TNFi.Aim To investigate the impact of TNFi on gut microbiota.Methods We evaluated 20 patients affected by enteropathic arthritis, naïve for biological drugs, treated with TNFi at baseline and after 6 months of therapy. All patients followed a Mediterranean diet. Patients performed self-sampling of a faecal sample at baseline and after 6 months of therapy. NGS-based ITS and 16S rRNA gene sequencing was performed, followed by the taxonomic bioinformatics analysis.Results After 6 months of therapy, we detected a remarkable increase in Lachnospiraceae family (Δ +10.3, p=0.04) and Coprococcus genus (Δ +2.8, p=0.003). We also noted a decreasing trend in Proteobacteria (Δ −8.0, p=0.095) and Gammaproteobacteria (Δ −9, p=0.093) and an increasing trend in Clostridia (Δ +8.2, p=0.083). We did not find differences between TNFi responders (SpA improvement or IBD remission achieved) and non-responders in terms of alpha and beta diversity.Conclusions Our findings are consistent with the hypothesis that TNFi therapy tends to restore the intestinal eubiosis.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. The study dataset is available upon reasonable request and is archived by the corresponding author. The protocol deposited with the Ethics Committee is also available.