TY - JOUR T1 - Intestinal microbiota changes induced by TNF-inhibitors in IBD-related spondyloarthritis JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2021-001755 VL - 7 IS - 3 SP - e001755 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 Y1 - 2021/09/01 UR - http://rmdopen.bmj.com/content/7/3/e001755.abstract N2 - 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. ER -