Observational studyRheumatology international2024
The failure of biological treatment in axial spondyloarthritis is linked to the factors related to increased intestinal permeability and dysbiosis: prospective observational cohort study.
Observational study in Rheumatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Mechanisms and clinical evidence of dietary patterns in axial spondyloarthritis.Rheumatology international · 2026Review
- Gut-bone axis in rheumatoid arthritis: microbiota-driven barrier dysfunction, immune crosstalk, and therapeutic strategies.Antonie van Leeuwenhoek · 2026Review
- Clinical Characteristics and a New Classification System of Mono-Segmental Thoracic and Lumbar Nonfusion in Patients With Ankylosing Spondylitis.Orthopaedic surgery · 2026Article
- Article
- Limosilactobacillus reuteri prevents progression of ankylosing spondylitis in mice by restoring gut microbiota-metabolism homeostasis.Journal of translational medicine · 2025Article
- Beyond Monotherapy: Exploring the Efficacy and Safety of Dual Biologic Strategies in Rheumatic Diseases.Biologics : targets & therapy · 2025Review
- Gut microbiota and ankylosing spondylitis: current insights and future challenges.Microbial cell (Graz, Austria) · 2025Review
- Precision medicine in axial spondyloarthritis: current opportunities and future perspectives.Therapeutic advances in musculoskeletal disease · 2024Review
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundA significant number of patients with axial spondyloarthritis (axSpA) do not respond to biological therapy. Therefore, we decided to investigate the specificity of this group of patients and, in particular, whether haptoglobin (Hp), its polymorphism and zonulin, in addition to other clinical features, are predictors of poor response to biological treatment.
methods48 patients with axSpA who were unsuccessfully treated with standard drugs were converted to biological treatment, and from this time on, a 12-week follow-up was started to assess the failure of biological treatment (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) decrease < 2 points). Predictors of treatment failure were identified using logistic regression analysis.
results21% of subjects had biological treatment failure. Patients who had a higher zonulin level, a history of frequent infections, were older, had inflammatory bowel disease (IBD), had a lower Hp level at the time of inclusion in biological therapy showed an increased risk of treatment failure.
conclusionsThe results of the study support the hypothesis that the effectiveness of biological treatment of axSpA is limited by changed microbiota and intestinal epithelial barrier dysfunction, as an increased risk of biological treatment failure was observed in patients who were older, had higher zonulin level, IBD and repeated courses of antibiotics due to frequent infections. Therefore, starting biological treatment should be followed by reducing intestinal permeability and regulating the disturbed gut microbiome.
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