A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents
Introduction: Psoriatic arthritis (PsA) is a complex condition within the Spondyloarthritis (SpA) group. Recent studies have focused on the important role of the intestinal microbiota in maintaining immunological homeostasis, highlighting how intestinal dysbiosis may act as a trigger for autoimmune...
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2024-11-01
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| author | Andrea Picchianti Diamanti Concetta Panebianco Valeria Di Gioia Ilaria Anna Bellofatto Simonetta Salemi Roberta Di Rosa Giorgio Sesti Gabriele Nalli Gerardo Salerno Etta Finocchiaro Bruno Laganà |
| author_facet | Andrea Picchianti Diamanti Concetta Panebianco Valeria Di Gioia Ilaria Anna Bellofatto Simonetta Salemi Roberta Di Rosa Giorgio Sesti Gabriele Nalli Gerardo Salerno Etta Finocchiaro Bruno Laganà |
| author_sort | Andrea Picchianti Diamanti |
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| description | Introduction: Psoriatic arthritis (PsA) is a complex condition within the Spondyloarthritis (SpA) group. Recent studies have focused on the important role of the intestinal microbiota in maintaining immunological homeostasis, highlighting how intestinal dysbiosis may act as a trigger for autoimmune diseases. Tofacitinib is a Janus kinase inhibitor (JAK-i) with proven efficacy for the treatment of both rheumatoid arthritis and PsA. However, there is a lack of data on its ability to reduce joint remission through ultrasonography (US) and the effects it might have on the composition of the gut microbiota. Methods: Here, we present a case series of seven bio-naïve PsA patients who received tofacitinib treatment and were followed up for 12 months. The clinical response was assessed using validated scores (DAPSA, ASDAS, and BASDAI), laboratory tests, and US assessment of the target joint and enthesis. Finally, we evaluated changes in the composition of the intestinal microbiota using next-generation sequencing analysis of fecal samples. Results: The patients in the study showed a significant improvement in all clinical scores used; this improvement was also confirmed by a significant reduction in the US synovitis scores. The data on the microbiota analysis suggested that the effectiveness of tofacitinib in ameliorating PsA activity was associated with a relevant modification of some gut bacterial lineages. No cases of severe adverse effects were reported. Conclusions: Treatment with tofacitinib proved to be effective, safe and capable of varying the composition of the gut microbiota by selecting bacterial strains considered beneficial in immune modulation. |
| format | Article |
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| institution | DOAJ |
| issn | 2076-2607 |
| language | English |
| publishDate | 2024-11-01 |
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| series | Microorganisms |
| spelling | doaj-art-dcb8532def0342e39720550c2d9ba3a62025-08-20T02:57:02ZengMDPI AGMicroorganisms2076-26072024-11-011212238710.3390/microorganisms12122387A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic AgentsAndrea Picchianti Diamanti0Concetta Panebianco1Valeria Di Gioia2Ilaria Anna Bellofatto3Simonetta Salemi4Roberta Di Rosa5Giorgio Sesti6Gabriele Nalli7Gerardo Salerno8Etta Finocchiaro9Bruno Laganà10Department of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDivision of Gastroenterology, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyDietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, ItalyDepartment of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, ItalyIntroduction: Psoriatic arthritis (PsA) is a complex condition within the Spondyloarthritis (SpA) group. Recent studies have focused on the important role of the intestinal microbiota in maintaining immunological homeostasis, highlighting how intestinal dysbiosis may act as a trigger for autoimmune diseases. Tofacitinib is a Janus kinase inhibitor (JAK-i) with proven efficacy for the treatment of both rheumatoid arthritis and PsA. However, there is a lack of data on its ability to reduce joint remission through ultrasonography (US) and the effects it might have on the composition of the gut microbiota. Methods: Here, we present a case series of seven bio-naïve PsA patients who received tofacitinib treatment and were followed up for 12 months. The clinical response was assessed using validated scores (DAPSA, ASDAS, and BASDAI), laboratory tests, and US assessment of the target joint and enthesis. Finally, we evaluated changes in the composition of the intestinal microbiota using next-generation sequencing analysis of fecal samples. Results: The patients in the study showed a significant improvement in all clinical scores used; this improvement was also confirmed by a significant reduction in the US synovitis scores. The data on the microbiota analysis suggested that the effectiveness of tofacitinib in ameliorating PsA activity was associated with a relevant modification of some gut bacterial lineages. No cases of severe adverse effects were reported. Conclusions: Treatment with tofacitinib proved to be effective, safe and capable of varying the composition of the gut microbiota by selecting bacterial strains considered beneficial in immune modulation.https://www.mdpi.com/2076-2607/12/12/2387gut microbiotapsoriatic arthritismusculoskeletal ultrasonographyJAK inhibitorstofacitinib |
| spellingShingle | Andrea Picchianti Diamanti Concetta Panebianco Valeria Di Gioia Ilaria Anna Bellofatto Simonetta Salemi Roberta Di Rosa Giorgio Sesti Gabriele Nalli Gerardo Salerno Etta Finocchiaro Bruno Laganà A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents Microorganisms gut microbiota psoriatic arthritis musculoskeletal ultrasonography JAK inhibitors tofacitinib |
| title | A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents |
| title_full | A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents |
| title_fullStr | A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents |
| title_full_unstemmed | A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents |
| title_short | A Case Series Report on the Effect of Tofacitinib on Joint Inflammation and Gut Microbiota Composition in Psoriatic Arthritis Patients Naive to Biologic Agents |
| title_sort | case series report on the effect of tofacitinib on joint inflammation and gut microbiota composition in psoriatic arthritis patients naive to biologic agents |
| topic | gut microbiota psoriatic arthritis musculoskeletal ultrasonography JAK inhibitors tofacitinib |
| url | https://www.mdpi.com/2076-2607/12/12/2387 |
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