Adalimumab therapy restores the gut microbiome in patients with ankylosing spondylitis (AS), according to study results published in Frontiers in Immunology.

Researchers observed gut microbiome alterations among patients with AS receiving adalimumab therapy, and studied the microbiome biomarkers that predict treatment response.

The gut microbial features of 30 patients with AS (mean age, 31.23±7.48 years) were evaluated before and after 6 months of treatment with adalimumab and compared with those of 24 healthy control participants.

Continue Reading

Six months after treatment, the clinical symptoms and signs of the AS were significantly improved and the microbiome was restored. Overall, the AS of 22 patients responded to therapy. Before treatment, measures of gut microbiome α- and β-diversity among patients with AS were lower compared with that of the healthy control participants (P <.01 and P <.001, respectively). However, there were no significant differences after treatment.

Gut microbial community structure between adalimumab responders and nonresponders showed no statistically significant differences; however, nonresponders had a higher abundance of the Comamonas species.

The study was limited in that patients who received treatment with other tumor necrosis factor inhibitors or nonsteroidal anti-inflammatory drugs were not enrolled; information on dietary patterns was not collected, and the power of the statistical analysis was limited by the small sample size. 

According to the researchers, “Our investigation suggests that the gut microbiota may be a potential tool for predicting the treatment response to adalimumab in patients [with AS].”


Chen Z, Zheng X, Wu X, et al. Adalimumab therapy restores the gut microbiota in patients with ankylosing spondylitis. Front Immunol. Published online September 1, 2021. doi:10.3389/fimmu.2021.700570