A recent systematic review examined how biologic therapies affect #gut #microbiota in patients with autoimmune and immune-mediated #arthritis (such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis), and whether specific microbial changes could serve as #biomarkersnt response and disease activity.
◦ Main Results:
- Number of studies included: 12 studies.
- Biologic agents studied: Primarily anti-TNF inhibitors and IL-17 inhibitors.
◦ Effects on gut microbiota:
- Biologics significantly altered gut microbiota composition and diversity.
- Most studies reported increased alpha diversity (richness and evenness within samples) and normalization of beta diversity (differences between samples/communities) after treatment.
- These changes were not entirely consistent across all studies.
◦ Specific microbial shifts:
- Restoration of beneficial taxa: Increased levels of short-chain fatty acid (SCFA)-producing bacteria, including:
• Faecalibacterium prausnitzii
• Megamonas
• Lachnoclostridium
• Blautia
- Reduction in pro-inflammatory taxa: Decreased levels of genera such as Escherichia-Shigella and Klebsiella.
◦ Biomarker potential:
- Certain taxa, particularly Lachnospiraceae and Megamonas, showed correlations with clinical improvement and reduced disease activity.
- Specific microbial signatures (e.g., increases in Lachnospiraceae, Blautia, and Faecalibacterium prausnitzii) appear promising as noninvasive biomarkers for predicting treatment response and monitoring disease activity.
This study highlights that biologic therapies (especially anti-TNF and IL-17 inhibitors) promote a shift from dysbiosis toward eubiosis (a healthier gut microbial balance) in patients with autoimmune arthritis. The gut microbiota is modulated by these treatments, likely through both direct and indirect mechanisms via immune homeostasis restoration. Microbial taxa such as Lachnospiraceae, Blautia, and Faecalibacterium prausnitzii have strong potential as biomarkers. The findings support the need for further longitudinal and interventional studies to validate these microbial signatures for clinical use.
📊 Relationship between microbiota and autoimmune/immunemediated arthritis, and the bidirectional interaction between biologics and microbiota.
*Rondla M, Zaazouee MS, Perumangote Vasudevan AA, Mathialagan K, Katamreddy R. Gut microbiota as a biomarker and target in biologic therapy for autoimmune and immune-mediated arthritis: a systematic review. J Rheumatol. Published online February 15, 2026.
doi.org/10.3899/jrheum…KA
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