TY - JOUR
T1 - Impact of gluten intake on clinical outcomes in patients with chronic inflammatory diseases initiating biologics
T2 - Secondary analysis of the prospective multicentre BELIEVE cohort study
AU - Gregersen, Laura
AU - Jessen, Pernille Dyhre
AU - Lund, Helene Wiencke
AU - Overgaard, Silja Hvid
AU - Hikmat, Zainab
AU - Ellingsen, Torkell
AU - Kjeldsen, Jens
AU - Pedersen, Andreas Kristian
AU - Petersen, Sofie Ronja
AU - Jawhara, Mohamad
AU - Nexøe, Anders Bathum
AU - Bygum, Anette
AU - Hvas, Christian Lodberg
AU - Dahlerup, Jens Frederik
AU - Bergenheim, Frederik Olof
AU - Glerup, Henning
AU - Henriksen, Rikke Holm
AU - Guldmann, Tanja
AU - Hvid, Lone
AU - Brodersen, Jacob
AU - Munk, Heidi Lausten
AU - Pedersen, Natalia
AU - Saboori, Sanaz
AU - Nielsen, Ole Haagen
AU - Heitmann, Berit Lillenthal
AU - Haldorsson, Thorhallur Ingi
AU - Christensen, Robin
AU - Andersen, Vibeke
N1 - © 2024 The Author(s). Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology.
PY - 2024/12
Y1 - 2024/12
N2 - Chronic inflammatory diseases (CIDs) pose a growing healthcare challenge, with a substantial proportion of patients showing inadequate response to biological treatment. There is renewed interest in dietary changes to optimize treatment regimens, with a growing body of evidence suggesting beneficial effects with adherence to a gluten-free diet. This study compared the likelihood of achieving clinical response to biological treatment after 14-16 weeks in patients with CID with high versus low-to-medium gluten intake. Secondary outcomes of interest included changes in disease activity, health-related quality of life and C-reactive protein. The study was a multicentre prospective cohort of 193 participants with a CID diagnosis (i.e. Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis, Axial Spondyloarthritis, Psoriatic Arthritis or Psoriasis) who initiated biological treatment between 2017 and 2020. Participants were stratified based on their habitual gluten intake: the upper 33.3% (high gluten intake) and the remaining 66.6% (low-to-medium gluten intake). The proportion of patients achieving clinical response to biological treatment after 14-16 weeks was compared using logistic regression models. The median gluten intake differed significantly between groups (12.5 g/day vs. 5.9 g/day, standardized mean difference = 1.399). In total, 108 (56%) achieved clinical response to treatment, with no difference between 35 (55%) in the high gluten group and 73 (57%) in the medium-to-low gluten group (OR = 0.96 [0.51-1.79], p = 0.897). No differences were found with secondary outcomes. In conclusion, this study found no association between gluten intake and response to biological treatment in patients with CID.
AB - Chronic inflammatory diseases (CIDs) pose a growing healthcare challenge, with a substantial proportion of patients showing inadequate response to biological treatment. There is renewed interest in dietary changes to optimize treatment regimens, with a growing body of evidence suggesting beneficial effects with adherence to a gluten-free diet. This study compared the likelihood of achieving clinical response to biological treatment after 14-16 weeks in patients with CID with high versus low-to-medium gluten intake. Secondary outcomes of interest included changes in disease activity, health-related quality of life and C-reactive protein. The study was a multicentre prospective cohort of 193 participants with a CID diagnosis (i.e. Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis, Axial Spondyloarthritis, Psoriatic Arthritis or Psoriasis) who initiated biological treatment between 2017 and 2020. Participants were stratified based on their habitual gluten intake: the upper 33.3% (high gluten intake) and the remaining 66.6% (low-to-medium gluten intake). The proportion of patients achieving clinical response to biological treatment after 14-16 weeks was compared using logistic regression models. The median gluten intake differed significantly between groups (12.5 g/day vs. 5.9 g/day, standardized mean difference = 1.399). In total, 108 (56%) achieved clinical response to treatment, with no difference between 35 (55%) in the high gluten group and 73 (57%) in the medium-to-low gluten group (OR = 0.96 [0.51-1.79], p = 0.897). No differences were found with secondary outcomes. In conclusion, this study found no association between gluten intake and response to biological treatment in patients with CID.
KW - biological treatment
KW - chronic inflammatory disease
KW - gluten
KW - Prospective Studies
KW - Humans
KW - Middle Aged
KW - Psoriasis/drug therapy
KW - Arthritis, Rheumatoid/drug therapy
KW - Glutens/administration & dosage
KW - Male
KW - Treatment Outcome
KW - Inflammation
KW - Biological Products/therapeutic use
KW - Crohn Disease/drug therapy
KW - Colitis, Ulcerative/drug therapy
KW - Quality of Life
KW - Adult
KW - Female
KW - Aged
KW - Chronic Disease
KW - Diet, Gluten-Free
UR - http://www.scopus.com/inward/record.url?scp=85205538544&partnerID=8YFLogxK
U2 - 10.1111/sji.13409
DO - 10.1111/sji.13409
M3 - Journal article
C2 - 39358910
SN - 0300-9475
VL - 100
JO - Scandinavian Journal of Immunology
JF - Scandinavian Journal of Immunology
IS - 6
M1 - e13409
ER -