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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\u2010free diet. This study compared the likelihood of achieving clinical response to biological treatment after 14\u201316\u2009weeks in patients with CID with high versus low\u2010to\u2010medium gluten intake. Secondary outcomes of interest included changes in disease activity, health\u2010related quality of life and C\u2010reactive 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\u2010to\u2010medium gluten intake). The proportion of patients achieving clinical response to biological treatment after 14\u201316\u2009weeks was compared using logistic regression models. The median gluten intake differed significantly between groups (12.5\u2009g\/day vs. 5.9\u2009g\/day, standardized mean difference\u2009=\u20091.399). 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\u2010to\u2010low gluten group (OR\u2009=\u20090.96 [0.51\u20131.79], <jats:italic>p<\/jats:italic>\u2009=\u20090.897). 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.<\/jats:p>","DOI":"10.1111\/sji.13409","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T05:04:36Z","timestamp":1727931876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of gluten intake on clinical outcomes in patients with chronic inflammatory diseases initiating biologics: Secondary analysis of the prospective multicentre <scp>BELIEVE<\/scp> cohort study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4233-7026","authenticated-orcid":false,"given":"Laura","family":"Gregersen","sequence":"first","affiliation":[{"name":"Molecular Diagnostics and Clinical Research Unit University Hospital of Southern Denmark  Aabenraa Denmark"},{"name":"The Faculty of Health Sciences Institute of Regional Health 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