Reduced Serological Response to COVID-19 Vaccines in Patients with IBD is Further Diminished by TNF Inhibitor Therapy; Early Results of the VARIATION study [VAriability in Response in IBD Against SARS-COV-2 ImmunisatiON]

被引：12

作者：

Doherty, Jayne ^{[1
,2
,10
]}

Morain, Neil O. ^{[1
,2
]}

Stack, Roisin ^{[1
,2
]}

Girod, Parker ^{[1
]}

Tosetto, Miriam ^{[2
]}

Inzitiari, Rosanna ^{[2
]}

Sheridan, Juliette ^{[1
,2
,3
]}

Cullen, Garret ^{[1
,2
,3
,10
]}

Mc Dermott, Edel ^{[1
,3
]}

Buckley, Maire ^{[1
,3
,4
]}

Horgan, Gareth ^{[1
,3
,5
]}

Mulcahy, Hugh ^{[1
,2
,3
]}

Ryan, Elizabeth J. ^{[6
]}

Daghfal, David ^{[7
]}

Doran, Peter ^{[2
]}

Morain, Colm O. ^{[8
,9
,10
]}

Doherty, Glen A. ^{[1
,2
,3
,10
]}

机构：

[1] St Vincents Univ Hosp, Ctr Colorectal Dis, Elm Pk, Dublin 4, Ireland

[2] Univ Coll Dublin, Sch Med, Dept Gastroenterol, Dublin, Ireland

[3] St Vincents Private Hosp, Dept Gastroenterol, Dublin, Ireland

[4] St Michaels Hosp, Dept Gastroenterol, Dun Laoghaire, Co Dublin, Ireland

[5] St Columcilles Hosp, Dept Gastroenterol, Loughlinstown, Co Dublin, Ireland

[6] Univ Limerick, Hlth Res Inst, Dept Biol Sci, Limerick, Ireland

[7] Abbott Labs, Abbott Diagnost, Diagnost Div, Lake Forest, IL 60045 USA

[8] Beacon Hosp, Dept Gastroenterol, Sandyford, Co Dublin, Ireland

[9] Trinity Coll Dublin, Dublin, Ireland

[10] INITIat IBD Res Network, Res Div, Dublin, Ireland

来源：

JOURNAL OF CROHNS & COLITIS | 2022年 / 16卷 / 09期

关键词：

Inflammatory bowel disease; COVID-19; vaccination; anti-tumour necrosis factor antagonists; INFLAMMATORY-BOWEL-DISEASE; VACCINATION; IMMUNE; MATURATION; DEFICIENT; ALPHA;

D O I：

10.1093/ecco-jcc/jjac029

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims Evidence suggests patients with inflammatory bowel disease [IBD] receiving TNF antagonists have attenuated response to vaccination against COVID-19. We sought to determine the impact of IBD and of various medications for treatment of IBD on antibody responses to vaccination against COVID-19. Methods Patients with IBD [n = 270] and healthy controls [HC, n = 116] were recruited prospectively, and quantitative antibody responses were assessed following COVID-19 vaccination. The impact of IBD and of medications for treatment of IBD on vaccine response rates was investigated. Results Of HC, 100% seroconverted following complete vaccination with two vaccine doses; 2% of patients with IBD failed to seroconvert. Median anti-spike protein [SP] immunoglobulin [Ig]G levels following complete vaccination in our IBD cohort was significantly lower than among HC [2613 AU/mL versus 6871 AU/mL, p <= 0.001]. A diagnosis of IBD was independently associated with lower anti-SP IgG levels [beta coefficient -0.2, p = 0.001]. Use of mRNA vaccines was independently associated with higher anti-SP IgG levels [beta coefficient 0.25, p <= 0.001]. Patients with IBD receiving TNF inhibitors had significantly lower anti-SP IgG levels [2445 AU/mL] than IBD patients not receiving TNF inhibitors [3868 AU/mL, p <= 0.001]. Patients with IBD not receiving TNF inhibitors still showed attenuated responses compared with HC [3868 AU/mL versus 8747 AU/mL, p = 0.001]. Conclusions Patients with IBD have attenuated serological responses to SARS-CoV-2 vaccination. Use of anti-TNF therapy negatively affects anti-SP IgG levels further. Patients who do not seroconvert following vaccination are a particularly vulnerable cohort. Impaired responses to vaccination in our study highlight the importance of booster vaccination programmes for patients with IBD.

引用

页码：1354 / 1362

页数：9

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