Anti-tumor necrosis factor therapy is associated with attenuated humoral response to SARS-COV-2 vaccines in patients with inflammatory bowel disease.
Anti-TNF-α
Booster
COVID-19 vaccines
Inflammatory bowel disease
Journal
Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899
Informations de publication
Date de publication:
13 06 2023
13 06 2023
Historique:
received:
30
11
2022
revised:
21
04
2023
accepted:
01
05
2023
medline:
14
6
2023
pubmed:
19
5
2023
entrez:
18
5
2023
Statut:
ppublish
Résumé
Immunosuppressive therapy used in the treatment of inflammatory bowel disease (IBD) is known to reduce vaccine immunogenicity. This study aimed to 1) predict the humoral response elicited by SARS-CoV-2 vaccination in IBD patients based on their ongoing treatment and other relevant patient and vaccine characteristics and 2) assess the humoral response to a booster dose of mRNA vaccine. We conducted a prospective study in adult IBD patients. Anti-spike (S) IgG antibodies were measured after initial vaccination and again after one booster dose. A multiple linear regression model was created to predict anti-S antibody titer following initial complete vaccination in different therapeutic groups (no immunosuppression, anti-TNF, immunomodulators and combination therapy). A two-tailed Wilcoxon test for two dependent groups was performed to compare anti-S values before and after the booster dose. Our study included 198 IBD patients. The multiple linear regression identified anti-TNF and combination therapy (versus no immunosuppression), current smoking, viral vector (versus mRNA) vaccine and interval between vaccination and anti-S measurement as statistically significant predictors of the log anti-S antibody levels (p < 0.001). No statistically significant differences were found between no immunosuppression and immunomodulators (p = 0.349) and between anti-TNF and combination therapy (p = 0.997). Statistically significant differences for anti-S antibody titer before and after the booster dose of mRNA SARS-CoV-2 vaccine were found, both for non-anti-TNF and anti-TNF groups. Anti-TNF treatment (either alone or in combination therapy) is associated with lower anti-S antibody levels. Booster mRNA doses seem to increase anti-S both in non-anti-TNF and anti-TNF treated patients. Special attention should be paid to this group of patients when planning vaccination schemes.
Sections du résumé
BACKGROUND
Immunosuppressive therapy used in the treatment of inflammatory bowel disease (IBD) is known to reduce vaccine immunogenicity.
AIMS
This study aimed to 1) predict the humoral response elicited by SARS-CoV-2 vaccination in IBD patients based on their ongoing treatment and other relevant patient and vaccine characteristics and 2) assess the humoral response to a booster dose of mRNA vaccine.
METHODS
We conducted a prospective study in adult IBD patients. Anti-spike (S) IgG antibodies were measured after initial vaccination and again after one booster dose. A multiple linear regression model was created to predict anti-S antibody titer following initial complete vaccination in different therapeutic groups (no immunosuppression, anti-TNF, immunomodulators and combination therapy). A two-tailed Wilcoxon test for two dependent groups was performed to compare anti-S values before and after the booster dose.
RESULTS
Our study included 198 IBD patients. The multiple linear regression identified anti-TNF and combination therapy (versus no immunosuppression), current smoking, viral vector (versus mRNA) vaccine and interval between vaccination and anti-S measurement as statistically significant predictors of the log anti-S antibody levels (p < 0.001). No statistically significant differences were found between no immunosuppression and immunomodulators (p = 0.349) and between anti-TNF and combination therapy (p = 0.997). Statistically significant differences for anti-S antibody titer before and after the booster dose of mRNA SARS-CoV-2 vaccine were found, both for non-anti-TNF and anti-TNF groups.
CONCLUSIONS
Anti-TNF treatment (either alone or in combination therapy) is associated with lower anti-S antibody levels. Booster mRNA doses seem to increase anti-S both in non-anti-TNF and anti-TNF treated patients. Special attention should be paid to this group of patients when planning vaccination schemes.
Identifiants
pubmed: 37202269
pii: S0264-410X(23)00530-3
doi: 10.1016/j.vaccine.2023.05.012
pmc: PMC10165058
pii:
doi:
Substances chimiques
Adjuvants, Immunologic
0
Antibodies, Viral
0
COVID-19 Vaccines
0
Immunoglobulin G
0
Tumor Necrosis Factor Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3862-3871Informations de copyright
Copyright © 2023. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Behav Res Methods. 2009 Nov;41(4):1149-60
pubmed: 19897823
Vaccines (Basel). 2022 Mar 14;10(3):
pubmed: 35335080
Lancet Gastroenterol Hepatol. 2022 Apr;7(4):342-352
pubmed: 35123676
J Crohns Colitis. 2022 Feb 23;16(2):251-258
pubmed: 34379729
Gut. 2021 May;70(5):865-875
pubmed: 33753421
Clin Gastroenterol Hepatol. 2022 Jun;20(6):e1493-e1499
pubmed: 34896283
Inflamm Bowel Dis. 2012 Jun;18(6):1042-7
pubmed: 21674732
J Clin Epidemiol. 1995 Dec;48(12):1503-10
pubmed: 8543964
Lancet. 2022 Jan 8;399(10320):152-160
pubmed: 34741818
Nat Med. 2021 Jul;27(7):1205-1211
pubmed: 34002089
Gastroenterology. 2022 Jan;162(1):316-319.e5
pubmed: 34529987
Inflamm Bowel Dis. 2022 Jul 1;28(7):1130-1133
pubmed: 35397000
Vaccines (Basel). 2022 Mar 15;10(3):
pubmed: 35335084
Nature. 2021 Sep;597(7876):318-324
pubmed: 34522017
Inflamm Bowel Dis. 2020 Mar 4;26(4):593-602
pubmed: 31504526
Int J Colorectal Dis. 2022 Nov;37(11):2277-2289
pubmed: 36271206
N Engl J Med. 2021 Apr 15;384(15):1412-1423
pubmed: 33626250
Nat Commun. 2022 Mar 16;13(1):1379
pubmed: 35296643
Aliment Pharmacol Ther. 2015 Nov;42(10):1200-10
pubmed: 26388424
Am J Gastroenterol. 2010 Jan;105(1):148-54
pubmed: 19755964
Clin Gastroenterol Hepatol. 2022 Jun;20(6):e1263-e1282
pubmed: 34954338
Lancet Gastroenterol Hepatol. 2022 Apr;7(4):280-282
pubmed: 35123675
Obesity (Silver Spring). 2022 Mar;30(3):606-613
pubmed: 34850576
Stat Med. 2019 Mar 30;38(7):1276-1296
pubmed: 30357870
Vaccines (Basel). 2020 Aug 14;8(3):
pubmed: 32824111
JCI Insight. 2022 Jun 22;7(12):
pubmed: 35730567
Lancet. 2021 May 1;397(10285):1646-1657
pubmed: 33901420
Aliment Pharmacol Ther. 2015 Jan;41(1):77-86
pubmed: 25348809
Lancet Gastroenterol Hepatol. 2022 Nov;7(11):1005-1015
pubmed: 36088954
Gastroenterology. 2021 Oct;161(4):1336-1339.e3
pubmed: 34144044
Am J Gastroenterol. 2022 Mar 1;117(3):462-469
pubmed: 35029167
Public Health. 2022 Feb;203:97-99
pubmed: 35038631
MedComm (2020). 2022 Aug 12;3(3):e166
pubmed: 35978853
J Crohns Colitis. 2022 Sep 8;16(9):1354-1362
pubmed: 35176770
Gastroenterology. 2022 Feb;162(2):454-467
pubmed: 34717923
Vaccines (Basel). 2022 Jul 30;10(8):
pubmed: 36016109
J Crohns Colitis. 2021 Jun 22;15(6):879-913
pubmed: 33730753
Inflamm Bowel Dis. 2022 Oct 3;28(10):1506-1512
pubmed: 34849919
Vaccine. 2021 Jul 22;39(32):4423-4428
pubmed: 34210573
Inflamm Bowel Dis. 2022 Aug 1;28(8):1265-1279
pubmed: 34718595
Vaccines (Basel). 2022 Feb 16;10(2):
pubmed: 35214761
Gut. 2021 Oct;70(10):1884-1893
pubmed: 33903149
Lancet. 2021 May 15;397(10287):1819-1829
pubmed: 33964222
Gut. 2022 Jul;71(7):1426-1439
pubmed: 35477864
N Engl J Med. 2021 Oct 7;385(15):1355-1371
pubmed: 34496194