Trajectory analyses to identify persistently low responders to COVID-19 vaccination in patients with inflammatory bowel disease: a prospective multicentre controlled study, J-COMBAT.

Humans COVID-19 / prevention & control COVID-19 Vaccines / administration & dosage Inflammatory Bowel Diseases / drug therapy Prospective Studies Vaccination
COVID-19 Inflammatory bowel disease Responder Trajectory analyses Vaccine

Journal

Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794

Informations de publication

Date de publication:
10 2023
Historique:
received: 18 05 2023
accepted: 18 07 2023
medline: 27 9 2023
pubmed: 10 8 2023
entrez: 10 8 2023
Statut: ppublish

Résumé

The degree of immune response to COVID-19 vaccination in inflammatory bowel disease (IBD) patients based on actual changes in anti-SARS-CoV-2 antibody titres over time is unknown. Data were prospectively acquired at four predetermined time points before and after two vaccine doses in a multicentre observational controlled study. The primary outcome was humoral immune response and vaccination safety in IBD patients. We performed trajectory analysis to identify the degree of immune response and associated factors in IBD patients compared with controls. Overall, 645 IBD patients and 199 control participants were analysed. At 3 months after the second vaccination, the seronegative proportions were 20.3% (combination of anti-tumour necrosis factor [TNF]α and thiopurine) and 70.0% (triple combination including steroids), despite that 80.0% receiving the triple combination therapy were seropositive at 4 weeks after the second vaccination. Trajectory analyses indicated three degrees of change in immune response over time in IBD patients: high (57.7%), medium (35.6%), and persistently low (6.7%). In the control group, there was only one degree, which corresponded with IBD high responders. Older age, combined anti-TNFα and thiopurine (odds ratio [OR], 37.68; 95% confidence interval [CI], 5.64-251.54), steroids (OR, 21.47; 95%CI, 5.47-84.26), and tofacitinib (OR, 10.66; 95%CI, 1.49-76.31) were factors associated with persistently low response. Allergy history (OR, 0.17; 95%CI, 0.04-0.68) was a negatively associated factor. Adverse reactions after the second vaccination were significantly fewer in IBD than controls (31.0% vs 59.8%; p < 0.001). Most IBD patients showed a sufficient immune response to COVID-19 vaccination regardless of clinical factors. Assessment of changes over time is essential to optimize COVID-19 vaccination, especially in persistently low responders.

Sections du résumé

BACKGROUND
The degree of immune response to COVID-19 vaccination in inflammatory bowel disease (IBD) patients based on actual changes in anti-SARS-CoV-2 antibody titres over time is unknown.
METHODS
Data were prospectively acquired at four predetermined time points before and after two vaccine doses in a multicentre observational controlled study. The primary outcome was humoral immune response and vaccination safety in IBD patients. We performed trajectory analysis to identify the degree of immune response and associated factors in IBD patients compared with controls.
RESULTS
Overall, 645 IBD patients and 199 control participants were analysed. At 3 months after the second vaccination, the seronegative proportions were 20.3% (combination of anti-tumour necrosis factor [TNF]α and thiopurine) and 70.0% (triple combination including steroids), despite that 80.0% receiving the triple combination therapy were seropositive at 4 weeks after the second vaccination. Trajectory analyses indicated three degrees of change in immune response over time in IBD patients: high (57.7%), medium (35.6%), and persistently low (6.7%). In the control group, there was only one degree, which corresponded with IBD high responders. Older age, combined anti-TNFα and thiopurine (odds ratio [OR], 37.68; 95% confidence interval [CI], 5.64-251.54), steroids (OR, 21.47; 95%CI, 5.47-84.26), and tofacitinib (OR, 10.66; 95%CI, 1.49-76.31) were factors associated with persistently low response. Allergy history (OR, 0.17; 95%CI, 0.04-0.68) was a negatively associated factor. Adverse reactions after the second vaccination were significantly fewer in IBD than controls (31.0% vs 59.8%; p < 0.001).
CONCLUSIONS
Most IBD patients showed a sufficient immune response to COVID-19 vaccination regardless of clinical factors. Assessment of changes over time is essential to optimize COVID-19 vaccination, especially in persistently low responders.

Identifiants

DOI: 10.1007/s00535-023-02029-z PMID: 37561155
pubmed: 37561155
doi: 10.1007/s00535-023-02029-z
pii: 10.1007/s00535-023-02029-z
doi:

Substances chimiques

COVID-19 Vaccines 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1015-1029

Subventions

Organisme : NCEZID CDC HHS
ID : 20HA2001
Pays : United States
Organisme : NCEZID CDC HHS
ID : 20HA2001
Pays : United States

Informations de copyright

© 2023. Japanese Society of Gastroenterology.

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Auteurs

Kenji Watanabe (K)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, Japan. kenjiw@med.u-toyama.ac.jp.
Department of Internal Medicine for Inflammatory Bowel Disease, University of Toyama, 2630, Sugitani, Toyama, 930-0194, Japan. kenjiw@med.u-toyama.ac.jp.
ORCID: 0000-0002-3781-4724

Masanori Nojima (M)

Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, Japan.
ORCID: 0000-0002-8788-2522

Hiroshi Nakase (H)

Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, Japan.
ORCID: 0000-0003-2848-6586

Toshiyuki Sato (T)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, Japan.
ORCID: 0000-0001-8307-2445

Minoru Matsuura (M)

Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Shinkawa 6-20-2, Mitaka-shi, Mitaka, Tokyo, Japan.
ORCID: 0000-0001-9590-2370

Nobuo Aoyama (N)

Aoyama Clinic, 3-3-9, Tamondouri, Kobe, Japan.
ORCID: 0000-0001-6677-9641

Taku Kobayashi (T)

Center for Advanced IBD Research and Treatment, Department of Gastroenterology, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo, Japan.
ORCID: 0000-0002-2073-4234

Hirotake Sakuraba (H)

Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, Japan.
ORCID: 0000-0002-6075-1282

Masakazu Nishishita (M)

Nishishita Gastrointestinal Hospital, 4-15, Kitakawahori-cho, Tennoji-ku, Osaka, Japan.

Kaoru Yokoyama (K)

Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, Japan.
ORCID: 0000-0003-4084-3654

Motohiro Esaki (M)

Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, 1-1,5-Chome, Nabeshima, Saga, Japan.
ORCID: 0000-0002-1195-0074

Fumihito Hirai (F)

Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Japan.
ORCID: 0000-0002-5493-5675

Masakazu Nagahori (M)

Clinical Research Center, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima Bunkyo-ku, Tokyo, Japan.
ORCID: 0000-0002-5323-7058

Sohachi Nanjo (S)

Third Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, Japan.
ORCID: 0000-0002-5826-2893

Teppei Omori (T)

Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan.
ORCID: 0000-0002-9959-5168

Satoshi Tanida (S)

Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
ORCID: 0000-0003-0068-1283

Yoshihiro Yokoyama (Y)

Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, Japan.
ORCID: 0000-0003-2434-1048

Kei Moriya (K)

Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.
ORCID: 0000-0002-7500-6728

Atsuo Maemoto (A)

IBD Center, Sapporo Higashi Tokushukai Hospital, 3-1, Kita 33-Jo Higashi 14-Chome, Higashi-ku, Sapporo, Japan.
ORCID: 0000-0002-9182-8502

Osamu Handa (O)

Department of Internal Medicine, Division of Gastroenterology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, Japan.
ORCID: 0000-0003-2228-0405

Naoki Ohmiya (N)

Department of Advanced Endoscopy, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake City, Aichi, Japan.
ORCID: 0000-0002-7651-402X

Kiichiro Tsuchiya (K)

Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, Japan.
ORCID: 0000-0002-1977-8707

Shinichiro Shinzaki (S)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, Japan.
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.

Shingo Kato (S)

Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, Japan.
ORCID: 0000-0002-9030-0474

Toshio Uraoka (T)

Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, Japan.
ORCID: 0000-0002-4425-4331

Hiroki Tanaka (H)

Sapporo IBD Clinic, 1-18, Minami-19, Nishi-8, Chuo-ku, Sapporo, Hokkaido, Japan.
ORCID: 0000-0002-6310-4697

Noritaka Takatsu (N)

Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Fukuoka, Japan.
ORCID: 0000-0002-1967-5169

Atsushi Nishida (A)

Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan.
ORCID: 0000-0002-1288-3272

Junji Umeno (J)

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan.
ORCID: 0000-0002-5253-5600

Masanao Nakamura (M)

Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan.
ORCID: 0000-0002-5444-143X

Yoshiyuki Mishima (Y)

Department of Internal Medicine II, Faculty of Medicine, Shimane University, 1060 Nishikawatsu-cho, Matsue,, Shimane, Japan.
ORCID: 0000-0001-5261-6411

Mikihiro Fujiya (M)

Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, Hokkaido, Japan.
ORCID: 0000-0002-4321-7774

Kenji Tsuchida (K)

Gastroenterology, Nagoya City University West Medical Center, 1-1-1, Hirate-cho, Kita-ku, Nagoya, Aichi, Japan.

Sakiko Hiraoka (S)

Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
ORCID: 0000-0002-9796-6930

Makoto Okabe (M)

Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan.
ORCID: 0000-0002-1181-497X

Takahiko Toyonaga (T)

Division of Internal Medicine, Department of Gastroenterology and Hepatology, The Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, Japan.
ORCID: 0000-0003-4027-2708

Katsuyoshi Matsuoka (K)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, 564-1, Shimoshidu, Sakura, Chiba, Japan.
ORCID: 0000-0002-2950-7660

Akira Andoh (A)

Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan.
ORCID: 0000-0001-8533-2669

Yoshio Hirota (Y)

Clinical Epidemiology Research Center, SOUSEIKAI Medical Group (Medical Co. LTA), 3-6-1, Kashii-Teriha, Higashi-ku, Fukuoka, Japan.
ORCID: 0000-0001-5406-3240

Tadakazu Hisamatsu (T)

Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Shinkawa 6-20-2, Mitaka-shi, Mitaka, Tokyo, Japan.
ORCID: 0000-0002-1178-3536

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Trajectory analyses to identify persistently...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Trajectory analyses to identify persistently...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Vaccins › Vaccins antiviraux › Vaccins contre la COVID-19 › Trajectory analyses to identify persistently...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies inflammatoires intestinales › Trajectory analyses to identify persistently...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Trajectory analyses to identify persistently...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pratiques en santé publique › Prévention primaire › Immunisation › Vaccination › Trajectory analyses to identify persistently...