Antibody response to the BNT162b2 SARS-CoV-2 vaccine in paediatric patients with inflammatory bowel disease treated with anti-TNF therapy

Shire, Zahra; Reicherz, Frederic; Lawrence, Sally; Sudan, Harjeev; Golding, Liam; Majdoubi, Abdelilah; Levett, Paul N.; Lavoie, Pascal; Jacobson, K

doi:10.1136/gutjnl-2021-326196

Cited by 11 publications

(8 citation statements)

References 6 publications

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“…In adult IBD patients, those on anti-TNFα have been reported to have lower antibody titers than those on non-anti-TNFα and healthy controls [ 10 , 11 , 13 ]. PIBD patients have also shown similar trends in short-term follow-ups [ 14 , 16 ]. In addition, several studies have reported that, in adult IBD patients on anti-TNFα, antibody titers decrease more rapidly after the second vaccination than in those on other IBD medications [ 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 91%

“…Many studies have demonstrated the humoral response to the BNT162b2 vaccine and its efficacy in adult IBD patients on immunosuppressive therapy, but in PIBD patients, only a few reports have studied the humoral response to the BNT162b2 vaccine [ 14 , 15 , 16 ]. The present study showed the efficacy of the BNT162b2 vaccine in PIBD patients by showing that all patients who completed two vaccine doses were seroconverted, even those treated with anti-TNFα.…”

Section: Discussionmentioning

confidence: 99%

“…However, in pediatric IBD (PIBD) patients, only a few studies have shown a reduction of the serological response against the BNT162b2 mRNA vaccine in those treated with biologic therapy, especially anti-TNFα [ 14 , 15 , 16 ]. In one study, antibody titers were significantly lower in PIBD patients on infliximab combination therapy than in healthy adults 28 days after the first vaccination [ 14 ]. However, antibody titers in PIBD patients were evaluated over a short follow-up period of 3 months after the second vaccination in that study.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Anti-TNFα Treatment on the Humoral Response to the BNT162b2 mRNA COVID-19 Vaccine in Pediatric Inflammatory Bowel Disease Patients

et al. 2022

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The efficacy of the COVID-19 mRNA vaccine, including the third vaccination in pediatric inflammatory bowel disease (PIBD) patients is not fully understood. This study aimed to evaluate the humoral immunogenicity of the BNT162b2 vaccine and the changes in durability until 20–28 weeks after the initial vaccine series in PIBD patients on immunosuppressive drugs. The safety of the initial vaccine series and the booster effect of the third vaccination were also evaluated. A single-center, prospective cohort study was conducted, and 63 participants (anti-TNFα: 11; non-anti-TNFα: 31; 5-ASA: 21), with a mean age of 15.2 (range 9.6–17.9) years, were enrolled. All PIBD patients were seroconverted, with no serious short-term AEs. PIBD patients on anti-TNFα had significantly lower antibody titers than those on other medications at all measurement points. Furthermore, antibody titers waned over time with anti-TNFα and were significantly lower at 20–28 weeks than at 3–9 weeks after a two-vaccine series. In all 10 patients (anti-TNFα: 5; non-anti-TNFα including 5-ASA: 5), the third vaccination led to antibody concentrations significantly higher than those at the same time point after the second vaccination. PIBD patients on anti-TNFα need to remain vigilant about COVID-19 even after two vaccinations, and a third vaccination may be considered.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Anti-TNFα Treatment on the Humoral Response to the BNT162b2 mRNA COVID-19 Vaccine in Pediatric Inflammatory Bowel Disease Patients

et al. 2022

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“…In our cohort, patients receiving combined therapy had significantly lower anti-RBD IgG titres than patients receiving cDMARDs, and yet non-statistically significantly lower those of than the patients receiving bDMARDs. In a recent study of paediatric patients with inflammatory bowel disease treated with anti-TNF therapy, the group of patients receiving infliximab, the group of patients receiving infliximab combined with MTX or AZA, and the healthy adult control group mounted similar humoral responses 3 months after the first dose of BNT162b2 mRNA vaccine [ 31 ]. In our cohort, although not reaching statistical significance, patients diagnosed with PFS had lower antibody responses compared with patients diagnosed with JIA.…”

Section: Discussionmentioning

confidence: 99%

Humoral response and safety of BNT162b2 mRNA vaccine in children with rheumatic diseases

et al. 2022

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Objectives The vaccine represents a cornerstone in tackling the COVID-19 pandemic and with the approval of the BNT162b2 mRNA vaccine in December 2020, it has become a beacon of hope for people around the world, including children. This study aimed to present the data on the humoral response and safety of vaccine in a cohort of patients with pediatric rheumatic diseases (PedRD) receiving immunomodulatory treatments. Methods Forty-one children with PedRD were included and were vaccinated with the BNT162b2 m-RNA vaccine (two doses of 30 µg administered three to four weeks apart). To assess the humoral response, IgG antibodies developed against the S1/Receptor-binding domain (RBD) of the SARS-CoV-2 spike protein at baseline and 3-4 weeks after the second dose were measured. The possible local and systemic side effects and disease activity scores were evaluated during the study period. Results After the second dose of vaccine, markedly elevated anti-RBD IgG titers were observed in all patients with a median titre of 20474 AU/ml (IQ range:6534–36151) with a good safety profile. The median disease duration was 4.3 (IQ: 3.5-5.6) years. In the cohort, 14 (34.1%) received cDMARDs, 16 (39%) received bDMARDs and 11 (26.8%) received a combined therapy (cDMARDs and bDMARDs). Patients treated with combined therapy (median 4695 [IQR:2764-26491]) had significantly lower median titers of anti-RBD IgG than those receiving only cDMARDs. Conclusion PedRD patients receiving immunomodulatory treatments were able to mount an effective humoral response after two dose regimens of BNT162b2 mRNA vaccine safely without interrupting their current treatments.

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“…They observed attenuated antibody responses to BNT162b2 in children on the treatment in combination with an immunomodulator, but in most patients antibody responses were still acceptable and comparable with adults. These findings highlighted the importance of booster doses to achieve complete protection in vulnerable patients, prompting future investigations to determine the duration of protection by the immune response [ 134 ]. Another similar group of especially vulnerable patients are adolescents with juvenile idiopathic arthritis treated with TNF inhibitors.…”

Section: Study Of Covid-19 In Particularly Vulnerable Childrenmentioning

confidence: 99%

The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment

et al. 2021

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Antibody response to the BNT162b2 SARS-CoV-2 vaccine in paediatric patients with inflammatory bowel disease treated with anti-TNF therapy

Cited by 11 publications

References 6 publications

Impact of Anti-TNFα Treatment on the Humoral Response to the BNT162b2 mRNA COVID-19 Vaccine in Pediatric Inflammatory Bowel Disease Patients

Impact of Anti-TNFα Treatment on the Humoral Response to the BNT162b2 mRNA COVID-19 Vaccine in Pediatric Inflammatory Bowel Disease Patients

Humoral response and safety of BNT162b2 mRNA vaccine in children with rheumatic diseases

The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment

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