Impact of Inflammatory Bowel Disease Therapies on Durability of Humoral Response to SARS-CoV-2 Vaccination

Charilaou, Paris; Tricarico, Christopher; Battat, Robert; Scherl, Ellen; Longman, Randy S.; Lukin, Dana J.

doi:10.1016/j.cgh.2021.12.007

Cited by 16 publications

(21 citation statements)

References 8 publications

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“…In this regard, CLARITY IBD demonstrated a shorter antibody half-life in infliximab-treated compared with vedolizumab-treated patients following two doses of BNT162b2 (infliximab: 26.8 days (95% CI 26.2 to 27.5) vs vedolizumab: 47.6 (95% CI 45.5 to 49.8), p<0.0001) and ChAdOx1 nCoV-19 (infliximab: 35.9 days (95% CI 34.9 to 36.8) vs vedolizumab: 58.0 days (95% CI 55.0 to 61.3) p<0.0001) vaccines 146. Similar findings were observed when antibody half-lives of anti-TNF-treated patients were compared with other non-anti-TNF treatments including ustekinumab, 5-ASA and budesonide in addition to vedolizumab (38 days vs 74 days, p=0.045) 163. Conversely, in patients with IBD treated with both biological and non-biological therapies, one retrospective cohort study reported vaccine effectiveness of 80.4%, following two doses of an mRNA-based vaccines (BNT162b2, mRNA-1273),164 a rate similar to original vaccine trials 165 166.…”

Section: Sars-cov-2 Vaccinationsupporting

confidence: 62%

“… 146 Similar findings were observed when antibody half-lives of anti-TNF-treated patients were compared with other non-anti-TNF treatments including ustekinumab, 5-ASA and budesonide in addition to vedolizumab (38 days vs 74 days, p=0.045). 163 Conversely, in patients with IBD treated with both biological and non-biological therapies, one retrospective cohort study reported vaccine effectiveness of 80.4%, following two doses of an mRNA-based vaccines (BNT162b2, mRNA-1273), 164 a rate similar to original vaccine trials. 165 166 In this large Veterans Health Administration with IBD cohort, most patients (54.8%, 8048/14,697) were treated with 5-ASA only, and the study was conducted when the major circulating variant was alpha (B1.1.7).…”

Section: Sars-cov-2 Vaccinationmentioning

confidence: 96%

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Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Lin

Lau

Chanchlani

et al. 2022

Gut

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The COVID-19 pandemic has raised considerable concerns that patients with inflammatory bowel disease (IBD), particularly those treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 acquisition, develop worse outcomes following COVID-19, and have suboptimal vaccine response compared with the general population. In this review, we summarise data on the risk of COVID-19 and associated outcomes, and latest guidance on SARS-CoV-2 vaccines in patients with IBD. Emerging evidence suggests that commonly used medications for IBD, such as corticosteroids but not biologicals, were associated with adverse outcomes to COVID-19. There has been no increased risk of de novo, or delayed, IBD diagnoses, however, an overall decrease in endoscopy procedures has led to a rise in the number of missed endoscopic-detected cancers during the pandemic. The impact of IBD medication on vaccine response has been a research priority recently. Data suggest that patients with IBD treated with antitumour necrosis factor (TNF) medications had attenuated humoral responses to SARS-CoV-2 vaccines, and more rapid antibody decay, compared with non-anti-TNF-treated patients. Reassuringly, rates of breakthrough infections and hospitalisations in all patients who received vaccines, irrespective of IBD treatment, remained low. International guidelines recommend that all patients with IBD treated with immunosuppressive therapies should receive, at any point during their treatment cycle, three primary doses of SARS-CoV-2 vaccines with a further booster dose as soon as possible. Future research should focus on our understanding of the rate of antibody decay in biological-treated patients, which patients require additional doses of SARS-CoV-2 vaccine, the long-term risks of COVID-19 on IBD disease course and activity, and the potential risk of long COVID-19 in patients with IBD.

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Section: Sars-cov-2 Vaccinationsupporting

confidence: 62%

Section: Sars-cov-2 Vaccinationmentioning

confidence: 96%

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Lin

Lau

Chanchlani

et al. 2022

Gut

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“…Thus, 21 studies were included in their entirety as shown in Table 1. These included 11 prospective studies, seven retrospective studies and three survey‐based studies 16–21,27–41 . The PRISMA Flow chart is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…These included 11 prospective studies, seven retrospective studies and three survey‐based studies. 16 , 17 , 18 , 19 , 20 , 21 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 The PRISMA Flow chart is shown in Figure 1 . The study details are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of SARS‐CoV‐2 vaccine in Inflammatory Bowel Disease patients: a systematic review, meta‐analysis and meta‐regression

Bhurwal

Mutneja

Bansal

et al. 2022

Aliment Pharmacol Ther

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Introduction: There are concerns regarding the effectiveness and safety of SARS-CoV-2 vaccine in inflammatory Bowel Disease (IBD) patients. This systematic review and meta-analysis comprehensively summarises the available literature regarding the safety and effectiveness of SARS-CoV-2 vaccine in IBD. Methods: Three independent reviewers performed a comprehensive review of all original articles describing the response of SARS-CoV-2 vaccines in patients with IBD. Primary outcomes were (1) pooled seroconversion rate SARS-CoV-2 vaccination in IBD patients (2) comparison of breakthrough COVID-19 infection rate SARS-CoV-2 vaccination in IBD patients with control cohort and (3) pooled adverse event rate of SARS-CoV-2 vaccine. All outcomes were evaluated for one and two doses of SARS-CoV-2 vaccine. Meta-regression was performed. Probability of publication bias was assessed using funnel plots and with Egger's test.Results: Twenty-one studies yielded a pooled seroconversion rate of 73.7% and 96.8% in IBD patients after one and two doses of SARS-CoV-2 vaccine respectively. Sub-group analysis revealed non-statistically significant differences between different immunosuppressive regimens for seroconversion. Meta-regression revealed that the vaccine type and study location independently influenced seroconversion rates.There was no statistically significant difference in breakthrough infection in IBD patients as compared to control after vaccination. Conclusion:In summary, the systematic review and meta-analysis suggest that SARS-CoV-2 vaccine is safe and effective in IBD patients.

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“…Regarding response of IBD patients to COVID-19 vaccines, a wider breadth of evidence is available, particularly regarding initial response of patients immunized with two doses of the presently available mRNA vaccines (54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70). Generally, data collected in IBD patients exposed to COVID-19 vaccines resemble those evidenced after SARS-CoV-2 infection.…”

Section: Immune Response Of Patients With Inflammatory Bowel Disease ...mentioning

confidence: 99%

Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence

Esposito

Caminiti

Giordano³

et al. 2022

Front. Immunol.

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Inflammatory bowel diseases (IBD), including Crohn’s disease, ulcerative colitis, and unclassified inflammatory bowel disease, are a group of chronic, immune mediated conditions that are presumed to occur in genetically susceptible individuals because of a dysregulated intestinal immune response to environmental factors. IBD patients can be considered subjects with an aberrant immune response that makes them at increased risk of infections, particularly those due to opportunistic pathogens. In many cases this risk is significantly increased by the therapy they receive. Aim of this narrative review is to describe the impact of SARS-CoV-2 infection and the immunogenicity of COVID-19 vaccines in patients with IBD. Available data indicate that patients with IBD do not have an increased susceptibility to infection with SARS-CoV-2 and that, if infected, in the majority of the cases they must not modify the therapy in place because this does not negatively affect the COVID-19 course. Only corticosteroids should be reduced or suspended due to the risk of causing severe forms. Furthermore, COVID-19 seems to modify the course of IBD mainly due to the impact on intestinal disease of the psychological factors deriving from the measures implemented to deal with the pandemic. The data relating to the immune response induced by SARS-CoV-2 or by COVID-19 vaccines can be considered much less definitive. It seems certain that the immune response to disease and vaccines is not substantially different from that seen in healthy subjects, with the exception of patients treated with anti-tumor necrosis factor alone or in combination with other immunosuppressants who showed a reduced immune response. How much, however, this problem reduces induced protection is not known. Moreover, the impact of SARS-CoV-2 variants on IBD course and immune response to SARS-CoV-2 infection and COVID-19 vaccines has not been studied and deserves attention. Further studies capable of facing and solving unanswered questions are needed in order to adequately protect IBD patients from the risks associated with SARS-CoV-2 infection.

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Impact of Inflammatory Bowel Disease Therapies on Durability of Humoral Response to SARS-CoV-2 Vaccination

Cited by 16 publications

References 8 publications

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic

Effectiveness and safety of SARS‐CoV‐2 vaccine in Inflammatory Bowel Disease patients: a systematic review, meta‐analysis and meta‐regression

Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence

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