Infliximab and/or immunomodulators inhibit immune responses to trivalent influenza vaccination in adults with inflammatory bowel disease

Hagihara, Yoshie; Ohfuji, Satoko; Watanabe, Kenji; Yamagami, Hirokazu; Fukushima, Wakaba; Maeda, Kazuhiro; Kamata, Noriko; Sogawa, Mitsue; Shiba, Masatsugu; Tanigawa, Tetsuya; Tominaga, Kazunari; Watanabe, Toshio; Fujiwara, Yasuhiro; Hirota, Yoshio

doi:10.1016/j.crohns.2013.08.008

Cited by 71 publications

(59 citation statements)

References 43 publications

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“…However, when patients are receiving immunosuppressive therapies with combined thiopurines and anti-TNF agents, serologic responses to vaccines are impaired ( 22,23,(43)(44)(45)(46)(47)(48)(49)(50)(51). Nonetheless, even a blunted vaccination response is thought to be of benefi t ( 52 ) and thus recommendations for infl uenza vaccination with inactivated vaccine continue to be broadly applicable to all patients, regardless of immunosuppression status ( 13,53 ).…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

403

421

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Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

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Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

403

421

View full text Add to dashboard Cite

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“…Only the single vaccination responded enough to meet the international licensing criteria of the European Agency for the Evaluation of Medical Products. In this study, the seroprotection rate after the first vaccination was high (H1N1: 85 %, H3N2: 82 %, B: 100 %) compared to our previous study (H1N1: 81 %, H3N2: 61 %, B: 86 %) [10]. This good reaction may be the reason for the low increase in antibody titers after the second vaccination.…”

Section: Discussionmentioning

confidence: 45%

“…Conversely, subjects with a higher pre-vaccination titer showed higher GMTs and seroprotection rates for H1N1 and H3N2 strains after vaccination (S1 or S2; Table 3), as described in our previous study [10]. Figure 2b shows the changing process of GMT for the 3 strains according to the pre-vaccination titer in the booster group.…”

Section: Stratified Immunogenicity Analysismentioning

confidence: 59%

“…For the first time, we also report an inhibited immune response to some strains of the trivalent influenza vaccination in adult IBD patients treated with IFX and/or immunomodulators [10]. Further investigations are needed to establish the appropriate influenza vaccination program for IBD patients taking immunosuppressive agents.…”

Section: Discussionmentioning

confidence: 94%

“…We previously reported that immune responses to the trivalent influenza vaccination were inhibited for some strains in adult IBD patients who were treated with infliximab (IFX) and/or immunomodulators [10]. This has also been reported in pediatric IBD patients [11].…”

Section: Introductionmentioning

confidence: 89%

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Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial

et al. 2015

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Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy

Bemben

Berg

2022

Pharmacotherapy

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Inactivated vaccines are generally considered safe in immunocompromised patients but the ability of immunocompromised patients to generate an effective immune response to vaccines is uncertain. Although recent reviews have focused on the effects of vaccines in patients who are immunocompromised due to various disease states (primary immunodeficiency), the effects of immunosuppressive drug therapy (secondary immunodeficiency) has received relatively less attention. This review evaluates evidence regarding the efficacy of inactivated vaccines against influenza, COVID-19, and other diseases in patients treated with immunosuppressive oncologic agents, immunosuppressants used for transplant recipients, and immunosuppressants used for autoimmune disorders. Although evidence is mixed for many immunosuppressive agents and vaccines, most studies have found an attenuated immune response to inactivated vaccines, with the majority of data indicate anti-B-cell antibodies have a more severe and prolonged negative effect on vaccine efficacy. K E Y W O R D S antirheumatic agents, immunosuppressive agents, inactivated vaccine, vaccine | 335 BEMBEN aNd BERG over 10 kg], as defined by the Advisory Committee on Immunization Practices [ACIP]), were considered to be immunosuppressive agents. 4 How to cite this article: Bemben NM, Berg ML. Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy. Pharmacotherapy.

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Infliximab and/or immunomodulators inhibit immune responses to trivalent influenza vaccination in adults with inflammatory bowel disease

Cited by 71 publications

References 43 publications

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial

Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy

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