Immunogenicity of Influenza Vaccine for Patients with Inflammatory Bowel Disease on Maintenance Infliximab Therapy
- 1 March 2016
- journal article
- research article
- Published by Oxford University Press (OUP) in Inflammatory Bowel Diseases
- Vol. 22 (3), 638-647
- https://doi.org/10.1097/mib.0000000000000615
Abstract
In patients with inflammatory bowel disease (IBD) on infliximab, data are limited on immune response to influenza vaccine and the impact of vaccine timing. The study aims were to evaluate immune responses to the influenza vaccine in IBD patients on infliximab and the impact of vaccine timing on immune responses. In this randomized study, 137 subjects with IBD on maintenance infliximab therapy were allocated to receive the 2012/2013 inactivated influenza vaccine at the time of infliximab infusion (n = 69) or midway between infusions (n = 68). Serum was collected before and after vaccination for hemagglutination inhibition titers. Serologic protection was defined by postvaccine titer of ≥1:40. Comparing subjects vaccinated at the time of infliximab with those vaccinated midway, serologic protection was achieved in 67% versus 66% to H1N1 (P = 0.8), in 43% versus 49% to H3N2 (P = 0.5), and in 69% versus 79% to influenza B (P = 0.2). Although solicited adverse events were common (60%), no subject experienced a serious adverse event requiring additional medical attention. Only 6% of subjects had a clinically significant increase in disease activity score, not impacted by vaccine timing. Serologic protection to influenza vaccine is achieved in only approximately 45% to 80% of IBD patients on maintenance infliximab therapy varying by antigen. Yet, importantly, vaccine timing relative to infliximab infusion does not affect the achievement of serologic protection, and the influenza vaccine is well tolerated. Therefore, influenza vaccination at any point during infliximab scheduling is recommended for patients with IBD and opportunities to broaden the availability and convenience of influenza vaccine to optimize coverage should be explored.Keywords
This publication has 29 references indexed in Scilit:
- Comparative Effectiveness of Immunosuppressants and Biologics for Inducing and Maintaining Remission in Crohn's Disease: A Network Meta-analysisGastroenterology, 2015
- Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel diseaseJournal of Crohn's and Colitis, 2014
- Increasing Incidence and Prevalence of the Inflammatory Bowel Diseases With Time, Based on Systematic ReviewGastroenterology, 2012
- Vaccination strategies for patients with inflammatory bowel disease on immunomodulators and biologicsInflammatory Bowel Diseases, 2009
- Role of influenza and other respiratory viruses in admissions of adults to Canadian hospitalsInfluenza and Other Respiratory Viruses, 2008
- Serious infection following anti–tumor necrosis factor α therapy in patients with rheumatoid arthritis: Lessons from interpreting data from observational studiesArthritis & Rheumatism, 2007
- Hospitalization Attributable to Influenza and Other Viral Respiratory Illnesses in Canadian ChildrenThe Pediatric Infectious Disease Journal, 2006
- Infections in patients with rheumatoid arthritis treated with biologic agentsArthritis & Rheumatism, 2005
- Guidelines for Immunizations in Patients With Inflammatory Bowel DiseaseInflammatory Bowel Diseases, 2004
- Respiratory Viral Infections in Immunocompetent and Immunocompromised PersonsThe American Journal of Medicine, 1997