Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD
Top Cited Papers
Open Access
- 26 April 2021
- Vol. 70 (10), 1884-1893
- https://doi.org/10.1136/gutjnl-2021-324789
Abstract
Objective Delayed second dose SARS-CoV-2 vaccination trades maximal effectiveness for a lower level of immunity across more of the population. We investigated whether patients with inflammatory bowel disease treated with infliximab have attenuated serological responses to a single dose of a SARS-CoV-2 vaccine. Design Antibody responses and seroconversion rates in infliximab-treated patients (n=865) were compared with a cohort treated with vedolizumab (n=428), a gut-selective anti-integrin α4β7 monoclonal antibody. Our primary outcome was anti-SARS-CoV-2 spike (S) antibody concentrations, measured using the Elecsys anti-SARS-CoV-2 spike (S) antibody assay 3–10 weeks after vaccination, in patients without evidence of prior infection. Secondary outcomes were seroconversion rates (defined by a cut-off of 15 U/mL), and antibody responses following past infection or a second dose of the BNT162b2 vaccine. Results Geometric mean (SD) anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab than vedolizumab, following BNT162b2 (6.0 U/mL (5.9) vs 28.8 U/mL (5.4) pConclusion Infliximab is associated with attenuated immunogenicity to a single dose of the BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Vaccination after SARS-CoV-2 infection, or a second dose of vaccine, led to seroconversion in most patients. Delayed second dosing should be avoided in patients treated with infliximab. Trial registration number ISRCTN45176516.Keywords
Funding Information
- F. Hoffmann-La Roche AG (NA)
- Biogen GmbH (NA)
- Royal Devon and Exeter NHS Foundation Trust (NA)
- Galapagos NV (NA)
- Hull University Teaching Hospital NHS Trust (NA)
- Celltrion Healthcare (NA)
- Takeda (NA)
This publication has 27 references indexed in Scilit:
- Antibody Response to Hepatitis B Virus Vaccine is Impaired in Patients With Inflammatory Bowel Disease on Infliximab TherapyInflammatory Bowel Diseases, 2018
- Stool Microbiota and Vaccine Responses of InfantsPEDIATRICS, 2014
- Increased Risk of Pneumonia Among Patients With Inflammatory Bowel DiseaseThe American Journal of Gastroenterology, 2013
- Genetic polymorphisms in host antiviral genes: Associations with humoral and cellular immunity to measles vaccineVaccine, 2011
- Immunosuppression Impairs Response to Pneumococcal Polysaccharide Vaccination in Patients With Inflammatory Bowel DiseaseThe American Journal of Gastroenterology, 2010
- Landscape Analysis of Interactions between Nutrition and Vaccine Responses in ChildrenJournal of Nutrition, 2009
- Analysis of the maturation process of dendritic cells deficient for TNF and lymphotoxin-α reveals an essential role for TNFJournal of Leukocyte Biology, 2003
- Immune and inflammatory responses in TNF alpha-deficient mice: a critical requirement for TNF alpha in the formation of primary B cell follicles, follicular dendritic cell networks and germinal centers, and in the maturation of the humoral immune response.The Journal of Experimental Medicine, 1996
- Influence of smoking on immunological responses to hepatitis B vaccineVaccine, 1994
- The effect of cigarette smoking on susceptibility to epidemic influenza and on serological responses to live attenuated and killed subunit influenza vaccinesEpidemiology and Infection, 1976