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Anti-tumor necrosis factor therapy is associated with attenuated humoral response to SARS-COV-2 vaccines in patients with inflammatory bowel disease |
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| Institution: | 1. Gastroenterology Department, Hospital Professor Doutor Fernando Fonseca, IC 19, 2720-276 Amadora, Portugal;2. Clinical Pathology Department, Hospital Professor Doutor Fernando Fonseca, IC 19, 2720-276 Amadora, Portugal;3. Independent researcher |
| Abstract: | BackgroundImmunosuppressive therapy used in the treatment of inflammatory bowel disease (IBD) is known to reduce vaccine immunogenicity.AimsThis study aimed to 1) predict the humoral response elicited by SARS-CoV-2 vaccination in IBD patients based on their ongoing treatment and other relevant patient and vaccine characteristics and 2) assess the humoral response to a booster dose of mRNA vaccine.MethodsWe conducted a prospective study in adult IBD patients. Anti-spike (S) IgG antibodies were measured after initial vaccination and again after one booster dose. A multiple linear regression model was created to predict anti-S antibody titer following initial complete vaccination in different therapeutic groups (no immunosuppression, anti-TNF, immunomodulators and combination therapy). A two-tailed Wilcoxon test for two dependent groups was performed to compare anti-S values before and after the booster dose.ResultsOur study included 198 IBD patients. The multiple linear regression identified anti-TNF and combination therapy (versus no immunosuppression), current smoking, viral vector (versus mRNA) vaccine and interval between vaccination and anti-S measurement as statistically significant predictors of the log anti-S antibody levels (p < 0.001). No statistically significant differences were found between no immunosuppression and immunomodulators (p = 0.349) and between anti-TNF and combination therapy (p = 0.997). Statistically significant differences for anti-S antibody titer before and after the booster dose of mRNA SARS-CoV-2 vaccine were found, both for non-anti-TNF and anti-TNF groups.ConclusionsAnti-TNF treatment (either alone or in combination therapy) is associated with lower anti-S antibody levels. Booster mRNA doses seem to increase anti-S both in non-anti-TNF and anti-TNF treated patients. Special attention should be paid to this group of patients when planning vaccination schemes. |
| Keywords: | Inflammatory bowel disease COVID-19 vaccines Booster Anti-TNF-α 5-ASA"} {"#name":"keyword" "$":{"id":"pc_pAvbRNPlYx"} "$$":[{"#name":"text" "_":"5-aminosalicylic acid BMI"} {"#name":"keyword" "$":{"id":"pc_Z6s3nq18Xu"} "$$":[{"#name":"text" "_":"body-mass index CD"} {"#name":"keyword" "$":{"id":"pc_DSeRCNEFHj"} "$$":[{"#name":"text" "_":"Crohn’s disease COI"} {"#name":"keyword" "$":{"id":"pc_ZfbnENjM5r"} "$$":[{"#name":"text" "_":"cut-off index COVID-19"} {"#name":"keyword" "$":{"id":"pc_bQ49MsRf0M"} "$$":[{"#name":"text" "_":"coronavirus disease 2019 CRP"} {"#name":"keyword" "$":{"id":"pc_zc5CZQL9VI"} "$$":[{"#name":"text" "_":"C-reactive protein CT"} {"#name":"keyword" "$":{"id":"pc_Jpno9zp4zc"} "$$":[{"#name":"text" "_":"combination therapy ESR"} {"#name":"keyword" "$":{"id":"pc_lKAs9fjFKA"} "$$":[{"#name":"text" "_":"erythrocyte sedimentation rate FC"} {"#name":"keyword" "$":{"id":"pc_UoZ5GWONcF"} "$$":[{"#name":"text" "_":"fecal calprotectin IBD"} {"#name":"keyword" "$":{"id":"pc_Gf9M5N4x07"} "$$":[{"#name":"text" "_":"inflammatory bowel disease IM"} {"#name":"keyword" "$":{"id":"pc_noQdcwKNrZ"} "$$":[{"#name":"text" "_":"immunomodulators IQR"} {"#name":"keyword" "$":{"id":"pc_4TNwWfPZfF"} "$$":[{"#name":"text" "_":"interquartile range mRNA"} {"#name":"keyword" "$":{"id":"pc_iREwPOkK2m"} "$$":[{"#name":"text" "_":"messenger ribonucleic acid NI"} {"#name":"keyword" "$":{"id":"pc_IgTLHXfHoF"} "$$":[{"#name":"text" "_":"no immunosuppression RBD"} {"#name":"keyword" "$":{"id":"pc_r42lYfMbUJ"} "$$":[{"#name":"text" "_":"receptor binding domain S"} {"#name":"keyword" "$":{"id":"pc_52L7vcbE74"} "$$":[{"#name":"text" "_":"spike SARS-CoV-2"} {"#name":"keyword" "$":{"id":"pc_USPJut9EQQ"} "$$":[{"#name":"text" "_":"severe acute respiratory syndrome coronavirus 2 TNF"} {"#name":"keyword" "$":{"id":"pc_Ac9gsQlhX5"} "$$":[{"#name":"text" "_":"tumor necrosis factor UC"} {"#name":"keyword" "$":{"id":"pc_UoK51YHMby"} "$$":[{"#name":"text" "_":"ulcerative colitis PRO-2"} {"#name":"keyword" "$":{"id":"pc_s3vvKUoA39"} "$$":[{"#name":"text" "_":"patient-reported outcome-2 SD"} {"#name":"keyword" "$":{"id":"pc_zLOe4U9YQd"} "$$":[{"#name":"text" "_":"standard deviation VIF"} {"#name":"keyword" "$":{"id":"pc_B9xEm8v4w4"} "$$":[{"#name":"text" "_":"variance inflation factor |
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