tetano
Editor, Senior Moderator
J Gastroenterol Hepatol
. 2022 Sep 6.
doi: 10.1111/jgh.16001. Online ahead of print.
Response to COVID19 vaccines is reduced in patients with inflammatory bowel disease, but improved with additional dose
Hisashi Shiga[SUP] 1 [/SUP], Yoichi Kakuta[SUP] 1 [/SUP], Kumiko An[SUP] 2 [/SUP], Yuko Abe[SUP] 2 [/SUP], Shinichi Fujimaki[SUP] 2 [/SUP], Yusuke Shimoyama[SUP] 1 [/SUP], Takeo Naito[SUP] 1 [/SUP], Rintaro Moroi[SUP] 1 [/SUP], Masatake Kuroha[SUP] 1 [/SUP], Seik-Soon Khor[SUP] 3 [/SUP], Yosuke Kawai[SUP] 3 [/SUP], Katsushi Tokunaga[SUP] 3 [/SUP], Yoshitaka Kinouchi[SUP] 4 [/SUP], Atsushi Masamune[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccination is recommended for patients with inflammatory bowel disease (IBD); however, suppressed immune responses have been reported for fully vaccinated patients under immunosuppressive therapy, mainly from Western countries. We prospectively analyzed antibody titers of IBD patients in Asia induced by two-dose and additional dose of messenger-RNA COVID-19 vaccine.
Methods: Factors associated with antibody titers were identified by multiple regression analyses using the following covariates: sex, age (≥60 or <60 years), disease type (Crohn's disease or ulcerative colitis), vaccine type (BNT162b2 or mRNA-1273), time from second/third vaccination, molecular-targeted agent (anti-tumor necrosis factor [TNF] agents, ustekinumab, vedolizumab, tofacitinib, or no molecular-targeted agents), thiopurine, steroid, and 5-aminosalicylic acid.
Results: Among 409 patients analyzed, mean titer was 1,316.7 U/ml (SD, 1,799.3); 403 (98.5%) were judged to be seropositive (≥0.8 U/ml), and 389 (95.1%) had neutralizing antibodies (≥15 U/ml). After the third vaccination, mean titer raised up to 21,123.8 U/ml (SD, 23,474.5); all 179 were seropositive, and 178 (99.4%) had neutralizing antibodies. In 248 patients with genetic data, there was no difference in mean titer after two/third doses between carriers and non-carriers of HLA-A24 associated with severe disease during COVID-19 infection. A multiple regression analysis using covariates revealed that older age, vaccine type (BNT162b2), time from second/third dose, anti-TNF agents, tofacitinib, and thiopurine were independently associated with lower antibody titers.
Conclusions: Our findings further support the recommendation for COVID-19 vaccination in patients under immunosuppressive therapy, especially additional third dose for patients receiving anti-TNF agents and/or thiopurine or tofacitinib.
Keywords: COVID-19; Crohn’s disease; anti-tumor necrosis factor; messenger-RNA vaccine; thiopurine; tofacitinib; ulcerative colitis.
. 2022 Sep 6.
doi: 10.1111/jgh.16001. Online ahead of print.
Response to COVID19 vaccines is reduced in patients with inflammatory bowel disease, but improved with additional dose
Hisashi Shiga[SUP] 1 [/SUP], Yoichi Kakuta[SUP] 1 [/SUP], Kumiko An[SUP] 2 [/SUP], Yuko Abe[SUP] 2 [/SUP], Shinichi Fujimaki[SUP] 2 [/SUP], Yusuke Shimoyama[SUP] 1 [/SUP], Takeo Naito[SUP] 1 [/SUP], Rintaro Moroi[SUP] 1 [/SUP], Masatake Kuroha[SUP] 1 [/SUP], Seik-Soon Khor[SUP] 3 [/SUP], Yosuke Kawai[SUP] 3 [/SUP], Katsushi Tokunaga[SUP] 3 [/SUP], Yoshitaka Kinouchi[SUP] 4 [/SUP], Atsushi Masamune[SUP] 1 [/SUP]
Affiliations
- PMID: 36066279
- DOI: 10.1111/jgh.16001
Abstract
Background: Coronavirus disease 2019 (COVID-19) vaccination is recommended for patients with inflammatory bowel disease (IBD); however, suppressed immune responses have been reported for fully vaccinated patients under immunosuppressive therapy, mainly from Western countries. We prospectively analyzed antibody titers of IBD patients in Asia induced by two-dose and additional dose of messenger-RNA COVID-19 vaccine.
Methods: Factors associated with antibody titers were identified by multiple regression analyses using the following covariates: sex, age (≥60 or <60 years), disease type (Crohn's disease or ulcerative colitis), vaccine type (BNT162b2 or mRNA-1273), time from second/third vaccination, molecular-targeted agent (anti-tumor necrosis factor [TNF] agents, ustekinumab, vedolizumab, tofacitinib, or no molecular-targeted agents), thiopurine, steroid, and 5-aminosalicylic acid.
Results: Among 409 patients analyzed, mean titer was 1,316.7 U/ml (SD, 1,799.3); 403 (98.5%) were judged to be seropositive (≥0.8 U/ml), and 389 (95.1%) had neutralizing antibodies (≥15 U/ml). After the third vaccination, mean titer raised up to 21,123.8 U/ml (SD, 23,474.5); all 179 were seropositive, and 178 (99.4%) had neutralizing antibodies. In 248 patients with genetic data, there was no difference in mean titer after two/third doses between carriers and non-carriers of HLA-A24 associated with severe disease during COVID-19 infection. A multiple regression analysis using covariates revealed that older age, vaccine type (BNT162b2), time from second/third dose, anti-TNF agents, tofacitinib, and thiopurine were independently associated with lower antibody titers.
Conclusions: Our findings further support the recommendation for COVID-19 vaccination in patients under immunosuppressive therapy, especially additional third dose for patients receiving anti-TNF agents and/or thiopurine or tofacitinib.
Keywords: COVID-19; Crohn’s disease; anti-tumor necrosis factor; messenger-RNA vaccine; thiopurine; tofacitinib; ulcerative colitis.