TY - JOUR
T1 - Factors Affecting Initial Humoral Immune Response to SARS-CoV-2 Vaccines among Patients with Inflammatory Bowel Diseases
AU - Kappelman, Michael D.
AU - Weaver, Kimberly N.
AU - Zhang, Xian
AU - Dai, Xiangfeng
AU - Watkins, Runa
AU - Adler, Jeremy
AU - Dubinsky, Marla C.
AU - Kastl, Arthur
AU - Bousvaros, Athos
AU - Strople, Jenifer A.
AU - Cross, Raymond K.
AU - Higgins, Peter D.R.
AU - Ungaro, Ryan C.
AU - Bewtra, Meenakshi
AU - Bellaguarda, Emanuelle A.
AU - Farraye, Francis A.
AU - Boccieri, Margie E.
AU - Firestine, A.
AU - Chun, Kelly Y.
AU - Fernando, Manory
AU - Bastidas, Monique
AU - Zikry, Michael
AU - Long, Millie D.
N1 - Funding Information:
Potential competing interests: M.D.K. has consulted for AbbVie, Janssen, Pfizer, and Takeda; is a shareholder in Johnson & Johnson; and has received research support from Pfizer, Takeda, Janssen, AbbVie, Lilly, Genentech, Boehringer Ingelheim, Bristol Myers Squibb, Celltrion, and Arenapharm. K.N.W. has consulted for AbbVie. X.Z., X.D., and R.W.—no disclosures. J.A. has consulted for Janssen and has received research support from the Gary and Rachel Glick Charitable Fund, Shaevsky Family Research Fund for Crohn's Disease, the Crohn's & Colitis Foundation, and the Leona M. and Harry B. Helmsley Charitable Trust. M.C.D.: consultant fees from AbbVie, Arena, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Pfizer, Prometheus Labs, and Takeda; grant Support from AbbVie, Prometheus Labs; and license fees from Takeda. A.K.—no disclosures. A.B.—has received research support (subinvestigator on protocols) from the following companies in the past 3 years: Janssen, AbbVie, Takeda, Buhlmann, Arena, and Eli Lilly. He has consulted for Arena, Best Doctors, Eli Lilly, and Takeda, and received royalties from UpToDate. J.A.S. reports no disclosures. R.K.C. has participated in advisory boards and consulting with AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, LabCorp, Pfizer, Samsung Bioepis, and Takeda. P.D.R.H. has consulted for AbbVie, Pfizer, and Takeda and has received grant support from NIH, CCF, AbbVie, Pfizer, Takeda, Genentech, Eli Lilly, Arena, and the Rainin Foundation. R.C.U. has served as an advisory board member or consultant for AbbVie, Bristol Myers Squibb, Eli Lilly, Janssen, Pfizer, and Takeda; research support from AbbVie, Boehringer Ingelheim, and Pfizer. R.C.U. is funded by an NIH Career Development Award (K23KD111995-01A1). M. Bewtra discloses research funding from Janssen, GlaxoSmithKline, and Takeda, having served as a consultant for Janssen, AbbVie, BMS, and Pfizer, and having received honorarium for participation in a CME program sponsored by AbbVie. E.A.B. has consulted for AbbVie, Pfizer, and Bristol Myers Squibb. F.A.F. is a consultant for Arena, BMS, Braintree Labs, Gilead, GI Reviewers, Innovation Pharmaceuticals, Iterative Scopes, Janssen, Pfizer, and Sebela. He sits on a Data Safety Monitoring Board for Lilly and Theravance. M.E.B., A.F., K.Y.C., M.F., M. Bestidas, M.Z.—no disclosures. M.D.L. has received research/grants from Pfizer and has consulted for AbbVie , Bristol Myers Squibb, Calibr, Eli Lilly, Genentech, Gilead Sciences, Janssen Pharmaceuticals, Pfizer , Roche, Takeda, TARGET PharmaSolutions, and Theravance Biopharma. Study Highlights WHAT IS KNOWN
Publisher Copyright:
© 2022 Wolters Kluwer Health. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - INTRODUCTION:Although an additional coronavirus disease 2019 vaccine dose for immunocompromised persons has been recommended in some countries, further data to guide vaccination strategies for patients with inflammatory bowel disease (IBD) are urgently needed. We sought to identify factors affecting initial humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines among patients with IBD.METHODS:In this prospective cohort of SARS-CoV-2 immunized patients with IBD, we evaluated associations between participant age, sex, vaccine type, medication use, and the presence of a detectable antireceptor binding domain antibody and quantitative antibody level.RESULTS:In total, 1,909 participants were included (1,123, 692, and 94 received BNT162b2, mRNA-1273, and Ad26.COV2.S, respectively) of whom 96% achieved a positive antibody response. On multivariable analysis, factors associated with lack of antibody response were older age (P = 0.043), BNT162b2 vs mRNA-1273 (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.0-3.9), and combination therapy with anti-TNF and 6MP, azathioprine, or methotrexate (OR 4.2, 95% CI 2.4-7.3). The use of 5-aminosalicylate or sulfasalazine (OR 0.3, 95% CI 0.1-0.8) and ustekinumab (OR 0.2, 95% CI 0.05-0.8) was associated with decreased odds of lacking antibody response.DISCUSSION:Most patients with IBD mount an initial response to SARS-CoV-2 vaccination; however, older patients and those treated with anti-TNF and immunomodulator have blunted responses and may benefit the most from an additional vaccine dose. Patients treated with other classes of immunosuppressive medications have more robust initial immune responses to vaccination. These data should inform key decisions about patient selection for additional coronavirus disease 2019 vaccine doses in patients with IBD.
AB - INTRODUCTION:Although an additional coronavirus disease 2019 vaccine dose for immunocompromised persons has been recommended in some countries, further data to guide vaccination strategies for patients with inflammatory bowel disease (IBD) are urgently needed. We sought to identify factors affecting initial humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines among patients with IBD.METHODS:In this prospective cohort of SARS-CoV-2 immunized patients with IBD, we evaluated associations between participant age, sex, vaccine type, medication use, and the presence of a detectable antireceptor binding domain antibody and quantitative antibody level.RESULTS:In total, 1,909 participants were included (1,123, 692, and 94 received BNT162b2, mRNA-1273, and Ad26.COV2.S, respectively) of whom 96% achieved a positive antibody response. On multivariable analysis, factors associated with lack of antibody response were older age (P = 0.043), BNT162b2 vs mRNA-1273 (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.0-3.9), and combination therapy with anti-TNF and 6MP, azathioprine, or methotrexate (OR 4.2, 95% CI 2.4-7.3). The use of 5-aminosalicylate or sulfasalazine (OR 0.3, 95% CI 0.1-0.8) and ustekinumab (OR 0.2, 95% CI 0.05-0.8) was associated with decreased odds of lacking antibody response.DISCUSSION:Most patients with IBD mount an initial response to SARS-CoV-2 vaccination; however, older patients and those treated with anti-TNF and immunomodulator have blunted responses and may benefit the most from an additional vaccine dose. Patients treated with other classes of immunosuppressive medications have more robust initial immune responses to vaccination. These data should inform key decisions about patient selection for additional coronavirus disease 2019 vaccine doses in patients with IBD.
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U2 - 10.14309/ajg.0000000000001619
DO - 10.14309/ajg.0000000000001619
M3 - Article
C2 - 35029167
AN - SCOPUS:85125683121
SN - 0002-9270
VL - 117
SP - 462
EP - 469
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 3
ER -