Janos Bolyai Research Grant(BO/00723/22) Funder: HAS
("Hetenyi Geza" Fund of the Faculty of Medicine, University of Szeged)
Subjects:
Gastroenterology and hepatology
Vaccines
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has complicated
the management of inflammatory bowel diseases (IBD).This study aimed to assess the
efficacy of different anti-SARS-CoV-2 vaccines under different treatments in IBD patients
and identify predictive factors associated with lower serological response, including
anti-tumor necrosis factor (anti-TNF) drug levels.A prospective, double-center study
of IBD patients was conducted following messenger ribonucleotide acid (mRNA) and non-mRNA
anti-SARS-CoV-2 vaccination.Healthy control (HC) patients were enrolled to reduce
bias. Baseline and control samples were obtained 14 days after the second dose to
assess the impact of conventional and biological treatments. Clinical and biochemical
activity, serological response level, and anti-TNF drug levels were measured.This
study included 199 IBD (mean age, 40.9 ± 12.72 years) and 77 HC participants (mean
age, 50.3 ± 12.36 years). Most patients (76.9%) and all HCs received mRNA vaccines.
Half of the IBD patients were on biological treatment (anti-TNF 68.7%). Biological
and thiopurine combined immunomodulation and biological treatment were associated
with lower serological response (p < 0.001), and mRNA vaccination promoted better
antibody levels (p < 0.001). Higher adalimumab levels caused lower serological response
(p = 0.006). W8 persistence of anti-SARS-CoV-2 level was equal in IBD and HC groups.
Vaccination did not aggravate clinical disease activity (p = 0.65).Anti-SARS-CoV-2
vaccination is considerably efficacious in IBD patients, with mRNA vaccines promoting
better antibody levels. The negative impact of combined biological treatment, especially
with high adalimumab drug levels, on serological response to vaccination should be
considered. Although midterm durability of vaccination is encouraging, more data are
needed to expand the existing understanding on this issue.
