Nationwide experiences with trough levels, durability, and disease activity among inflammatory bowel disease patients following COVID-19 vaccination.

IF 4.2 3区医学

Therapeutic Advances in Gastroenterology Pub Date : 2023-01-01 DOI:10.1177/17562848231183529

Tamás Resál, Péter Bacsur, Miklós Horváth, Kata Szántó, Mariann Rutka, Anita Bálint, Anna Fábián, Renáta Bor, Zoltán Szepes, János Fekete, Klaudia Farkas, Pál Miheller, Tamás Molnár

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Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has complicated the management of inflammatory bowel diseases (IBD).

Objectives: 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.

Design: A prospective, double-center study of IBD patients was conducted following messenger ribonucleotide acid (mRNA) and non-mRNA anti-SARS-CoV-2 vaccination.

Methods: 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.

Results: 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).

Conclusion: 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.

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COVID-19疫苗接种后炎症性肠病患者的低谷水平、持久性和疾病活动性的全国经验

背景:严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)大流行使炎症性肠病(IBD)的治疗复杂化。目的:本研究旨在评估不同抗sars - cov -2疫苗在不同治疗下对IBD患者的疗效，并确定与低血清学反应相关的预测因素，包括抗肿瘤坏死因子(anti-TNF)药物水平。设计:在信使核糖核酸(mRNA)和非mRNA抗sars - cov -2疫苗接种后，对IBD患者进行了一项前瞻性双中心研究。方法:纳入健康对照(HC)患者，以减少偏倚。在第二次给药后14天获得基线和对照样本，以评估常规治疗和生物治疗的影响。测定临床生化活性、血清学反应水平及抗肿瘤坏死因子药物水平。结果:本研究纳入199例IBD(平均年龄40.9±12.72岁)和77例HC(平均年龄50.3±12.36岁)参与者。大多数患者(76.9%)和所有hcc均接种了mRNA疫苗。一半的IBD患者接受生物治疗(抗肿瘤坏死因子68.7%)。生物和硫嘌呤联合免疫调节和生物治疗与较低的血清学反应相关(p p p = 0.006)。IBD组和HC组抗sars - cov -2水平的W8持久性相同。接种疫苗不会加重临床疾病活动性(p = 0.65)。结论:抗sars - cov -2疫苗接种对IBD患者有效，mRNA疫苗可提高抗体水平。应考虑联合生物治疗，特别是高阿达木单抗药物水平对疫苗接种血清学反应的负面影响。尽管疫苗接种的中期持久性令人鼓舞，但需要更多的数据来扩大对这一问题的现有理解。

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来源期刊

Therapeutic Advances in Gastroenterology Medicine-Gastroenterology

自引率

2.40%

发文量

103

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.