TY - JOUR
AU - Lin, Simeng
AU - Kennedy, Nicholas A.
AU - Saifuddin, Aamir
AU - Sandoval, Diana Muñoz
AU - Reynolds, Catherine J.
AU - Seoane, Rocio Castro
AU - Kottoor, Sherine H.
AU - Pieper, Franziska P.
AU - Lin, Kai Min
AU - Butler, David K.
AU - Chanchlani, Neil
AU - Nice, Rachel
AU - Chee, Desmond
AU - Bewshea, Claire
AU - Janjua, Malik
AU - McDonald, Timothy J.
AU - Sebastian, Shaji
AU - Alexander, James L.
AU - Constable, Laura
AU - Lee, James
AU - Murray, Charles D.
AU - Hart, Ailsa
AU - Irving, Peter M
AU - Jones, Gareth Rhys
AU - Kok, Klaartje B.
AU - Lamb, Christopher A.
AU - Lees, Charlie W
AU - Altmann, Daniel M.
AU - Boyton, Rosemary J.
AU - Goodhand, James R.
AU - Powell, Nick
AU - Ahmad, Tariq
AU - CLARITY IBD study
PY - 2022
DA - March
TI - Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab
JO - Nature Communications
VL - 13
DO - https://doi.org/10.1038/s41467-022-28517-z
AB - Anti tumour necrosis factor (anti-TNF) drugs increase the risk of serious respiratory infection and impair protective immunity following pneumococcal and influenza vaccination. Here we report SARS-CoV-2 vaccine-induced immune responses and breakthrough infections in patients with inflammatory bowel disease, who are treated either with the anti-TNF antibody, infliximab, or with vedolizumab targeting a gut-specific anti-integrin that does not impair systemic immunity. Geometric mean [SD] anti-S RBD antibody concentrations are lower and half-lives shorter in patients treated with infliximab than vedolizumab, following two doses of BNT162b2 (566.7 U/mL [6.2] vs 4555.3 U/mL [5.4], p &lt;0.0001; 26.8 days [95% CI 26.2 – 27.5] vs 47.6 days [45.5 – 49.8], p &lt;0.0001); similar results are also observed with ChAdOx1 nCoV-19 vaccination (184.7 U/mL [5.0] vs 784.0 U/mL [3.5], p &lt;0.0001; 35.9 days [34.9 – 36.8] vs 58.0 days [55.0 – 61.3], p value &lt; 0.0001). One fifth of patients fail to mount a T cell response in both treatment groups. Breakthrough SARS-CoV-2 infections are more frequent (5.8% (201/3441) vs 3.9% (66/1682), p = 0.0039) in patients treated with infliximab than vedolizumab, and the risk of breakthrough SARS-CoV-2 infection is predicted by peak anti-S RBD antibody concentration after two vaccine doses. Irrespective of the treatments, higher, more sustained antibody levels are observed in patients with a history of SARS-CoV-2 infection prior to vaccination. Our results thus suggest that adapted vaccination schedules may be required to induce immunity in at-risk, anti-TNF-treated patients.
PB - Springer Nature
UR - https://discovery.dundee.ac.uk/en/publications/8bb21c50-753b-407f-ad9d-9e30c2ac5e3b
KW - Coronavirus (COVID-19)
ER