Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD
Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD
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DOI：
10.1136/gutjnl-2021-324789
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发表时间：
2021-10-01
期刊：
影响因子：
24.5
通讯作者：
Ahmad, Tariq
中科院分区：
文献类型：
--
作者：
Kennedy, Nicholas A.;Lin, Simeng;Ahmad, Tariq
目的延迟第二次接种SARS-CoV-2疫苗在更多人群中以较低的免疫水平换取最大的有效性。我们调查了接受英夫利昔单抗治疗的炎症性肠病患者对单剂量SARS-CoV-2疫苗的血清学反应是否减弱。研究比较了英夫利昔单抗治疗的患者（n=865）与vedolizumab治疗的患者（n=428）的抗体反应和血清转换率，vedolizumab是一种肠道选择性抗整合素α 4 β 7单克隆抗体。我们的主要结局是在接种疫苗后3-10周使用Elecsys anti-SARS-CoV-2 spike (S) antibody assay测量无既往感染证据的患者的抗sars - cov -2 spike (S) antibody浓度。次要结局是血清转换率（临界值为15U/mL），以及过去感染或第二剂BNT162b2疫苗后的抗体反应。结果在英夫利昔单抗治疗的患者中，抗sars - cov -2抗体的几何平均（SD）浓度低于维多单抗，其次是BNT162b2 (6.0 U/mL (5.9) vs 28.8 U/mL (5.4) p
Objective Delayed second dose SARS-CoV-2 vaccination trades maximal effectiveness for a lower level of immunity across more of the population. We investigated whether patients with inflammatory bowel disease treated with infliximab have attenuated serological responses to a single dose of a SARS-CoV-2 vaccine.Design Antibody responses and seroconversion rates in infliximab-treated patients (n=865) were compared with a cohort treated with vedolizumab (n=428), a gut-selective anti-integrin alpha 4 beta 7 monoclonal antibody. Our primary outcome was anti-SARS-CoV-2 spike (S) antibody concentrations, measured using the Elecsys anti-SARS-CoV-2 spike (S) antibody assay 3-10 weeks after vaccination, in patients without evidence of prior infection. Secondary outcomes were seroconversion rates (defined by a cut-off of 15U/mL), and antibody responses following past infection or a second dose of the BNT162b2 vaccine.Results Geometric mean (SD) anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab than vedolizumab, following BNT162b2 (6.0 U/mL (5.9) vs 28.8 U/mL (5.4) p