Decrease in uptake of SARS-CoV-2 vaccine in patients with inflammatory bowel disease on intravenous biological therapy.
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ABSTRACT:
SUBMITTER: Selim R
PROVIDER: S-EPMC9492423 | biostudies-literature | 2022 Nov
REPOSITORIES: biostudies-literature
Publications
Decrease in uptake of SARS-CoV-2 vaccine in patients with inflammatory bowel disease on intravenous biological therapy.
Selim Rania R Wellens Judith J Brann Stephanie S Marlow Luke L Adams Alex A Satsangi Jack J JJ
The lancet. Gastroenterology & hepatology 20220922 11
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| S-EPMC8514341 | biostudies-literature
Project description:Background and aimsSARS-CoV-2 is a worldwide serious health problem and vaccination seems to have a crucial role in managing the COVID-19 pandemic. The aim of this prospective observational study was to monitor the trend of antibodies against SARS-CoV-2 after vaccination with BNT162b2 (COMIRNATY) in patients with inflammatory bowel disease treated by immunosuppressive and/or biological therapy, demonstrate whether any type of this therapy is associated with poorer production of antibodies against COVID-19 and evaluate the safety of vaccination against COVID-19 in these patients.MethodsEighty-seven eligible patients from one tertiary gastroenterological center with inflammatory bowel disease (60 with CD, 27 with UC) treated by immunosuppressive and/or biological therapy from the antiTNFα group were indicated to vaccination against SARS-CoV-2. Effectiveness of vaccination was evaluated by the values of antibodies before and 4 weeks after 2nd dose of vaccine. Additional goal was to evaluate adverse events of vaccination.ResultsBefore the 2nd dose of vaccine, geometric mean of SARS-CoV-2 IgG antibodies were 40.7 U/ml in the biological therapy group, 34.8 U/ml in the azathioprine group and 44.8 U/ml in the combination therapy group of patients. The geometric means were 676.5.7 U/ml in the biological therapy group, 614.4 U/ml in the azathioprine group and 500.1 U/ml in the combination therapy group of patients four weeks after 2nd dose. Statistically significant differences between these groups were not proved. Several non-severe local and general adverse events were present in our patients with a majority of these events on the day of vaccine administration and the day after, no anaphylactic reactions were present.ConclusionsOur measurements proved the efficacy and safety of vaccination against SARS-CoV-2 in patients with inflammatory bowel disease treated by immunosuppressive and/or biological therapy. Statistically significant differences between our groups of patients were not proved.
| S-EPMC9439210 | biostudies-literature
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| S-EPMC8863433 | biostudies-literature
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| S-EPMC8986165 | biostudies-literature
Project description:IntroductionThere are limited data on the safety profile of the severe acute respiratory syndrome coronavirus-2 vaccine among patients taking immunosuppressive medications. Our aim was to evaluate the adverse events related to the vaccines in a nationwide cohort of patients with inflammatory bowel disease on diverse immunosuppressive medications.MethodsThis was a retrospective cohort study using data from the Veterans Health Administration. The primary outcome was any adverse event of special interest (cerebrovascular accident, venous thromboembolism, acute myocardial infarction, Bell palsy) within 90 days of vaccination.ResultsA total of 17,201 patients were included, and 12,351 patients (71.8%) received at least 1 vaccine dose. The most common adverse events were acute myocardial infarction and venous thromboembolism. In inverse probability treatment weighting-adjusted logistic regression, full vaccination was not significantly associated with increased adverse events through 90 days, relative to unvaccinated patients.DiscussionFull severe acute respiratory syndrome coronavirus-2 vaccination was not associated with an increased rate of key adverse events relative to unvaccinated individuals among patients with inflammatory bowel disease.
| S-EPMC10132715 | biostudies-literature
Project description:BackgroundThe severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine is thought to be the most effective preventive method of controlling the coronavirus disease 2019 (COVID-19) epidemic. Some patients with immune-related diseases, including inflammatory bowel disease (IBD) patients, however, may hesitate to be vaccinated for various reasons. Although several guidelines recommend vaccinating all IBD patients with inactivated SARS-CoV-2 vaccines, there is still a lack of real-world data on the safety of inactivated SARS-CoV-2 vaccines and COVID-19 vaccination rate in IBD patients. In this study, we investigated the reasons for hesitancy in COVID-19 vaccination, the COVID-19 vaccination rate, and the safety of SARS-CoV-2-inactivated vaccination in patients with IBD.MethodsThis was a retrospective study. A total of 418 participants with IBD were enrolled to calculate the vaccination rates. A total of 232 patients with IBD who did not receive SARS-CoV-2 vaccination were recruited to investigate the reasons for hesitation. A follow-up survey of 151 IBD patients and 188 healthy participants who had received the SARS-CoV-2-inactivated vaccination was conducted to analyze adverse reactions.ResultsThe COVID-19 vaccination rate was 49.3% and almost half of the participants were 'Concerned about the safety of the vaccine (such as adverse reactions) due to IBD'. After SARS-CoV-2 vaccination, adverse reactions were mild or moderate. The adverse reactions in the IBD and non-IBD populations were roughly the same, and IBD medications did not increase the risk of adverse reactions.ConclusionSARS-CoV-2-inactivated vaccination rates in IBD patients are still low and a significant proportion of patients are hesitant about the vaccine because of safety concerns. SARS-CoV-2-inactivated vaccination in patients with IBD appears to be safe.
| S-EPMC9189530 | biostudies-literature
Project description:Suboptimal vaccine response is a significant concern in patients with Inflammatory Bowel Disease (IBD) receiving biologic drugs. This single-center observational study involved 754 patients with IBD. In Phase I (October 2020-April 2021), 754 IBD participants who had not previously received the SARS-CoV-2 vaccine, underwent blood extraction to assess the seroprevalence of SARS-CoV-2 infection and IBD-related factors. Phase II (May 2021-October 2021) included a subgroup of 52 IBD participants with confirmed previous SARS-CoV-2 infection, who were studied for humoral and cellular response to the SARS-CoV-2 vaccine. In Phase I, treatment with anti-TNF was associated with lower rates of seroconversion (aOR 0.25 95% CI [0.10-0.61]). In Phase II, a significant increase in post-vaccination IgG levels was observed regardless of biologic treatment. However, patients treated with anti-TNF exhibited significantly lower IgG levels compared to those without IBD therapy (5.32 ± 2.47 vs. 7.99 ± 2.59 U/ml, p = 0.042). Following vaccination, a lymphocyte, monocyte, and NK cell activation pattern was observed, with no significant differences between patients receiving biologic drugs and those without IBD treatment. Despite lower seroprevalence and humoral response to the SARS-CoV-2 vaccine in patients treated with anti-TNF, the cellular response to the vaccine did not differ significantly from that patients without IBD therapy.
| S-EPMC10754931 | biostudies-literature
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| S-EPMC9597523 | biostudies-literature
Project description:Dysregulated immune responses contribute to the excessive and uncontrolled inflammation observed in severe COVID-19. However, how immunity to SARS-CoV-2 is induced and regulated remains unclear. Here we uncover a role of the complement system in the induction of innate and adaptive immunity to SARS-CoV-2. Complement rapidly opsonizes SARS-CoV-2 particles via the lectin pathway. Complement-opsonized SARS-CoV-2 efficiently induces type-I interferon and pro-inflammatory cytokine responses via activation of dendritic cells, which are inhibited by antibodies against the complement receptors (CR) 3 and 4. Serum from COVID-19 patients, or monoclonal antibodies against SARS-CoV-2, attenuate innate and adaptive immunity induced by complement-opsonized SARS-CoV-2. Blocking of CD32, the FcγRII antibody receptor of dendritic cells, restores complement-induced immunity. These results suggest that opsonization of SARS-CoV-2 by complement is involved in the induction of innate and adaptive immunity to SARS-CoV-2 in the acute phase of infection. Subsequent antibody responses limit inflammation and restore immune homeostasis. These findings suggest that dysregulation of the complement system and FcγRII signaling may contribute to severe COVID-19.
| S-SCDT-10_1038-S44318-024-00061-0 | biostudies-other
Project description:BackgroundLong-term biological therapies for inflammatory bowel disease (IBD) include infliximab and vedolizumab, which are administered intravenously. Although highly effective, non-adherence to these biologics is common and is associated with adverse sequelae and loss of response.ObjectiveIn this study, we aim to characterize long-term intravenous biologic adherence trajectories among IBD patients and identify the factors linked with these trajectories.MethodsWe conducted a retrospective multicenter study of IBD patients over 2 years to assess their adherence to infliximab and vedolizumab. The date of infusion was determined based on medical and pharmacy records. Using group-based trajectory modeling (GBTM), adherence trajectories were identified based on patients' 90-day coverage of days over time. The effect of relevant variables on adherence behavior was assessed using multinomial regression analysis.Results374 patients with IBD were included in the study, 68.2% males with a median age of 34.3 (IQR 28.0-44.4) years old. Three distinct adherence trajectories were identified for intravenous biologics: "consistent adherence" (n = 136, 36.4%), "slow decline" (n = 137, 36.6%) and "rapid decline" (n = 101, 27.0%). Compared with consistent adherence, concomitant use of aminosalicylates (OR 3.49, 95% CI 1.34-9.05) was associated with a significantly greater risk of rapid decline. Conversely, being married at the initiation of biologics (OR 0.43, 95% CI 0.19-0.95) and having been hospitalized within preceding years (OR 0.44, 95% CI 0.23-0.88) appeared to have a protective effect against rapid decline. Additionally, being male (OR 0.57, 95% CI 0.32-1.01) was found to be protective against slow decline.ConclusionDistinct adherence patterns for infusion biologics among IBD patients have been identified, offering valuable insights to refine the design and timing of adherence interventions. However, only limited factors were found to be associated with specific adherence trajectories, revealing the complex nature of adherence behavior.
| S-EPMC11634588 | biostudies-literature