Despite receiving biologics, IBD patients develop antibodies after COVID-19 vaccines
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Serological responses from patients with inflammatory bowel disease on biologic therapies had 100% seropositivity after two doses of the COVID-19 mRNA vaccinations, according to a study published in Gastroenterology.
“Based upon recent studies of antibodies in patients who have had COVID-19 or just one of two vaccine doses, concerns have been raised whether IBD patients receiving biological therapies can mount immune responses to COVID-19 vaccination,” lead author, Serre-Yu Wong, MD, PhD, instructor, division of gastroenterology, Icahn School of Medicine at Mount Sinai, told Healio Gastroenterology. “Reassuringly, our study shows that all patients, regardless of medication type or timing of medications, made antibodies after completing both mRNA vaccine doses.”
Wong and colleagues enrolled 48 patients in the COVID-19 Therapeutic Infusion study, an ongoing survey of SARS-CoV-2 in people with IBD. The analysis included 23 patients with Crohn’s disease and 25 patients with ulcerative colitis.
The vaccinations included in the evaluation were the SARS-CoV-2 spike(S) mRNA BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (NIH-Moderna).
Researchers said specimens were collected at routine infusion center and clinic appointments, which were not timed to vaccination dates.
The control group comprised 14 completely vaccinated health care workers (HCW) without IBD who underwent a single blood draw and 29 vaccinated healthy volunteers without IBD who underwent serial blood draws after vaccination. Investigators also included results from antibody testing of 21 patients infected with SARS-CoV-2.
“IBD patient and HCW sera were analyzed using the (1) Siemens Healthineers COV2T and sCOVG assays testing for total immunoglobulins (Igs) and IgG, respectively, to the receptor binding domain (RBD) of the SARS-CoV-2 S protein and (2) Roche assay for antibodies to nucleocapsid protein,” the researchers wrote.
The 26 IBD patients who completed two-dose vaccine schedules had positive anti-RBD tests, according to Wong and colleagues. Of these patients, eight received TNF antagonist monotherapy, 12 Entyvio (vedolizumab, Takeda) monotherapy, two Stelara (ustekinumab, Janssen), and four received no medications.
“Analyses of the effects of anti-TNF and vedolizumab monotherapy on serological response in these patients revealed that anti-TNFs were associated with lower anti-RBD total Ig only (P = .0299), and vedolizumab was associated with lower anti-RBD total Ig (P = .0069), anti-RBD IgG (P = .045), and anti-S IgG (P = .0043) than in HCW controls,” the investigators wrote.
Wong and colleagues reported two patients with IBD with prior COVID-19 infection after a single dose achieved high index values, which were higher than values achieved from natural SARS-CoV-2 infection.
“Thus, at this time, while we will continue to follow our patients closely, we recommend for patients not to delay COVID-19 vaccinations and to continue biologics without interruption while getting vaccinated,” they said.
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