Patients with IBD have 'robust' response to COVID-19 vaccines
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Adults with inflammatory bowel disease produced strong antibody responses to messenger RNA COVID-19 vaccines, according to findings published in Annals of Internal Medicine.
Researchers said the findings may “reassure” patients receiving immunosuppressive therapy for inflammatory bowel disease (IBD) that “initial humoral responses to mRNA vaccines are generally robust.”
“For some, like organ transplant recipients and people undergoing chemotherapy, there is a significant portion of immunocompromised patients who do not respond to vaccination, and those patients need to be treated with special guidelines,” Gil Melmed, MD, the director of IBD clinical research at Cedars-Sinai Medical Center, told Healio Primary Care. “But other forms of immune suppression like medications that are used to treat IBD reassuringly demonstrate that the overwhelming proportion of patients do respond, and so not all immune suppression is the same.”
Melmed and colleagues assessed antibody titers in adults with IBD on different medication regimens following mRNA COVID-19 vaccination. They evaluated antibody levels from 5 days after the first dose up until the day of the second dose, and then around 2 weeks, 8 weeks and 16 weeks after the second dose.
Melmed and colleagues enrolled 582 participants in total. Their mean age was 44 years; 35% were women. Also, 59% received the Pfizer-BioNTech vaccine and 41% received the Moderna vaccine. The medications that participants were receiving at the time of vaccination included anti-integrin therapy, anti-interleukin-12/23 therapy, immunomodulator monotherapy, anti-tumor necrosis factor monotherapy, Janus kinase inhibitors, systemic corticosteroids and anti-tumor necrosis factor therapy with an immunomodulator.
Overall, 49% of participants had positive levels of antibodies after their first vaccine dose, 92% after their second dose and 99% 2 weeks after the second dose, according to Melmed and colleagues.
Quantitative levels peaked at 2 weeks and then decreased across all groups, according to the researchers. After 8 weeks, antibody levels were lowest in participants on anti-tumor necrosis factor combination therapy or corticosteroids and higher in those on anti-integrin and anti-interleukin-12/23 therapy. However, the researchers noted that “the study was not powered to assess differences across medication subgroups.” They also noted that antibody responses in patients with IBD were similar to those of patients who were not immunocompromised.
The findings suggest that patients receiving treatment for IBD may not need to receive a COVID-19 booster shot early, according to Melmed.
“It’s very possible that these patients could wait the full 6 months like others for receiving a booster dose and do not necessarily need a third dose as part of their primary series to achieve protection,” he said.
References:
COVID-19 vaccine gets strong response in some with weak immunity. https://www.cedars-sinai.org/newsroom/covid-19-vaccine-gets-strong-response-in-some-with-weak-immunity/. Published Nov. 2, 2021. Accessed Nov. 3, 2021.
Melmed GY, et al. Ann Int Med. 2021;doi:10.7326/M21-2483.