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10.1136/gutjnl-2021-324789

http://scihub22266oqcxt.onion/10.1136/gutjnl-2021-324789
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33903149!ä!33903149

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suck abstract from ncbi


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pmid33903149      Gut 2021 ; 70 (10): 1884-1893
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  • Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD #MMPMID33903149
  • Kennedy NA; Lin S; Goodhand JR; Chanchlani N; Hamilton B; Bewshea C; Nice R; Chee D; Cummings JF; Fraser A; Irving PM; Kamperidis N; Kok KB; Lamb CA; Macdonald J; Mehta S; Pollok RC; Raine T; Smith PJ; Verma AM; Jochum S; McDonald TJ; Sebastian S; Lees CW; Powell N; Ahmad T
  • Gut 2021[Oct]; 70 (10): 1884-1893 PMID33903149show ga
  • 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 alpha4beta7 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 15 U/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<0.0001) and ChAdOx1 nCoV-19 (4.7 U/mL (4.9)) vs 13.8 U/mL (5.9) p<0.0001) vaccines. In our multivariable models, antibody concentrations were lower in infliximab-treated compared with vedolizumab-treated patients who received the BNT162b2 (fold change (FC) 0.29 (95% CI 0.21 to 0.40), p<0.0001) and ChAdOx1 nCoV-19 (FC 0.39 (95% CI 0.30 to 0.51), p<0.0001) vaccines. In both models, age >/=60 years, immunomodulator use, Crohn's disease and smoking were associated with lower, while non-white ethnicity was associated with higher, anti-SARS-CoV-2 antibody concentrations. Seroconversion rates after a single dose of either vaccine were higher in patients with prior SARS-CoV-2 infection and after two doses of BNT162b2 vaccine. CONCLUSION: Infliximab is associated with attenuated immunogenicity to a single dose of the BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Vaccination after SARS-CoV-2 infection, or a second dose of vaccine, led to seroconversion in most patients. Delayed second dosing should be avoided in patients treated with infliximab. TRIAL REGISTRATION NUMBER: ISRCTN45176516.
  • |Adult[MESH]
  • |Antibodies, Monoclonal, Humanized/therapeutic use[MESH]
  • |Antibodies, Viral/immunology[MESH]
  • |Antibody Formation/immunology[MESH]
  • |BNT162 Vaccine[MESH]
  • |COVID-19 Vaccines/administration & dosage/*immunology[MESH]
  • |COVID-19/immunology/*prevention & control[MESH]
  • |ChAdOx1 nCoV-19[MESH]
  • |Female[MESH]
  • |Gastrointestinal Agents/*adverse effects[MESH]
  • |Humans[MESH]
  • |Inflammatory Bowel Diseases/*drug therapy[MESH]
  • |Infliximab/*therapeutic use[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |SARS-CoV-2[MESH]


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