Patients With Inflammatory Bowel Diseases Have Impaired Antibody Production After Anti-SARS-CoV-2 Vaccination: Results From a Panhellenic Registry

• Published in: Inflammatory bowel diseases 2023-02, Vol.29 (2), p.228-237
• Main Authors: Zacharopoulou, Eirini, Orfanoudaki, Eleni, Tzouvala, Maria, Tribonias, George, Kokkotis, Georgios, Kitsou, Vassiliki, Almpani, Foteini, Christidou, Aggeliki, Viazis, Nikolaos, Mantzaris, Gerassimos J, Tsafaridou, Maria, Karmiris, Konstantinos, Theodoropoulou, Angeliki, Papathanasiou, Evgenia, Zampeli, Evanthia, Michopoulos, Spyridon, Tigkas, Stefanos, Michalopoulos, Georgios, Laoudi, Efrossini, Karatzas, Pantelis, Mylonas, Iordanis, Kyriakos, Nikolaos, Liatsos, Christos, Kafetzi, Theodora, Theocharis, Georgios, Taka, Styliani, Panagiotopoulou, Konstantina, Koutroubakis, Ioannis E, Bamias, Giorgos
• Format: Article
• Language: English
• Subjects: Antibodies, Viral; Antibody Formation; COVID-19 - prevention & control; COVID-19 Vaccines; Humans; Inflammatory Bowel Diseases - drug therapy; Male; Middle Aged; Original s - Clinical; Prospective Studies; SARS-CoV-2; Vaccination; Viral Vaccines
• ISSN: 1078-0998; 1536-4844
• DOI: 10.1093/ibd/izac068

Abstract Background Four EMA-approved vaccines against SARS-CoV-2 are currently available. Data regarding antibody responses to initial vaccination regimens in patients with inflammatory bowel diseases (IBD) are limited. Methods We conducted a prospective, controlled, multicenter study in tertiary Greek IBD centers. Participating patients had completed the initial vaccination regimens (1 or 2 doses, depending on the type of COVID-19 vaccine) at least 2 weeks before study enrolment. Anti-S1 IgG antibody levels were measured. Demographic and adverse events data were collected. Results We tested 403 patients (Crohn’s disease, 58.9%; male, 53.4%; median age, 45 years) and 124 healthy controls (HCs). Following full vaccination, 98% of patients seroconverted, with mRNA vaccines inducing higher seroconversion rates than viral vector vaccines (P = .021). In total, IBD patients had lower anti-S1 levels than HCs (P < .001). In the multivariate analysis, viral vector vaccines (P < .001), longer time to antibody testing (P < .001), anti-TNFα treatment (P = .013), and age (P = .016) were independently associated with lower anti-S1 titers. Vedolizumab monotherapy was associated with higher antibody levels than anti-TNFα or anti-interleukin-12/IL-23 monotherapy (P = .023 and P = .032). All anti- SARS-CoV-2 vaccines were safe. Conclusions Patients with IBD have impaired antibody responses to anti-SARS-CoV-2 vaccination, particularly those receiving viral vector vaccines and those on anti-TNFα treatment. Older age also hampers antibody production after vaccination. For those low-response groups, administration of accelerated or prioritized booster vaccination may be considered. Lay Summary Thisis a multicenter study on IBD patients after COVID-19 vaccination and anti-S1 IgG antibody levels measurement. Patients with IBD have lower antibody responses than healthy controls, particularly those receiving viral vector vaccines and those on anti-TNFα or combination treatment.