Serologic response to COVID-19 mRNA vaccine reduced in IBD patients on anti-TNFα

Patients with IBS treated with anti-TNFα showed a reduced immune response to COVID-19 mRNA vaccines compared to IBD patients without anti-TNFα treatment and healthy controls.

The study examined immunogenicity and safety of the BNT 162b2 mRNA vaccine

IBD patients are exposed to infections, and they need (COVID-19) vaccines. However, anti-TNFα therapy has been associated with a reduced immune response to vaccines, stated Ms Hadar Edelman-Klapper (Rabin Medical Center, Israel)1. To what extent IBD patients on anti-TNFα therapy show a decreased immune response to COVID-19 mRNA vaccines has not yet been investigated.

Therefore, the current study examines the immunogenicity and safety of the BNT 162b2 mRNA vaccine in IBD patients stratified by treatment type (anti-TNFα: n=67, non-anti-TNFα: n=118) and healthy controls (n=73). Primary outcome measures are the seropositivity rate and the magnitude of the immune response. IBD patients treated with anti-TNFα showed a lower serological response than healthy controls and IBD patients on non-anti-TNFα therapies (P<0.001) after the second dose of the mRNA vaccine.

Modification of the timing of the vaccine will not change study results

Interestingly, after the first vaccine dose, a significantly lower number of the anti-TNFα patients had reached the seropositivity threshold of 50 Arbitrary Units/ml, compared with non-anti-TNFα receivers and healthy controls. Nonetheless, infection rate after the second vaccination was less than 2% in all groups and adverse events rates did not differ between anti-TNFα receivers, non-anti-TNF α receivers, and healthy controls.

The authors did not find correlations between vaccine response and drug levels, anti-drug antibodies, or interval time between drug and vaccine administration. This suggests that modification of the timing of the vaccine will not change the results of this study.

Reference
  1. Edelman-Klapper H, et al. Decreased Serologic Response to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases Treated with Anti-TNFα: A Prospective, Multi-Center Israeli Study. OP020, UEG Week 2021 Virtual Congress, 3-5 October.