BibTex format
@article{Kennedy:2021:10.1136/gutjnl-2021-324388,
author = {Kennedy, NA and Goodhand, JR and Bewshea, C and Nice, R and Chee, D and Lin, S and Chanchlani, N and Butterworth, J and Cooney, R and Croft, NM and Hart, AL and Irving, PM and Kok, KB and Lamb, CA and Limdi, JK and Macdonald, J and McGovern, DP and Mehta, SJ and Murray, CD and Patel, KV and Pollok, RC and Raine, T and Russell, RK and Selinger, CP and Smith, PJ and Bowden, J and McDonald, TJ and Lees, CW and Sebastian, S and Powell, N and Ahmad, T and Contributors, to the CLARITY IBD study},
doi = {10.1136/gutjnl-2021-324388},
journal = {Gut},
pages = {865--875},
title = {Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab},
url = {http://dx.doi.org/10.1136/gutjnl-2021-324388},
volume = {70},
year = {2021}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - OBJECTIVE: Antitumour necrosis factor (anti-TNF) drugs impair protective immunity following pneumococcal, influenza and viral hepatitis vaccination and increase the risk of serious respiratory infections. We sought to determine whether infliximab-treated patients with IBD have attenuated serological responses to SARS-CoV-2 infections. DESIGN: Antibody responses in participants treated with infliximab were compared with a reference cohort treated with vedolizumab, a gut-selective anti-integrin α4β7 monoclonal antibody that is not associated with impaired vaccine responses or increased susceptibility to systemic infections. 6935 patients were recruited from 92 UK hospitals between 22 September and 23 December 2020. RESULTS: Rates of symptomatic and proven SARS-CoV-2 infection were similar between groups. Seroprevalence was lower in infliximab-treated than vedolizumab-treated patients (3.4% (161/4685) vs 6.0% (134/2250), p<0.0001). Multivariable logistic regression analyses confirmed that infliximab (vs vedolizumab; OR 0.66 (95% CI 0.51 to 0.87), p=0.0027) and immunomodulator use (OR 0.70 (95% CI 0.53 to 0.92), p=0.012) were independently associated with lower seropositivity. In patients with confirmed SARS-CoV-2 infection, seroconversion was observed in fewer infliximab-treated than vedolizumab-treated patients (48% (39/81) vs 83% (30/36), p=0.00044) and the magnitude of anti-SARS-CoV-2 reactivity was lower (median 0.8 cut-off index (0.2-5.6) vs 37.0 (15.2-76.1), p<0.0001). CONCLUSIONS: Infliximab is associated with attenuated serological responses to SARS-CoV-2 that were further blunted by immunomodulators used as concomitant therapy. Impaired serological responses to SARS-CoV-2 infection might have important implications for global public health policy and individual anti-TNF-treated patients. Serological testing and virus surveillance should be considered to detect suboptimal vaccine responses, persistent infection and viral evolution to inform pub
AU - Kennedy,NA
AU - Goodhand,JR
AU - Bewshea,C
AU - Nice,R
AU - Chee,D
AU - Lin,S
AU - Chanchlani,N
AU - Butterworth,J
AU - Cooney,R
AU - Croft,NM
AU - Hart,AL
AU - Irving,PM
AU - Kok,KB
AU - Lamb,CA
AU - Limdi,JK
AU - Macdonald,J
AU - McGovern,DP
AU - Mehta,SJ
AU - Murray,CD
AU - Patel,KV
AU - Pollok,RC
AU - Raine,T
AU - Russell,RK
AU - Selinger,CP
AU - Smith,PJ
AU - Bowden,J
AU - McDonald,TJ
AU - Lees,CW
AU - Sebastian,S
AU - Powell,N
AU - Ahmad,T
AU - Contributors,to the CLARITY IBD study
DO - 10.1136/gutjnl-2021-324388
EP - 875
PY - 2021///
SN - 0017-5749
SP - 865
TI - Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab
T2 - Gut
UR - http://dx.doi.org/10.1136/gutjnl-2021-324388
UR - https://www.ncbi.nlm.nih.gov/pubmed/33753421
UR - https://gut.bmj.com/content/70/5/865
VL - 70
ER -