Imperial College London
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DrJamesAlexander

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Senior Lecturer
 
 
 
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Contact

 

j.alexander

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Alexander:2022:10.1016/S2468-1253(22)00274-6,
author = {Alexander, J and Liu, Z and Munoz, Sandoval D and Reynolds, C and Ibraheim, H and Saifuddin, M and Constable, L and Altmann, D and Balarajah, S and Hicks, L and Williams, H and Teare, J and Hart, A and Boyton, R and Powell, N},
doi = {10.1016/S2468-1253(22)00274-6},
journal = {The Lancet Gastroenterology & Hepatology},
pages = {1005--1015},
title = {COVID-19 vaccine-induced antibody and T cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose: a multicentre, prospective, case-control study},
url = {http://dx.doi.org/10.1016/S2468-1253(22)00274-6},
volume = {7},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:COVID-19 vaccine-induced antibody responses are reduced in patients with inflammatory bowel disease (IBD) taking anti-TNF or tofacitinib after two vaccine doses. We sought to determine whether immunosuppressive treatments were associated with reduced antibody and T cell responses after a third vaccine dose.Methods:352 adults (72 healthy controls and 280 IBD) were sampled 28-49 days after a third dose of SARS-CoV-2 vaccine. IBD medications studied included thiopurines (n=65), infliximab (n=46), thiopurine/infliximab combination therapy (n=49), ustekinumab (n=44), vedolizumab (n=50) or tofacitinib (n=26). SARS-CoV-2 spike antibody binding and T cell responses were measured. Findings:Geometric mean [geometric SD] anti-S1 RBD antibody concentrations increased in all groups following a third dose, but were significantly lower in patients treated with infliximab (2736.8 U/mL [4.3]; P<0.0001), infliximab and thiopurine combination (1818.3 U/mL [6.7]; P<0.0001) and tofacitinib (8071.5 U/mL [3.1]; P=0.0018) compared to controls (16774.2 U/ml [2.6]). There were no significant differences in anti-S1 RBD antibody concentrations between control subjects and thiopurine (12019.7 U/mL [2.2]; P=0.099), ustekinumab (11089.3 U/mL [2.8]; P=0.060), nor vedolizumab treated patients (13564.9 U/mL [2.4]; P=0.27). In multivariable modelling, lower anti-S1 RBD antibody concentrations were independently associated with infliximab (Geometric mean ratio 0.15, 95% CI 0.11-0.21, P<0.0001), tofacitinib (0.52, 95% CI 0.31-0.87, P=0.012) and thiopurine (0.69, 95% CI 0.51-0.95, P=0.021), but not with ustekinumab (0.64, 95% CI 0.39-1.06, P=0.083), or vedolizumab (0.84, 95% CI 0.54-1.30, P=0.43). Previous SARS-CoV-2 infection (1.58, 95% CI 1.22-2.05, P=0.00056) and older age (0.88, 95% CI 0.80-0.97, P=0.0073) were independently associated with higher and lower anti-S1 antibody concentrations respectively. Antigen specific T cell responses were similar  in all groups, except for reci
AU  - Alexander,J
AU  - Liu,Z
AU  - Munoz,Sandoval D
AU  - Reynolds,C
AU  - Ibraheim,H
AU  - Saifuddin,M
AU  - Constable,L
AU  - Altmann,D
AU  - Balarajah,S
AU  - Hicks,L
AU  - Williams,H
AU  - Teare,J
AU  - Hart,A
AU  - Boyton,R
AU  - Powell,N
DO  - 10.1016/S2468-1253(22)00274-6
EP  - 1015
PY  - 2022///
SN  - 2468-1253
SP  - 1005
TI  - COVID-19 vaccine-induced antibody and T cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose: a multicentre, prospective, case-control study
T2  - The Lancet Gastroenterology & Hepatology
UR  - http://dx.doi.org/10.1016/S2468-1253(22)00274-6
UR  - https://www.sciencedirect.com/science/article/pii/S2468125322002746?via%3Dihub
UR  - http://hdl.handle.net/10044/1/99045
VL  - 7
ER  -
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