Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab.
Authors
Reynolds, Catherine J
Seoane, Rocio Castro
Kottoor, Sherine H
Pieper, Franziska P
Lin, Kai-Min
Butler, David K
Nice, Rachel
Chee, Desmond
Janjua, Malik
McDonald, Timothy J
Alexander, James L
Lee, James C
Murray, Charles D
Hart, Ailsa L
Irving, Peter M
Jones, Gareth-Rhys
Kok, Klaartje B
Altmann, Daniel M
Powell, Nick
CLARITY IBD study
Publication Date
2022-03-16Journal Title
Nat Commun
ISSN
2041-1723
Publisher
Springer Science and Business Media LLC
Volume
13
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Lin, S., Kennedy, N. A., Saifuddin, A., Sandoval, D. M., Reynolds, C. J., Seoane, R. C., Kottoor, S. H., et al. (2022). Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab.. Nat Commun, 13 (1) https://doi.org/10.1038/s41467-022-28517-z
Description
Funder: Royal Devon and Exeter NHS Foundation Trust (Royal Devon & Exeter NHS Foundation Trust); doi: https://doi.org/10.13039/100009745
Funder: Roche (F. Hoffmann-La Roche Ltd); doi: https://doi.org/10.13039/100004337
Funder: Celltrion Healthcare; doi: https://doi.org/10.13039/100010780
Funder: NIHR Imperial Biomedical Research Centre, Hull University Teaching Hospital NHS Trust, UKRI (MR/V036939/1), Biogen GmbH (Switzerland), Takeda (UK), and Galapagos NV (Belgium).
Abstract
Anti tumour necrosis factor (anti-TNF) drugs increase the risk of serious respiratory infection and impair protective immunity following pneumococcal and influenza vaccination. Here we report SARS-CoV-2 vaccine-induced immune responses and breakthrough infections in patients with inflammatory bowel disease, who are treated either with the anti-TNF antibody, infliximab, or with vedolizumab targeting a gut-specific anti-integrin that does not impair systemic immunity. Geometric mean [SD] anti-S RBD antibody concentrations are lower and half-lives shorter in patients treated with infliximab than vedolizumab, following two doses of BNT162b2 (566.7 U/mL [6.2] vs 4555.3 U/mL [5.4], p <0.0001; 26.8 days [95% CI 26.2 - 27.5] vs 47.6 days [45.5 - 49.8], p <0.0001); similar results are also observed with ChAdOx1 nCoV-19 vaccination (184.7 U/mL [5.0] vs 784.0 U/mL [3.5], p <0.0001; 35.9 days [34.9 - 36.8] vs 58.0 days [55.0 - 61.3], p value < 0.0001). One fifth of patients fail to mount a T cell response in both treatment groups. Breakthrough SARS-CoV-2 infections are more frequent (5.8% (201/3441) vs 3.9% (66/1682), p = 0.0039) in patients treated with infliximab than vedolizumab, and the risk of breakthrough SARS-CoV-2 infection is predicted by peak anti-S RBD antibody concentration after two vaccine doses. Irrespective of the treatments, higher, more sustained antibody levels are observed in patients with a history of SARS-CoV-2 infection prior to vaccination. Our results thus suggest that adapted vaccination schedules may be required to induce immunity in at-risk, anti-TNF-treated patients.
Keywords
Article, /631/250/590, /692/4020/1503/257, /631/250/2152/2153, /631/326/596/4130, article
Identifiers
s41467-022-28517-z, 28517
External DOI: https://doi.org/10.1038/s41467-022-28517-z
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335091
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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