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dc.contributor.authorLin, Simeng
dc.contributor.authorKennedy, Nicholas A
dc.contributor.authorSaifuddin, Aamir
dc.contributor.authorSandoval, Diana Muñoz
dc.contributor.authorReynolds, Catherine J
dc.contributor.authorSeoane, Rocio Castro
dc.contributor.authorKottoor, Sherine H
dc.contributor.authorPieper, Franziska P
dc.contributor.authorLin, Kai-Min
dc.contributor.authorButler, David K
dc.contributor.authorChanchlani, Neil
dc.contributor.authorNice, Rachel
dc.contributor.authorChee, Desmond
dc.contributor.authorBewshea, Claire
dc.contributor.authorJanjua, Malik
dc.contributor.authorMcDonald, Timothy J
dc.contributor.authorSebastian, Shaji
dc.contributor.authorAlexander, James L
dc.contributor.authorConstable, Laura
dc.contributor.authorLee, James C
dc.contributor.authorMurray, Charles D
dc.contributor.authorHart, Ailsa L
dc.contributor.authorIrving, Peter M
dc.contributor.authorJones, Gareth-Rhys
dc.contributor.authorKok, Klaartje B
dc.contributor.authorLamb, Christopher A
dc.contributor.authorLees, Charlie W
dc.contributor.authorAltmann, Daniel M
dc.contributor.authorBoyton, Rosemary J
dc.contributor.authorGoodhand, James R
dc.contributor.authorPowell, Nick
dc.contributor.authorAhmad, Tariq
dc.contributor.authorCLARITY IBD study
dc.date.accessioned2022-03-17T10:04:25Z
dc.date.available2022-03-17T10:04:25Z
dc.date.issued2022-03-16
dc.date.submitted2021-09-30
dc.identifier.issn2041-1723
dc.identifier.others41467-022-28517-z
dc.identifier.other28517
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/335091
dc.descriptionFunder: Royal Devon and Exeter NHS Foundation Trust (Royal Devon & Exeter NHS Foundation Trust); doi: https://doi.org/10.13039/100009745
dc.descriptionFunder: Roche (F. Hoffmann-La Roche Ltd); doi: https://doi.org/10.13039/100004337
dc.descriptionFunder: Celltrion Healthcare; doi: https://doi.org/10.13039/100010780
dc.descriptionFunder: NIHR Imperial Biomedical Research Centre, Hull University Teaching Hospital NHS Trust, UKRI (MR/V036939/1), Biogen GmbH (Switzerland), Takeda (UK), and Galapagos NV (Belgium).
dc.description.abstractAnti 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.
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.subjectArticle
dc.subject/631/250/590
dc.subject/692/4020/1503/257
dc.subject/631/250/2152/2153
dc.subject/631/326/596/4130
dc.subjectarticle
dc.titleAntibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab.
dc.typeArticle
dc.date.updated2022-03-17T10:04:24Z
prism.issueIdentifier1
prism.publicationNameNat Commun
prism.volume13
dc.identifier.doi10.17863/CAM.82533
dcterms.dateAccepted2022-01-26
rioxxterms.versionofrecord10.1038/s41467-022-28517-z
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidLin, Simeng [0000-0002-4201-4879]
dc.contributor.orcidKennedy, Nicholas A [0000-0003-4368-1961]
dc.contributor.orcidSaifuddin, Aamir [0000-0002-5888-5556]
dc.contributor.orcidSandoval, Diana Muñoz [0000-0001-8350-3989]
dc.contributor.orcidChanchlani, Neil [0000-0003-0207-6706]
dc.contributor.orcidBewshea, Claire [0000-0002-0965-9587]
dc.contributor.orcidSebastian, Shaji [0000-0002-3670-6545]
dc.contributor.orcidConstable, Laura [0000-0003-1043-9888]
dc.contributor.orcidLamb, Christopher A [0000-0002-7271-4956]
dc.contributor.orcidLees, Charlie W [0000-0002-0732-8215]
dc.contributor.orcidBoyton, Rosemary J [0000-0002-5608-0797]
dc.contributor.orcidGoodhand, James R [0000-0003-3112-376X]
dc.contributor.orcidAhmad, Tariq [0000-0002-6058-5528]
dc.identifier.eissn2041-1723
cam.issuedOnline2022-03-16


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