Humoral immune response to SARS-CoV-2 vaccination in patients with inflammatory bowel disease on immunosuppressive medication: association to serum drug levels and disease type
Immune responses following SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) are not well characterized. The aims of this study were to explore the serological response associated with IBD, and immunosuppressive medications including serum concentrations of biologics and thiop...
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| Veröffentlicht in: | Scandinavian journal of gastroenterology 2023-08, Vol.58 (8), p.874-882 |
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| creator | Jørgensen, Kristin Kaasen Høivik, Marte Lie Chopra, Adity Benth, Jūratė Šaltytė Ricanek, Petr Moum, Prof Bjørn Jyssum, Ingrid Bolstad, Nils Warren, David John Vaage, Prof John T. Munthe, Prof Ludvig A. Lundin, Prof Knut E.A Anisdahl, Karoline Syversen, Silje Watterdal Goll, Guro Løvik Lund-Johansen, Fridtjof Medhus, Asle W. Jahnsen, Prof Jørgen |
| description | Immune responses following SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) are not well characterized. The aims of this study were to explore the serological response associated with IBD, and immunosuppressive medications including serum concentrations of biologics and thiopurine metabolites.
This prospective, observational study included adult patients with ulcerative colitis (UC) and Crohn's disease (CD), and healthy controls. Antibodies to the receptor-binding domain of SARS-CoV-2 spike proteins, and serum concentrations of ongoing biologic and immunomodulatory medications were assessed prior to, and 2-5 weeks after the second vaccine dose. Serologic response was defined as anti-Spike antibodies ≥70 AU/ml.
In 958 IBD patients (380 UC, 578 CD) and 323 healthy controls, the median (Q
1;
Q
3
) anti-Spike antibody level (AU/ml) was lower in patients (618 (192; 4370)) compared to controls (3355 (896; 7849)) (p |
| doi_str_mv | 10.1080/00365521.2023.2177884 |
| format | Article |
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This prospective, observational study included adult patients with ulcerative colitis (UC) and Crohn's disease (CD), and healthy controls. Antibodies to the receptor-binding domain of SARS-CoV-2 spike proteins, and serum concentrations of ongoing biologic and immunomodulatory medications were assessed prior to, and 2-5 weeks after the second vaccine dose. Serologic response was defined as anti-Spike antibodies ≥70 AU/ml.
In 958 IBD patients (380 UC, 578 CD) and 323 healthy controls, the median (Q
1;
Q
3
) anti-Spike antibody level (AU/ml) was lower in patients (618 (192; 4370)) compared to controls (3355 (896; 7849)) (p < 0.001). The antibody levels were lower in CD (439 (174; 3304)) compared to UC (1088 (251; 5975)) (p < 0.001). No associations were demonstrated between antibody levels and serum drug concentrations for TNF inhibitor (TNFi), vedolizumab and ustekinumab. Patients receiving TNFi + thiopurines with a subtherapeutic 6-thioguanine nucleotide (6-TGN) level had higher response rate (93%) compared to patients with 6-TGN within the therapeutic range (53%) (p = 0.003). A diagnosis of UC, mRNA-1273 vaccine, and other treatments than TNFi + thiopurines were associated with humoral response.
Patients with CD had an attenuated humoral response to SARS-COV-2 vaccination as compared to patients with UC. The lack of association between serum levels of biologics and serologic response indicates vaccination regardless of proximity to drug administration.</description><identifier>ISSN: 0036-5521</identifier><identifier>EISSN: 1502-7708</identifier><identifier>DOI: 10.1080/00365521.2023.2177884</identifier><identifier>PMID: 36788656</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>2019-nCoV Vaccine mRNA-1273 ; Adult ; Antibodies, Viral ; biologic medication ; Colitis, Ulcerative - drug therapy ; COVID-19 - prevention & control ; COVID-19 Vaccines ; Crohn Disease - drug therapy ; Humans ; Immunity, Humoral ; Immunogenicity ; Immunosuppressive Agents ; Inflammatory bowel disease ; Inflammatory Bowel Diseases - drug therapy ; Prospective Studies ; SARS-CoV-2 ; SARS-CoV-2 vaccine ; Vaccination</subject><ispartof>Scandinavian journal of gastroenterology, 2023-08, Vol.58 (8), p.874-882</ispartof><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group 2023</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-6a88e29b26b0e0d1e17e03e11eb31edc9b73c082f94c680f2368b36b48c92f313</citedby><cites>FETCH-LOGICAL-c438t-6a88e29b26b0e0d1e17e03e11eb31edc9b73c082f94c680f2368b36b48c92f313</cites><orcidid>0000-0002-2445-1258 ; 0000-0002-0838-1675 ; 0000-0003-1713-5545 ; 0000-0003-2454-7388 ; 0000-0002-0104-465X ; 0000-0003-2041-9100 ; 0000-0001-7118-5127 ; 0000-0002-3693-7706 ; 0000-0002-0419-2914</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,777,882,26548</link.rule.ids><linktorsrc>$$Uhttp://hdl.handle.net/10852/103034$$EView_record_in_NORA$$FView_record_in_$$GNORA$$Hfree_for_read</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36788656$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jørgensen, Kristin Kaasen</creatorcontrib><creatorcontrib>Høivik, Marte Lie</creatorcontrib><creatorcontrib>Chopra, Adity</creatorcontrib><creatorcontrib>Benth, Jūratė Šaltytė</creatorcontrib><creatorcontrib>Ricanek, Petr</creatorcontrib><creatorcontrib>Moum, Prof Bjørn</creatorcontrib><creatorcontrib>Jyssum, Ingrid</creatorcontrib><creatorcontrib>Bolstad, Nils</creatorcontrib><creatorcontrib>Warren, David John</creatorcontrib><creatorcontrib>Vaage, Prof John T.</creatorcontrib><creatorcontrib>Munthe, Prof Ludvig A.</creatorcontrib><creatorcontrib>Lundin, Prof Knut E.A</creatorcontrib><creatorcontrib>Anisdahl, Karoline</creatorcontrib><creatorcontrib>Syversen, Silje Watterdal</creatorcontrib><creatorcontrib>Goll, Guro Løvik</creatorcontrib><creatorcontrib>Lund-Johansen, Fridtjof</creatorcontrib><creatorcontrib>Medhus, Asle W.</creatorcontrib><creatorcontrib>Jahnsen, Prof Jørgen</creatorcontrib><title>Humoral immune response to SARS-CoV-2 vaccination in patients with inflammatory bowel disease on immunosuppressive medication: association to serum drug levels and disease type</title><title>Scandinavian journal of gastroenterology</title><addtitle>Scand J Gastroenterol</addtitle><description>Immune responses following SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) are not well characterized. The aims of this study were to explore the serological response associated with IBD, and immunosuppressive medications including serum concentrations of biologics and thiopurine metabolites.
This prospective, observational study included adult patients with ulcerative colitis (UC) and Crohn's disease (CD), and healthy controls. Antibodies to the receptor-binding domain of SARS-CoV-2 spike proteins, and serum concentrations of ongoing biologic and immunomodulatory medications were assessed prior to, and 2-5 weeks after the second vaccine dose. Serologic response was defined as anti-Spike antibodies ≥70 AU/ml.
In 958 IBD patients (380 UC, 578 CD) and 323 healthy controls, the median (Q
1;
Q
3
) anti-Spike antibody level (AU/ml) was lower in patients (618 (192; 4370)) compared to controls (3355 (896; 7849)) (p < 0.001). The antibody levels were lower in CD (439 (174; 3304)) compared to UC (1088 (251; 5975)) (p < 0.001). No associations were demonstrated between antibody levels and serum drug concentrations for TNF inhibitor (TNFi), vedolizumab and ustekinumab. Patients receiving TNFi + thiopurines with a subtherapeutic 6-thioguanine nucleotide (6-TGN) level had higher response rate (93%) compared to patients with 6-TGN within the therapeutic range (53%) (p = 0.003). A diagnosis of UC, mRNA-1273 vaccine, and other treatments than TNFi + thiopurines were associated with humoral response.
Patients with CD had an attenuated humoral response to SARS-COV-2 vaccination as compared to patients with UC. The lack of association between serum levels of biologics and serologic response indicates vaccination regardless of proximity to drug administration.</description><subject>2019-nCoV Vaccine mRNA-1273</subject><subject>Adult</subject><subject>Antibodies, Viral</subject><subject>biologic medication</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>COVID-19 - prevention & control</subject><subject>COVID-19 Vaccines</subject><subject>Crohn Disease - drug therapy</subject><subject>Humans</subject><subject>Immunity, Humoral</subject><subject>Immunogenicity</subject><subject>Immunosuppressive Agents</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory Bowel Diseases - drug therapy</subject><subject>Prospective Studies</subject><subject>SARS-CoV-2</subject><subject>SARS-CoV-2 vaccine</subject><subject>Vaccination</subject><issn>0036-5521</issn><issn>1502-7708</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>3HK</sourceid><recordid>eNp9kcuKFDEUhoMoTjv6CEqWbqrNpS4pVw6NOsKA4KjbkEqd0kguZZLqpt_KRzRld8_STRLCd74D_4_QS0q2lAjyhhDeNg2jW0YY3zLadULUj9CGNoRVXUfEY7RZmWqFrtCzlH4RQpqu7p-iK94Wum3aDfpzu7gQlcXGucUDjpDm4BPgHPD9zZf7ahe-VwzvldbGq2yCx8bjubzA54QPJv8sH5NVzqkc4hEP4QAWjyaBKpYVX8UhLfNc3MnsATsYjf7neotVSkGbk7isTBAXh8e4_MAW9mATVn58sOXjDM_Rk0nZBC_O9zX69uH9191tdff546fdzV2lay5y1SohgPUDawcCZKRAOyAcKIWBUxh1P3RcE8GmvtatIBPjrRh4O9RC92zilF8jfPLqaFI2XvoSkyzRN6ycnPC6IK9PyBzD7wVSls4kDdYqD2FJknWlB0p62hW0udhCShEmOUfjVDwW1yol8tKnXPuU5z7L3KvzimUosT1MXQoswLsTUEoI0alDiHaUWR1tiFNUXpsk-f93_AW7qLGk</recordid><startdate>20230803</startdate><enddate>20230803</enddate><creator>Jørgensen, Kristin Kaasen</creator><creator>Høivik, Marte Lie</creator><creator>Chopra, Adity</creator><creator>Benth, Jūratė Šaltytė</creator><creator>Ricanek, Petr</creator><creator>Moum, Prof Bjørn</creator><creator>Jyssum, Ingrid</creator><creator>Bolstad, Nils</creator><creator>Warren, David John</creator><creator>Vaage, Prof John T.</creator><creator>Munthe, Prof Ludvig A.</creator><creator>Lundin, Prof Knut E.A</creator><creator>Anisdahl, Karoline</creator><creator>Syversen, Silje Watterdal</creator><creator>Goll, Guro Løvik</creator><creator>Lund-Johansen, Fridtjof</creator><creator>Medhus, Asle W.</creator><creator>Jahnsen, Prof Jørgen</creator><general>Taylor & Francis</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>3HK</scope><orcidid>https://orcid.org/0000-0002-2445-1258</orcidid><orcidid>https://orcid.org/0000-0002-0838-1675</orcidid><orcidid>https://orcid.org/0000-0003-1713-5545</orcidid><orcidid>https://orcid.org/0000-0003-2454-7388</orcidid><orcidid>https://orcid.org/0000-0002-0104-465X</orcidid><orcidid>https://orcid.org/0000-0003-2041-9100</orcidid><orcidid>https://orcid.org/0000-0001-7118-5127</orcidid><orcidid>https://orcid.org/0000-0002-3693-7706</orcidid><orcidid>https://orcid.org/0000-0002-0419-2914</orcidid></search><sort><creationdate>20230803</creationdate><title>Humoral immune response to SARS-CoV-2 vaccination in patients with inflammatory bowel disease on immunosuppressive medication: association to serum drug levels and disease type</title><author>Jørgensen, Kristin Kaasen ; Høivik, Marte Lie ; Chopra, Adity ; Benth, Jūratė Šaltytė ; Ricanek, Petr ; Moum, Prof Bjørn ; Jyssum, Ingrid ; Bolstad, Nils ; Warren, David John ; Vaage, Prof John T. ; Munthe, Prof Ludvig A. ; Lundin, Prof Knut E.A ; Anisdahl, Karoline ; Syversen, Silje Watterdal ; Goll, Guro Løvik ; Lund-Johansen, Fridtjof ; Medhus, Asle W. ; Jahnsen, Prof Jørgen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-6a88e29b26b0e0d1e17e03e11eb31edc9b73c082f94c680f2368b36b48c92f313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>2019-nCoV Vaccine mRNA-1273</topic><topic>Adult</topic><topic>Antibodies, Viral</topic><topic>biologic medication</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>COVID-19 - prevention & control</topic><topic>COVID-19 Vaccines</topic><topic>Crohn Disease - drug therapy</topic><topic>Humans</topic><topic>Immunity, Humoral</topic><topic>Immunogenicity</topic><topic>Immunosuppressive Agents</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory Bowel Diseases - drug therapy</topic><topic>Prospective Studies</topic><topic>SARS-CoV-2</topic><topic>SARS-CoV-2 vaccine</topic><topic>Vaccination</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jørgensen, Kristin Kaasen</creatorcontrib><creatorcontrib>Høivik, Marte Lie</creatorcontrib><creatorcontrib>Chopra, Adity</creatorcontrib><creatorcontrib>Benth, Jūratė Šaltytė</creatorcontrib><creatorcontrib>Ricanek, Petr</creatorcontrib><creatorcontrib>Moum, Prof Bjørn</creatorcontrib><creatorcontrib>Jyssum, Ingrid</creatorcontrib><creatorcontrib>Bolstad, Nils</creatorcontrib><creatorcontrib>Warren, David John</creatorcontrib><creatorcontrib>Vaage, Prof John T.</creatorcontrib><creatorcontrib>Munthe, Prof Ludvig A.</creatorcontrib><creatorcontrib>Lundin, Prof Knut E.A</creatorcontrib><creatorcontrib>Anisdahl, Karoline</creatorcontrib><creatorcontrib>Syversen, Silje Watterdal</creatorcontrib><creatorcontrib>Goll, Guro Løvik</creatorcontrib><creatorcontrib>Lund-Johansen, Fridtjof</creatorcontrib><creatorcontrib>Medhus, Asle W.</creatorcontrib><creatorcontrib>Jahnsen, Prof Jørgen</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><jtitle>Scandinavian journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Jørgensen, Kristin Kaasen</au><au>Høivik, Marte Lie</au><au>Chopra, Adity</au><au>Benth, Jūratė Šaltytė</au><au>Ricanek, Petr</au><au>Moum, Prof Bjørn</au><au>Jyssum, Ingrid</au><au>Bolstad, Nils</au><au>Warren, David John</au><au>Vaage, Prof John T.</au><au>Munthe, Prof Ludvig A.</au><au>Lundin, Prof Knut E.A</au><au>Anisdahl, Karoline</au><au>Syversen, Silje Watterdal</au><au>Goll, Guro Løvik</au><au>Lund-Johansen, Fridtjof</au><au>Medhus, Asle W.</au><au>Jahnsen, Prof Jørgen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Humoral immune response to SARS-CoV-2 vaccination in patients with inflammatory bowel disease on immunosuppressive medication: association to serum drug levels and disease type</atitle><jtitle>Scandinavian journal of gastroenterology</jtitle><addtitle>Scand J Gastroenterol</addtitle><date>2023-08-03</date><risdate>2023</risdate><volume>58</volume><issue>8</issue><spage>874</spage><epage>882</epage><pages>874-882</pages><issn>0036-5521</issn><eissn>1502-7708</eissn><abstract>Immune responses following SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD) are not well characterized. The aims of this study were to explore the serological response associated with IBD, and immunosuppressive medications including serum concentrations of biologics and thiopurine metabolites.
This prospective, observational study included adult patients with ulcerative colitis (UC) and Crohn's disease (CD), and healthy controls. Antibodies to the receptor-binding domain of SARS-CoV-2 spike proteins, and serum concentrations of ongoing biologic and immunomodulatory medications were assessed prior to, and 2-5 weeks after the second vaccine dose. Serologic response was defined as anti-Spike antibodies ≥70 AU/ml.
In 958 IBD patients (380 UC, 578 CD) and 323 healthy controls, the median (Q
1;
Q
3
) anti-Spike antibody level (AU/ml) was lower in patients (618 (192; 4370)) compared to controls (3355 (896; 7849)) (p < 0.001). The antibody levels were lower in CD (439 (174; 3304)) compared to UC (1088 (251; 5975)) (p < 0.001). No associations were demonstrated between antibody levels and serum drug concentrations for TNF inhibitor (TNFi), vedolizumab and ustekinumab. Patients receiving TNFi + thiopurines with a subtherapeutic 6-thioguanine nucleotide (6-TGN) level had higher response rate (93%) compared to patients with 6-TGN within the therapeutic range (53%) (p = 0.003). A diagnosis of UC, mRNA-1273 vaccine, and other treatments than TNFi + thiopurines were associated with humoral response.
Patients with CD had an attenuated humoral response to SARS-COV-2 vaccination as compared to patients with UC. The lack of association between serum levels of biologics and serologic response indicates vaccination regardless of proximity to drug administration.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>36788656</pmid><doi>10.1080/00365521.2023.2177884</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2445-1258</orcidid><orcidid>https://orcid.org/0000-0002-0838-1675</orcidid><orcidid>https://orcid.org/0000-0003-1713-5545</orcidid><orcidid>https://orcid.org/0000-0003-2454-7388</orcidid><orcidid>https://orcid.org/0000-0002-0104-465X</orcidid><orcidid>https://orcid.org/0000-0003-2041-9100</orcidid><orcidid>https://orcid.org/0000-0001-7118-5127</orcidid><orcidid>https://orcid.org/0000-0002-3693-7706</orcidid><orcidid>https://orcid.org/0000-0002-0419-2914</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0036-5521 |
| ispartof | Scandinavian journal of gastroenterology, 2023-08, Vol.58 (8), p.874-882 |
| issn | 0036-5521 1502-7708 |
| language | eng |
| recordid | cdi_cristin_nora_10852_103034 |
| source | NORA - Norwegian Open Research Archives |
| subjects | 2019-nCoV Vaccine mRNA-1273 Adult Antibodies, Viral biologic medication Colitis, Ulcerative - drug therapy COVID-19 - prevention & control COVID-19 Vaccines Crohn Disease - drug therapy Humans Immunity, Humoral Immunogenicity Immunosuppressive Agents Inflammatory bowel disease Inflammatory Bowel Diseases - drug therapy Prospective Studies SARS-CoV-2 SARS-CoV-2 vaccine Vaccination |
| title | Humoral immune response to SARS-CoV-2 vaccination in patients with inflammatory bowel disease on immunosuppressive medication: association to serum drug levels and disease type |
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