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Infliximab May Reduce Immunogenicity to SARS-CoV-2 Vaccine

Antibody concentrations lower in infliximab-treated individuals with IBD receiving single dose of BNT162b2 or ChAdOx1 nCoV-19 vaccine

TUESDAY, May 18, 2021 (HealthDay News) — Individuals with inflammatory bowel disease who are treated with infliximab rather than vedolizumab have reduced immunogenicity to a single dose of BNT162b2 and ChAdOx1 nCoV-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, according to a study published online April 26 in Gut.

Nicholas A. Kennedy, M.B.B.S., from the Royal Devon and Exeter NHS Foundation Trust in the United Kingdom, and colleagues compared antibody responses and seroconversion rates in 865 infliximab-treated patients and a cohort of 428 patients treated with vedolizumab. The primary outcome was anti-SARS-CoV-2 spike antibody concentrations measured three to 10 weeks after vaccination.

The researchers found that compared with patients treated with vedolizumab, patients treated with infliximab had lower geometric mean anti-SARS-CoV-2 antibody concentrations following the BNT162b2 and ChAdOx1 nCoV-19 vaccines. Antibody concentrations were lower in infliximab- versus vedolizumab-treated patients who received the BNT162b2 and ChAdOx1 nCoV-19 vaccines in multivariable models (fold change, 0.29 and 0.39, respectively). Anti-SARS-CoV-2 antibody concentrations were lower in association with age 60 years and older, immunomodulator use, Crohn disease, and smoking, and they were higher in association with non-White ethnicity in both models. Patients with prior SARS-CoV-2 infection had higher seroconversion rates after a single dose of either vaccine and after two doses of the BNT162b2 vaccine.

“Our findings come as countries across Europe are opting to delay the second dose of vaccine,” a coauthor said in a statement. “We recommend prioritizing second doses to patients taking anti-tumor necrosis factor drugs, who will remain at high risk after their first dose.”

Several authors disclosed financial ties to the biopharmaceutical industry, including several companies that provided study funding.

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