Enregistrement W4310718486 · doi:10.1016/s2468-1253(22)00389-2

Neutralising antibody potency against SARS-CoV-2 wild-type and omicron BA.1 and BA.4/5 variants in patients with inflammatory bowel disease treated with infliximab and vedolizumab after three doses of COVID-19 vaccine (CLARITY IBD): an analysis of a prospective multicentre cohort study

2022· article· en· W4310718486 sur OpenAlexfundno aff

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JOHN, Michelle Edwards, Katie Smith, Linda Howard, Dianne Wood, Ajay Muddu, L Barman, Janine Mallinson, Tania Neale, D Ionita, Kerry Elliot, Alison Turnball, Iola Thomas, Alice Thomas, Kelly S. Andrews, Jonathon Sutton, Caroline Mulvaney Jones, Julia Roberts, Jeannie Bishop

Notice bibliographique

RevueThe Lancet. Gastroenterology & hepatology · 2022

Typearticle

Langueen

DomaineMedicine

ThématiqueSARS-CoV-2 and COVID-19 Research

Établissements canadiensnon disponible

Organismes subventionnairesAllerganSanofi PasteurSeqirusCrohn's and Colitis UKNational Institute for Health and Care ResearchCelltrionMylanBristol-Myers SquibbEli Lilly and CompanyUK Research and InnovationAstraZenecaCelltrion HealthcareMedical Research CouncilChan Zuckerberg InitiativeCelgeneBiogenUniversity of OttawaSanofiNIHR Imperial Biomedical Research CentreAmgenVifor PharmaPfizer

Mots-clésInfliximabMedicineVedolizumabAntibodyVirologyVaccinationImmunologyInflammatory bowel diseaseDrugDiseaseTumor necrosis factor alphaPharmacologyInternal medicine

DOI10.1016/s2468-1253(22)00389-2

Résumé

récupéré en direct d'OpenAlex

BACKGROUND: Anti-TNF drugs, such as infliximab, are associated with attenuated antibody responses after SARS-CoV-2 vaccination. We aimed to determine how the anti-TNF drug infliximab and the anti-integrin drug vedolizumab affect vaccine-induced neutralising antibodies against highly transmissible omicron (B.1.1.529) BA.1, and BA.4 and BA.5 (hereafter BA.4/5) SARS-CoV-2 variants, which possess the ability to evade host immunity and, together with emerging sublineages, are now the dominating variants causing current waves of infection. METHODS: CLARITY IBD is a prospective, multicentre, observational cohort study investigating the effect of infliximab and vedolizumab on SARS-CoV-2 infection and vaccination in patients with inflammatory bowel disease (IBD). Patients aged 5 years and older with a diagnosis of IBD and being treated with infliximab or vedolizumab for 6 weeks or longer were recruited from infusion units at 92 hospitals in the UK. In this analysis, we included participants who had received uninterrupted biological therapy since recruitment and without a previous SARS-CoV-2 infection. The primary outcome was neutralising antibody responses against SARS-CoV-2 wild-type and omicron subvariants BA.1 and BA.4/5 after three doses of SARS-CoV-2 vaccine. We constructed Cox proportional hazards models to investigate the risk of breakthrough infection in relation to neutralising antibody titres. The study is registered with the ISRCTN registry, ISRCTN45176516, and is closed to accrual. FINDINGS: Between Sept 22 and Dec 23, 2020, 7224 patients with IBD were recruited to the CLARITY IBD study, of whom 1288 had no previous SARS-CoV-2 infection after three doses of SARS-CoV-2 vaccine and were established on either infliximab (n=871) or vedolizumab (n=417) and included in this study (median age was 46·1 years [IQR 33·6-58·2], 610 [47·4%] were female, 671 [52·1%] were male, 1209 [93·9%] were White, and 46 [3·6%] were Asian). After three doses of SARS-CoV-2 vaccine, 50% neutralising titres (NT50s) were significantly lower in patients treated with infliximab than in those treated with vedolizumab, against wild-type (geometric mean 2062 [95% CI 1720-2473] vs 3440 [2939-4026]; p<0·0001), BA.1 (107·3 [86·40-133·2] vs 648·9 [523·5-804·5]; p<0·0001), and BA.4/5 (40·63 [31·99-51·60] vs 223·0 [183·1-271·4]; p<0·0001) variants. Breakthrough infection was significantly more frequent in patients treated with infliximab (119 [13·7%; 95% CI 11·5-16·2] of 871) than in those treated with vedolizumab (29 [7·0% [4·8-10·0] of 417; p=0·00040). Cox proportional hazards models of time to breakthrough infection after the third dose of vaccine showed infliximab treatment to be associated with a higher hazard risk than treatment with vedolizumab (hazard ratio [HR] 1·71 [95% CI 1·08-2·71]; p=0·022). Among participants who had a breakthrough infection, we found that higher neutralising antibody titres against BA.4/5 were associated with a lower hazard risk and, hence, a longer time to breakthrough infection (HR 0·87 [0·79-0·95]; p=0·0028). INTERPRETATION: Our findings underline the importance of continued SARS-CoV-2 vaccination programmes, including second-generation bivalent vaccines, especially in patient subgroups where vaccine immunogenicity and efficacy might be reduced, such as those on anti-TNF therapies. FUNDING: Royal Devon University Healthcare NHS Foundation Trust; Hull University Teaching Hospital NHS Trust; NIHR Imperial Biomedical Research Centre; Crohn's and Colitis UK; Guts UK; National Core Studies Immunity Programme, UK Research and Innovation; and unrestricted educational grants from F Hoffmann-La Roche, Biogen, Celltrion Healthcare, Takeda, and Galapagos.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction machine sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.

score de la tête « metaresearch » (Codex)0,002

score de la tête « metaresearch » (Gemma)0,003

Version: metacan-v3-hybrid-931329e0061cStatut de validation: machine_predicted_unvalidated

Catégories candidatesaucune

Catégories consensuellesaucune

DomaineSignal candidat: aucune · Signal consensuel: aucune

Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel

GenreSignal candidat: Empirique · Signal consensuel: Empirique

Score de désaccord entre enseignants0,003

Score d'incertitude au seuil0,008

Scores du classifieur distillé par catégorie (deux têtes)

Catégorie	Codex	Gemma
Métarecherche	0,002	0,003
Méta-épidémiologie (sens strict)	0,001	0,001
Méta-épidémiologie (sens large)	0,001	0,001
Bibliométrie	0,001	0,001
Études des sciences et des technologies	0,001	0,000
Communication savante	0,001	0,001
Science ouverte	0,001	0,001
Intégrité de la recherche	0,001	0,001
Charge utile insuffisante (le modèle a refusé de juger)	0,001	0,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,015

Tête enseignante GPT0,297

Écart entre enseignants0,282 · la distance entre les deux têtes enseignantes sur ce seul travail

Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.

Devis d'étudeObservationnel

Domainenon disponible

GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations35

Publié2022

Routes d'admission1

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