S1098 Serological Responses to SARS-CoV-2 Vaccination in Patients With Inflammatory Bowel Disease Are Impaired for Those on Anti-TNF and Immunomodulator Combination Therapy
Notice bibliographique
Résumé
Introduction: Anti-tumor necrosis factor (TNF) reduces the serological responses (SR) to SARS-CoV-2 vaccination and impairs SR durability within individuals with IBD.1-3 Additional doses of SARS-CoV-2 vaccination effectively increase antibody titers in patients treated with anti-TNF agents, responses are still lower compared to healthy controls.4 5 Data comparing serological responses between anti-TNF monotherapy and combination therapy are lacking. This study aims to compare serological responses from SARS-CoV-2 vaccination between IBD patients treated with anti-TNF monotherapy or combined with an immunomodulator. Methods: Adults with IBD, at least two doses of a SARS-CoV-2 vaccine, with anti-TNF monotherapy (anti-TNF alone) or combination therapy (anti-TNF in addition to methotrexate or azathioprine) were recruited through the STOP COVID-19 in IBD cohort.5 Serum samples were drawn for assessment of IgG antibodies to the spike protein of SARS-CoV-2 (anti-S) using the Abbott Architect SARS-CoV-2 IgG II Quant assay following 1–8 weeks after 1st dose vaccination, and both 1–8 weeks and 8+ weeks after 2nd, 3rd, and 4th dose vaccination. Demographic and medication status information was collected through chart review. SR was defined as IgG levels of ≥50 AU/mL; positive SR rates were compared between medication groups using two-sample proportion tests. Anti-S concentrations were reported as geometric mean titres (GMT) with 95% confidence intervals and were compared between medication groups using Mann Whitney-U tests. Results: 207 patients on anti-TNF monotherapy and 68 on combination therapy were recruited. Anti-S titres were significantly decreased for individuals on combination therapy compared to anti-TNF monotherapy 1–8 weeks after 1st dose vaccination, and both 1–8 weeks and 8+ weeks after 2nd dose vaccination. No significant differences in GMTs were determined between anti-TNF monotherapy and combination therapy groups following all timepoints after additional dose vaccination (Table 1, Figure 1). Conclusion: IBD patients treated with combination therapy develop a significantly reduced serological response to a two-dose SARS-CoV-2 regimen compared to those with anti-TNF monotherapy. These differences are no longer observed following additional vaccine doses and both medication groups develop robust antibody responses. These findings highlight the importance of additional doses for adequate serological protection within the IBD population and especially for those on anti-TNF combination therapy. Table 1. - Overall patient characteristics, seroconversion, and GMT with associated 95% CIs per vaccine serology timepoint for anti-TNF monotherapy and anti-TNF + IMM combination therapy with associated univariate analyses Characteristic Time point Anti-TNF Monotherapy (n = 207) Anti-TNF + IMM (n = 68) P-value Male sex, n (%) Overall 89 (43.0%) 36 (52.9%) – Mean age (SD) 48.1 (14.8) 45.0 (13.8) – IBD type, n (%) – Crohn’s disease 154 (74.4%) 53 (77.9%) Ulcerative colitis 49 (23.7%) 14 (20.6%) IBD-Unclassified 4 (1.9%) (1.5%) Seroconversion, n/N (%) Post-1st 65/77 (83.1%) 16/32 (50.0%) < 0.001 Post-2nd (1–8 weeks) 114/115 (99.1%) 36/37 (97.3%) 0.395 Post-2nd (8+ weeks) 90/95 (94.7%) 18/22 (81.8%) 0.041 Post-3rd (1–8 weeks) 90/90 (100.0%) 30/30 (100.0%) N/A Post-3rd (8+ weeks) 116/117 (99.2%) 37/37 (100.0%) 0.573 Post-4th (1–8 weeks) 31/31 (100.0%) 11/11 (100.0%) N/A Post-4th (8+ weeks) 24/25 (96.0%) 14/14 (100.0%) 0.448 GMT (95% CI) Post-1st 266 (176, 400) 84 (45, 156) < 0.001 Post-2nd (1–8 weeks) 3185 (2528, 4011) 1102 (728, 1670) < 0.001 Post-2nd (8+ weeks) 612 (437, 858) 289 (139, 599) 0.045 Post-3rd (1–8 weeks) 9013 (7166, 11335) 5664 (3493, 9185) 0.096 Post-3rd (8+ weeks) 2698 (2006, 3630) 1695 (947, 3034) 0.210 Post-4th (1–8 weeks) 9803 (6911, 13907) 7711 (4071, 14607) 0.393 Post-4th (8+ weeks) 2931 (1597, 5381) 2996 (1455, 6168) 0.861 Figure 1.: Anti-SARS-CoV-2 antibody concentration per vaccine category stratified anti-TNF monotherapy (squares) and anti-TNF combination therapy (triangles). Black circles represent GMTs while narrow black bars represent bounds of 95% CI associated with each GMT. Solid blue line for positive seroconversion (50 AU/mL).
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 enseignantsNi 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.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
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.
score_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 découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».