Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib
<p><strong>Background and Aims: </strong>We sought to determine whether six commonly used immunosuppressive regimens were associated with lower antibody responses after seasonal influenza vaccination in patients with inflammatory bowel disease [IBD].</p> <p><...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2023
|
| _version_ | 1797111910388203520 |
|---|---|
| author | Liu, Z Alexander, JL Eng, KY Ibraheim, H Anandabaskaran, S Saifuddin, A Constable, L Seoane, RC Bewshea, C Nice, R D'Mello, A Jones, GR Balarajah, S Fiorentino, F Sebastian, S Irving, PM Hicks, LC Williams, HRT Kent, AJ Linger, R Parkes, M Kok, K Patel, KV Teare, JP Altmann, DM Boyton, RJ Hart, AL Lees, CW Goodhand, JR Kennedy, NA Pollock, KM Ahmad, T Powell, N |
| author2 | VIP study investigators |
| author_facet | VIP study investigators Liu, Z Alexander, JL Eng, KY Ibraheim, H Anandabaskaran, S Saifuddin, A Constable, L Seoane, RC Bewshea, C Nice, R D'Mello, A Jones, GR Balarajah, S Fiorentino, F Sebastian, S Irving, PM Hicks, LC Williams, HRT Kent, AJ Linger, R Parkes, M Kok, K Patel, KV Teare, JP Altmann, DM Boyton, RJ Hart, AL Lees, CW Goodhand, JR Kennedy, NA Pollock, KM Ahmad, T Powell, N |
| author_sort | Liu, Z |
| collection | OXFORD |
| description | <p><strong>Background and Aims: </strong>We sought to determine whether six commonly used immunosuppressive regimens were associated with lower antibody responses after seasonal influenza vaccination in patients with inflammatory bowel disease [IBD].</p>
<p><strong>Methods:</strong> We conducted a prospective study including 213 IBD patients and 53 healthy controls: 165 who had received seasonal influenza vaccine and 101 who had not. IBD medications included infliximab, thiopurines, infliximab and thiopurine combination therapy, ustekinumab, vedolizumab, or tofacitinib. The primary outcome was antibody responses against influenza/A H3N2 and A/H1N1, compared to controls, adjusting for age, prior vaccination, and interval between vaccination and sampling.</p>
<p><strong>Results:</strong> Lower antibody responses against influenza A/H3N2 were observed in patients on infliximab (geometric mean ratio 0.35 [95% confidence interval 0.20–0.60], <em>p</em> = 0.0002), combination of infliximab and thiopurine therapy (0.46 [0.27–0.79], <em>p</em> = 0.0050), and tofacitinib (0.28 [0.14–0.57], <em>p</em> = 0.0005) compared to controls. Lower antibody responses against A/H1N1 were observed in patients on infliximab (0.29 [0.15–0.56], <em>p</em> = 0.0003), combination of infliximab and thiopurine therapy (0.34 [0.17–0.66], <em>p</em> = 0.0016), thiopurine monotherapy (0.46 [0.24–0.87], <em>p</em> = 0.017), and tofacitinib (0.23 [0.10–0.56], <em>p</em> = 0.0013). Ustekinumab and vedolizumab were not associated with reduced antibody responses against A/H3N2 or A/H1N1. Vaccination in the previous year was associated with higher antibody responses to A/H3N2. Vaccine-induced anti-SARS-CoV-2 antibody concentration weakly correlated with antibodies against H3N2 [<em>r</em> = 0.27; <em>p</em> = 0.0004] and H1N1 [<em>r</em> = 0.33; <em>p</em> < 0.0001].</p>
<p><strong>Conclusions:</strong> Vaccination in both the 2020–2021 and 2021–2022 seasons was associated with significantly higher antibody responses to influenza/A than no vaccination or vaccination in 2021–2022 alone. Infliximab and tofacitinib are associated with lower binding antibody responses to influenza/A, similar to COVID-19 vaccine-induced antibody responses.</p> |
| first_indexed | 2024-03-07T08:17:00Z |
| format | Journal article |
| id | oxford-uuid:496d0dd0-94a0-4b5a-a7e9-3f7ca653c3b7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:17:00Z |
| publishDate | 2023 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:496d0dd0-94a0-4b5a-a7e9-3f7ca653c3b72024-01-10T06:50:53ZAntibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinibJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:496d0dd0-94a0-4b5a-a7e9-3f7ca653c3b7EnglishSymplectic ElementsOxford University Press2023Liu, ZAlexander, JLEng, KYIbraheim, HAnandabaskaran, SSaifuddin, AConstable, LSeoane, RCBewshea, CNice, RD'Mello, AJones, GRBalarajah, SFiorentino, FSebastian, SIrving, PMHicks, LCWilliams, HRTKent, AJLinger, RParkes, MKok, KPatel, KVTeare, JPAltmann, DMBoyton, RJHart, ALLees, CWGoodhand, JRKennedy, NAPollock, KMAhmad, TPowell, NVIP study investigators<p><strong>Background and Aims: </strong>We sought to determine whether six commonly used immunosuppressive regimens were associated with lower antibody responses after seasonal influenza vaccination in patients with inflammatory bowel disease [IBD].</p> <p><strong>Methods:</strong> We conducted a prospective study including 213 IBD patients and 53 healthy controls: 165 who had received seasonal influenza vaccine and 101 who had not. IBD medications included infliximab, thiopurines, infliximab and thiopurine combination therapy, ustekinumab, vedolizumab, or tofacitinib. The primary outcome was antibody responses against influenza/A H3N2 and A/H1N1, compared to controls, adjusting for age, prior vaccination, and interval between vaccination and sampling.</p> <p><strong>Results:</strong> Lower antibody responses against influenza A/H3N2 were observed in patients on infliximab (geometric mean ratio 0.35 [95% confidence interval 0.20–0.60], <em>p</em> = 0.0002), combination of infliximab and thiopurine therapy (0.46 [0.27–0.79], <em>p</em> = 0.0050), and tofacitinib (0.28 [0.14–0.57], <em>p</em> = 0.0005) compared to controls. Lower antibody responses against A/H1N1 were observed in patients on infliximab (0.29 [0.15–0.56], <em>p</em> = 0.0003), combination of infliximab and thiopurine therapy (0.34 [0.17–0.66], <em>p</em> = 0.0016), thiopurine monotherapy (0.46 [0.24–0.87], <em>p</em> = 0.017), and tofacitinib (0.23 [0.10–0.56], <em>p</em> = 0.0013). Ustekinumab and vedolizumab were not associated with reduced antibody responses against A/H3N2 or A/H1N1. Vaccination in the previous year was associated with higher antibody responses to A/H3N2. Vaccine-induced anti-SARS-CoV-2 antibody concentration weakly correlated with antibodies against H3N2 [<em>r</em> = 0.27; <em>p</em> = 0.0004] and H1N1 [<em>r</em> = 0.33; <em>p</em> < 0.0001].</p> <p><strong>Conclusions:</strong> Vaccination in both the 2020–2021 and 2021–2022 seasons was associated with significantly higher antibody responses to influenza/A than no vaccination or vaccination in 2021–2022 alone. Infliximab and tofacitinib are associated with lower binding antibody responses to influenza/A, similar to COVID-19 vaccine-induced antibody responses.</p> |
| spellingShingle | Liu, Z Alexander, JL Eng, KY Ibraheim, H Anandabaskaran, S Saifuddin, A Constable, L Seoane, RC Bewshea, C Nice, R D'Mello, A Jones, GR Balarajah, S Fiorentino, F Sebastian, S Irving, PM Hicks, LC Williams, HRT Kent, AJ Linger, R Parkes, M Kok, K Patel, KV Teare, JP Altmann, DM Boyton, RJ Hart, AL Lees, CW Goodhand, JR Kennedy, NA Pollock, KM Ahmad, T Powell, N Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title | Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title_full | Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title_fullStr | Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title_full_unstemmed | Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title_short | Antibody responses to Influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| title_sort | antibody responses to influenza vaccination are diminished in patients with inflammatory bowel disease on infliximab or tofacitinib |
| work_keys_str_mv | AT liuz antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT alexanderjl antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT engky antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT ibraheimh antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT anandabaskarans antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT saifuddina antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT constablel antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT seoanerc antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT bewsheac antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT nicer antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT dmelloa antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT jonesgr antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT balarajahs antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT fiorentinof antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT sebastians antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT irvingpm antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT hickslc antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT williamshrt antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT kentaj antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT lingerr antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT parkesm antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT kokk antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT patelkv antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT tearejp antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT altmanndm antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT boytonrj antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT hartal antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT leescw antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT goodhandjr antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT kennedyna antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT pollockkm antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT ahmadt antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib AT powelln antibodyresponsestoinfluenzavaccinationarediminishedinpatientswithinflammatoryboweldiseaseoninfliximabortofacitinib |