Immunogenicity of 13-Valent Pneumococcal Conjugate Vaccine in Pediatric Patients with Inflammatory Bowel Disease

Banaszkiewicz, Aleksandra; Targońska, Brygida; Kowalska-Duplaga, Kinga; Karolewska-Bochenek, Katarzyna; Sieczkowska, Agnieszka; Gawrońska, Agnieszka; Grzybowska-Chłebowczyk, Urszula; Krzesiek, Elżbieta; Łazowska-Przeorek, Izabella; Kotowska, Maria; Sienkiewicz, Edyta; Walkowiak, Jarosław; Gregorek, Hanna; Radzikowski, Andrzej; Albrecht, Piotr

doi:10.1097/mib.0000000000000406

Cited by 25 publications

(24 citation statements)

References 34 publications

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“…Most studies performed in the literature among patients with IBD and rheumatol ogical conditions including patients treated with anti-TNF therapy suggest that pneumococcal vaccine responses are most infl uenced by the presence of an immunomodulator (thiopurine or methotrexate) but not monotherapy with anti-TNF ( 42 ). PCV13 has been shown to be safe and eff ective in children with IBD ( 66 ). Vaccination with both PPSV23 and PCV13 is recommended for those receiving immunosuppressive treatment, to maximize the breadth of serotypes covered (i.e., with PPSV23) and ensure optimal protection against the most common and virulent strains (i.e., with PCV13 ( 10,11 )).…”

Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

391

421

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Recent data suggest that infl ammatory bowel disease (IBD) patients do not receive preventive services at the same rate as general medical patients. Patients with IBD often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to IBD patients, health maintenance issues need to be co-managed by both the gastroenterologist and primary care team. Gastroenterologists need to explicitly inform the primary care provider of the unique needs of the IBD patient, especially those on immunomodulators and biologics or being considered for such therapy. In particular, documentation of up to date vaccinations are crucial as IBD patients are often treated with long-term immune-suppressive therapies and may be at increased risk for infections, many of which are preventable with vaccinations. Health maintenance issues addressed in this guideline include identifi cation, safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer as well as identifi cation of depression and anxiety and smoking cessation. To accomplish these health maintenance goals, coordination between the primary care provider, gastroenterology team and other specialists is necessary. of evidence, we entered data from the papers of highest evidence into the GRADE program (accessible at http://www.gradepro.org ). Th e recommendation statements from this guideline are shown in Table 1 . Summary statements, when listed, are designed to be descriptive in nature without associated evidence-based ratings. VACCINATIONSRecent data suggest that IBD patients do not receive preventive services at the same rate as general medical patients ( 2 ). Members of the gastroenterology team are oft en the only clinicians that a patient with IBD will see. As such, it is incumbent upon gastroenterologists to take a proactive role in the health care needs of their IBD patients ( 3-5 ). It is crucial to clarify with the patient the limits of the specialist's responsibilities and delegate routine health care issues to the primary care clinician. It is equally important to educate the primary care clinician to the unique health maintenance needs of the IBD patient, especially those on immunomodulators and biologic agents. Although it appears that both primary care clinicians and gastroenterologists are hesitant to take ownership of vaccinations ( 6-8 ), it is reasonable ( 9 ) that vaccination recommendations be the responsibility of the treating gastroenterologist, but the actual delivery/administration of these vaccines may be a shared responsibility ( 10-13 ). Communicating specifi c recommendations to the primary care team in a concise fashion are needed. Consider empowering the patient by giving written recommendations to bring to their primary care physician. Clinicians sharing an electronic medical record should use this platform to send recommendations to the referring clinician.Patients with IBD are oft en treated with long-term immunesuppressive therapies and may t...

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Section: Summary Of Evidencementioning

confidence: 99%

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Farraye

Melmed

Lichtenstein

et al. 2017

American Journal of Gastroenterology

391

421

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“…33,34 It has also been shown that the immunological response to vaccination is sometimes decreased in patients exposed to immunosuppressive therapy. [35][36][37] How to treat IBD after a serious infection…”

Section: What Type Of Vaccine For Which Type Of Patients?mentioning

confidence: 99%

Predicting, Preventing, and Managing Treatment-Related Complications in Patients With Inflammatory Bowel Diseases

Beaugerie

Rahier

Kirchgesner

2020

Clinical Gastroenterology and Hepatology

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“…PCV13 is commonly encountered in pediatric clinics compared to PPSV23 since the conjugate vaccine is fundamental to the primary vaccine series. Banaszkiewics et al demonstrated that pediatric IBD patients have a good response to PCV13, further supporting that T-cell immunity seems to be conserved in IBD patients receiving immunosuppressive therapy and that T-dependent vaccines may be preferential to T-independent vaccines in these patients[ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Vaccinations in immunosuppressive-dependent pediatric inflammatory bowel disease

Nguyen¹,

Minar²,

Jackson³

et al. 2017

WJG

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AIMTo determine the vaccination rates in pediatric immunosuppression-dependent inflammatory bowel disease (IBD) and review the safety and efficacy of vaccinations in this population.METHODSThe electronic medical records from October 2009 to December 2015 of patients diagnosed with IBD at 10 years of age or younger and prescribed anti-tumor necrosis factor alpha (anti-TNF-α) therapy were reviewed for clinical history, medication history, vaccination history, and hepatitis B and varicella titers. Literature discussing vaccination response in IBD patients were identified through search of the MEDLINE database and reviewed using the key words “inflammatory bowel disease”, “immunization”, “vaccination”, “pneumococcal”, “varicella”, and “hepatitis B”. Non-human and non-English language studies were excluded. Search results were reviewed by authors to select articles that addressed safety and efficacy of immunizations in inflammatory bowel disease.RESULTSA total of 51 patients diagnosed with IBD prior to the age of 10 and receiving anti-TNF-α therapy were identified. Thirty-three percent of patients (17/51) had incomplete or no documentation of vaccinations. Sixteen case reports, cohort studies, cross-sectional studies, and randomized trials were determined through review of the literature to describe the safety and efficacy of hepatitis B, pneumococcal, and varicella immunizations in adult and pediatric patients with IBD. These studies showed that patients safely tolerated the vaccines without significant adverse effects. Importantly, IBD patients receiving immunosuppressive medications, particularly anti-TNF-α treatment, have decreased vaccine response compared to controls. However, the majority of patients are still able to achieve protective levels of specific antibodies.CONCLUSIONImmunizations have been shown to be well-tolerated and protective immunity can be achieved in patients with IBD requiring immunosuppressive therapy.

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Immunogenicity of 13-Valent Pneumococcal Conjugate Vaccine in Pediatric Patients with Inflammatory Bowel Disease

Abstract: PCV13 is both immunogenic and safe in pediatric patients with IBD.

Cited by 25 publications

References 34 publications

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease

Predicting, Preventing, and Managing Treatment-Related Complications in Patients With Inflammatory Bowel Diseases

Vaccinations in immunosuppressive-dependent pediatric inflammatory bowel disease

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