Maintenance therapy with infliximab or vedolizumab in IBD is not associated with increased SARS-CoV-2 seroprevalence: UK experience in the 2020 pandemic

McGregor, Colleen Gc; Adams, Alexander T.; Sadler, Ross; Arancibia‐Cárcamo, Carolina V.; Palmer, Rebecca; Ambrose, Tim; Brain, Oliver; Walsh, Alissa; Klenerman, Paul; Travis, Simon; Croft, Nicholas M.; Lindsay, James O.; Satsangi, Jack

doi:10.1136/gutjnl-2021-324116

Cited by 8 publications

(8 citation statements)

References 6 publications

(5 reference statements)

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“…A lower prevalence rate of SARS-CoV-2 serum antibodies in IBD patients has been noted in one recent report from the United Kingdom, where seroprevalence rates were 3.0% and 7.2% in adult IBD patients from Oxford and London, respectively. Rates were significantly lower than those reported in the non-IBD healthcare professional control groups [ 14 ].…”

Section: Discussionmentioning

confidence: 68%

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A Seroprevalence Study of Anti-SARS-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease during the Second Wave of the COVID-19 Pandemic in Italy

et al. 2021

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Background and Objectives: Studies have shown a lower prevalence of anti-SARS-CoV-2 antibodies in patients with inflammatory bowel disease (IBD), including amongst those receiving biological therapy. Aims were to determine the seroprevalence of anti-SARS-CoV-2 antibodies in IBD patients and to assess any association between seropositivity and IBD characteristics. Materials and Methods: Serum from adult IBD patients was prospectively collected between December 2020 and January 2021 and analyzed for anti-SARS-CoV-2 antibodies. Information about IBD characteristics and SARS-CoV-2 exposure risk factors was collected and analyzed. Serum from non-IBD healthcare workers formed the control group. Results: 311 IBD patients on biologics and 75 on mesalazine were enrolled. Ulcerative colitis (UC) extension (p < 0.001), Crohn’s disease (CD) phenotype (p = 0.009) and use of concomitant corticosteroids (p < 0.001) were significantly different between the two IBD groups. Overall seroprevalence among IBD patients was 10.4%. The control group showed a prevalence of 13.0%, not significantly different to that of IBD patients (p = 0.145). Only a close contact with SARS-CoV-2 positive individuals and the use of non-FFP2 masks were independently associated with a higher likelihood of seropositivity amongst IBD patients. Conclusion: In IBD patients, the prevalence of anti-SARS-CoV-2 antibodies is not determined by their ongoing treatment. Disease-related characteristics are not associated with a greater risk of antibody seropositivity.

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Section: Discussionmentioning

confidence: 68%

“…Relatively few studies have investigated the prevalence of SARS-CoV-2 serum antibodies in IBD patients, and of these studies contrasting results have been reported. As yet, most studies have addressed the first phase of the COVID-19 pandemic only [ 14 , 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

A Seroprevalence Study of Anti-SARS-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease during the Second Wave of the COVID-19 Pandemic in Italy

et al. 2021

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“…The effect of immunomodulator and biological therapy for inflammatory bowel disease (IBD) on the immune response to SARS--CoV--2 is of substantial interest to patients and clinicians worldwide. The CLARITY IBD study recently reported attenuated serological responses in IBD patients treated with infliximab in comparison to vedolizumab 1 , with the effect greatest in those on infliximab/thiopurine combination therapy.…”

Section: Textmentioning

confidence: 99%

“…Our cohort of 640 IBD patients as previously described by McGregor et al was followed-up over time until vaccination for COVID--19 1 . This cohort includes adult and paediatric patients from the Royal London Hospital (London, UK) and adult patients from the John Radcliffe Hospital (Oxford, UK).…”

Section: Supplementary Materialsmentioning

confidence: 99%

“…Blood samples were collected from consenting patients attending infusion centres in Oxford and London between May and December 2020. Sera were initially screened by Abbott assay for SARS-CoV-2 antibody responses 6 . Serological reactivity profiles in positive samples were compared with those from healthy adult controls seropositive in the same assay 7 (Supplementary information table 1).…”

Section: Textmentioning

confidence: 99%

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Combination therapy of infliximab and thiopurines, but not monotherapy with infliximab or vedolizumab, is associated with attenuated IgA and neutralisation responses to SARS-CoV-2 in inflammatory bowel disease

Wellens

Edmans

Obolski

et al. 2021

Preprint

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There is substantial interest regarding the perceived risk that immunomodulator and biologic therapy could have on COVID-19 disease severity among patients with inflammatory bowel disease (IBD) and clinicians. In this study, we show that infliximab/thiopurine combination therapy is associated with significantly lower IgA, a range of lower IgG responses as well as impaired neutralising antibody responses, compared to responses observed in healthy individuals. We also demonstrate that whilst IgG responses were significantly reduced in individuals with IBD treated with infliximab or vedolizumab monotherapy compared to healthy controls, there was no significant reduction in IgA and neutralising antibody responses. As neutralising antibody responses correlate with protection, this observation may provide the mechanistic explanation for the observation reported by the SECURE-IBD study that individuals on infliximab/thiopurine combination therapy were at greater risk of severe COVID-19 outcomes than patients on monotherapy.

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High seroprevalence against SARS-CoV-2 in non-vaccinated patients with inflammatory bowel disease from Northern India

Kante

Vuyyuru

Gupta

et al. 2023

Indian J Gastroenterol

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Background The information on seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in patients with IBD and healthy controls (HCs). Methods Patients with IBD and HCs (contact of patients) underwent SARS-CoV-2 antibody testing (chemiluminescent immunoassay: Siemens kit IgG against antigen-S1RBD) between July 2020 and April 2021. Information on demography, disease characteristics, drug history and past history of SARS-CoV-2 infection were noted. Patients on 5-aminosalicylic acid or no treatment were considered not on immunosuppressants and those who had received steroids, thiopurines or methotrexate within six months of inclusion were considered being on immunosuppressants. Results A total of 235 patients (51.9%, males; mean age, 38.7 ± 12.4 years; median disease duration, 60 months [interquartile range, IQR: 36–120]) (ulcerative colitis [UC]: 69.4%, Crohn’s disease [CD]: 28.9%, IBD unclassified [IBDU]: 1.7%) and 73 HCs (mean age, 39.6 ± 10.9 years, 80% males) were enrolled. Of the 235 patients, 128 (54.5%) patients were on immunosuppressants and 107 (45.5%) were not on immunosuppressants. Seventy-four (31.5%) patients were seropositive, of which two (0.9%) had previous history of SARS-CoV-2 infection and none received coronavirus disease-19 (COVID-19) vaccine. Seroprevalence between IBD patients and HCs (32% vs. 27%, p > 0.05) and between patients with and without immunosuppressants (28.1% vs. 36%, p > 0.05) was similar. Age, gender, disease type, duration and activity in the last six months; and medication use were similar between patients with positive and negative serology. There was a progressive increase in seroprevalence from July 2020 to April 2021. Conclusion Up to 1/3rd of patients with IBD were seropositive for immunoglobulin G (IgG) SARS-Cov-2 antibody indicating high seroprevalence in patients with IBD from Northern India. Supplementary Information The online version contains supplementary material available at 10.1007/s12664-022-01310-y.

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Maintenance therapy with infliximab or vedolizumab in IBD is not associated with increased SARS-CoV-2 seroprevalence: UK experience in the 2020 pandemic

Cited by 8 publications

References 6 publications

A Seroprevalence Study of Anti-SARS-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease during the Second Wave of the COVID-19 Pandemic in Italy

A Seroprevalence Study of Anti-SARS-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease during the Second Wave of the COVID-19 Pandemic in Italy

Combination therapy of infliximab and thiopurines, but not monotherapy with infliximab or vedolizumab, is associated with attenuated IgA and neutralisation responses to SARS-CoV-2 in inflammatory bowel disease

High seroprevalence against SARS-CoV-2 in non-vaccinated patients with inflammatory bowel disease from Northern India

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