Vaccines (Jul 2022)

Anti-TNFα Treatment Impairs Long-Term Immune Responses to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases

  • Keren Masha Rabinowitz,
  • Michal Navon,
  • Hadar Edelman-Klapper,
  • Eran Zittan,
  • Ariella Bar-Gil Shitrit,
  • Idan Goren,
  • Irit Avni-Biron,
  • Jacob E. Ollech,
  • Lev Lichtenstein,
  • Hagar Banai-Eran,
  • Henit Yanai,
  • Yifat Snir,
  • Maor H. Pauker,
  • Adi Friedenberg,
  • Adva Levy-Barda,
  • Arie Segal,
  • Yelena Broitman,
  • Eran Maoz,
  • Baruch Ovadia,
  • Maya Aharoni Golan,
  • Eyal Shachar,
  • Shomron Ben-Horin,
  • Nitsan Maharshak,
  • Michal Mor,
  • Haim Ben Zvi,
  • Rami Eliakim,
  • Revital Barkan,
  • Tali Sharar-Fischler,
  • Sophy Goren,
  • Noy Krugliak,
  • Edward Pichinuk,
  • Michael Mor,
  • Michal Werbner,
  • Joel Alter,
  • Hanan Abu-Taha,
  • Kawsar Kaboub,
  • Moshe Dessau,
  • Meital Gal-Tanamy,
  • Dani Cohen,
  • Natalia T. Freund,
  • Iris Dotan,
  • on behalf of the Responses to COVID-19 Vaccine Israeli IBD Group

DOI
https://doi.org/10.3390/vaccines10081186
Journal volume & issue
Vol. 10, no. 8
p. 1186

Abstract

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Patients with inflammatory bowel disease (IBD) treated with anti-tumor-necrosis factor-alpha (TNFα) exhibited lower serologic responses one-month following the second dose of the COVID-19 BNT162b2 vaccine compared to those not treated with anti-TNFα (non-anti-TNFα) or to healthy controls (HCs). We comprehensively analyzed long-term humoral responses, including anti-spike (S) antibodies, serum inhibition, neutralization, cross-reactivity and circulating B cell six months post BNT162b2, in patients with IBD stratified by therapy compared to HCs. Subjects enrolled in a prospective, controlled, multi-center Israeli study received two BNT162b2 doses. Anti-S levels, functional activity, specific B cells, antigen cross-reactivity, anti-nucleocapsid levels, adverse events and IBD disease score were detected longitudinally. In total, 240 subjects, 151 with IBD (94 not treated with anti-TNFα and 57 treated with anti-TNFα) and 89 HCs participated. Six months after vaccination, patients with IBD treated with anti-TNFα had significantly impaired BNT162b2 responses, specifically, more seronegativity, decreased specific circulating B cells and cross-reactivity compared to patients untreated with anti-TNFα. Importantly, all seronegative subjects were patients with IBD; of those, >90% were treated with anti-TNFα. Finally, IBD activity was unaffected by BNT162b2. Altogether these data support the earlier booster dose administration in these patients.

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