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新型冠状病毒疫苗在炎症性肠病患者中的有效性和安全性:系统评价、荟萃分析和荟萃回归。

Effectiveness and safety of SARS-CoV-2 vaccine in Inflammatory Bowel Disease patients: a systematic review, meta-analysis and meta-regression.

机构信息

Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, USA.

Division of Gastroenterology and Hepatology, John H. Stroger Cook County Hospital, Chicago, Illinois, USA.

出版信息

Aliment Pharmacol Ther. 2022 May;55(10):1244-1264. doi: 10.1111/apt.16913. Epub 2022 Mar 30.

Abstract

INTRODUCTION

There are concerns regarding the effectiveness and safety of SARS-CoV-2 vaccine in inflammatory Bowel Disease (IBD) patients. This systematic review and meta-analysis comprehensively summarises the available literature regarding the safety and effectiveness of SARS-CoV-2 vaccine in IBD.

METHODS

Three independent reviewers performed a comprehensive review of all original articles describing the response of SARS-CoV-2 vaccines in patients with IBD. Primary outcomes were (1) pooled seroconversion rate SARS-CoV-2 vaccination in IBD patients (2) comparison of breakthrough COVID-19 infection rate SARS-CoV-2 vaccination in IBD patients with control cohort and (3) pooled adverse event rate of SARS-CoV-2 vaccine. All outcomes were evaluated for one and two doses of SARS-CoV-2 vaccine. Meta-regression was performed. Probability of publication bias was assessed using funnel plots and with Egger's test.

RESULTS

Twenty-one studies yielded a pooled seroconversion rate of 73.7% and 96.8% in IBD patients after one and two doses of SARS-CoV-2 vaccine respectively. Sub-group analysis revealed non-statistically significant differences between different immunosuppressive regimens for seroconversion. Meta-regression revealed that the vaccine type and study location independently influenced seroconversion rates. There was no statistically significant difference in breakthrough infection in IBD patients as compared to control after vaccination.

CONCLUSION

In summary, the systematic review and meta-analysis suggest that SARS-CoV-2 vaccine is safe and effective in IBD patients.

摘要

简介

人们对 SARS-CoV-2 疫苗在炎症性肠病(IBD)患者中的有效性和安全性存在担忧。本系统评价和荟萃分析全面总结了关于 SARS-CoV-2 疫苗在 IBD 患者中的安全性和有效性的现有文献。

方法

三位独立评审员对所有描述 IBD 患者 SARS-CoV-2 疫苗反应的原始文章进行了全面审查。主要结局为(1)IBD 患者 SARS-CoV-2 疫苗接种的总体血清转化率,(2)IBD 患者 SARS-CoV-2 疫苗突破性 COVID-19 感染率与对照组的比较,(3)SARS-CoV-2 疫苗的总体不良事件发生率。所有结局均评估了 SARS-CoV-2 疫苗的一剂和两剂接种。进行了元回归分析。使用漏斗图和 Egger 检验评估发表偏倚的可能性。

结果

21 项研究得出,IBD 患者接种一剂和两剂 SARS-CoV-2 疫苗后的血清转化率分别为 73.7%和 96.8%。亚组分析显示,不同免疫抑制方案之间的血清转化率没有统计学差异。元回归显示,疫苗类型和研究地点独立影响血清转化率。接种疫苗后,IBD 患者的突破性感染与对照组相比没有统计学差异。

结论

总之,系统评价和荟萃分析表明,SARS-CoV-2 疫苗在 IBD 患者中是安全有效的。

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