Department of Internal Medicine, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
1st Department of Infectious Diseases, 2nd Medical Faculty Charles University in Prague and Hospital Na Bulovce, Prague, Czech Republic.
PLoS One. 2022 Sep 2;17(9):e0273612. doi: 10.1371/journal.pone.0273612. eCollection 2022.
SARS-CoV-2 is a worldwide serious health problem and vaccination seems to have a crucial role in managing the COVID-19 pandemic. The aim of this prospective observational study was to monitor the trend of antibodies against SARS-CoV-2 after vaccination with BNT162b2 (COMIRNATY) in patients with inflammatory bowel disease treated by immunosuppressive and/or biological therapy, demonstrate whether any type of this therapy is associated with poorer production of antibodies against COVID-19 and evaluate the safety of vaccination against COVID-19 in these patients.
Eighty-seven eligible patients from one tertiary gastroenterological center with inflammatory bowel disease (60 with CD, 27 with UC) treated by immunosuppressive and/or biological therapy from the antiTNFα group were indicated to vaccination against SARS-CoV-2. Effectiveness of vaccination was evaluated by the values of antibodies before and 4 weeks after 2nd dose of vaccine. Additional goal was to evaluate adverse events of vaccination.
Before the 2nd dose of vaccine, geometric mean of SARS-CoV-2 IgG antibodies were 40.7 U/ml in the biological therapy group, 34.8 U/ml in the azathioprine group and 44.8 U/ml in the combination therapy group of patients. The geometric means were 676.5.7 U/ml in the biological therapy group, 614.4 U/ml in the azathioprine group and 500.1 U/ml in the combination therapy group of patients four weeks after 2nd dose. Statistically significant differences between these groups were not proved. Several non-severe local and general adverse events were present in our patients with a majority of these events on the day of vaccine administration and the day after, no anaphylactic reactions were present.
Our measurements proved the efficacy and safety of vaccination against SARS-CoV-2 in patients with inflammatory bowel disease treated by immunosuppressive and/or biological therapy. Statistically significant differences between our groups of patients were not proved.
SARS-CoV-2 是全球严重的健康问题,疫苗接种似乎在管理 COVID-19 大流行方面发挥着关键作用。本前瞻性观察研究的目的是监测接受 BNT162b2(COMIRNATY)疫苗接种后炎症性肠病患者体内针对 SARS-CoV-2 的抗体趋势,证明任何类型的治疗是否与针对 COVID-19 的抗体产生较差有关,并评估这些患者接种 COVID-19 疫苗的安全性。
从一家三级胃肠病学中心招募了 87 名符合条件的炎症性肠病患者(60 名 CD,27 名 UC),这些患者接受免疫抑制和/或生物治疗,从抗 TNFα 组开始接种 SARS-CoV-2 疫苗。通过疫苗接种后第 2 剂 4 周后抗体值评估疫苗接种的有效性。另一个目标是评估疫苗接种的不良事件。
在接种第 2 剂疫苗之前,生物治疗组的 SARS-CoV-2 IgG 抗体几何平均浓度为 40.7 U/ml,硫唑嘌呤组为 34.8 U/ml,联合治疗组为 44.8 U/ml。第 2 剂疫苗接种后 4 周,生物治疗组的几何平均浓度为 676.5.7 U/ml,硫唑嘌呤组为 614.4 U/ml,联合治疗组为 500.1 U/ml。这些组之间的统计学差异没有证明。我们的患者中存在一些非严重的局部和全身不良事件,大多数事件发生在疫苗接种当天和次日,没有过敏反应。
我们的测量结果证明了在接受免疫抑制和/或生物治疗的炎症性肠病患者中接种 SARS-CoV-2 疫苗的有效性和安全性。我们的患者组之间没有证明统计学上的显著差异。