Efficacy of COVID-19 vaccines in inflammatory bowel disease patients receiving -TNF therapy: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES

There are concerns about the serological responses to Coronavirus disease 2019 (COVID-19) vaccines in inflammatory bowel disease (IBD) patients, particularly those receiving -TNF therapy. This study aimed to systematically evaluate the efficacy of COVID-19 vaccines in IBD patients receiving -TNF therapy.

METHODS

Electronic databases were searched to identify relevant studies. We calculated pooled seroconversion rate after COVID-19 vaccination and subgroup analysis for vaccine types and different treatments were performed. Additionally, we estimated pooled rate of T cell response, neutralization response, and breakthrough infections in this population.

RESULTS

32 studies were included in the meta-analysis. IBD patients receiving -TNF therapy had relatively high overall seroconversion rate after complete vaccination, with no statistical difference in antibody responses associated with different drug treatments. The pooled positivity rate of T cell response was 0.85 in IBD patients receiving -TNF therapy. Compared with healthy controls, the positivity of neutralization assays was significantly lower in IBD patients receiving -TNF therapy. The pooled rate of breakthrough infections in IBD patients receiving -TNF therapy was 0.04.

CONCLUSIONS

COVID-19 vaccines have shown good efficacy in IBD patients receiving -TNF therapy. However, IBD patients receiving -TNF have a relatively high rate of breakthrough infections and a low level of neutralization response.