Introduction
Patients with inflammatory bowel disease (IBD) frequently use immunosuppressants and immunobiologicals for maintenance treatment. The humoral responsiveness to COVID-19 vaccines in this group of patients using this drugs is still not fully understood, as the need for more vaccine boosters.
Aims & Methods
Our study aims to evaluate the humoral response to different types of vaccines against SARS-Cov-2 in this population, as well as to compare this response with the healthy population. Patients with IBD enrolled at the Policlinic Piquet Carneiro (UERJ) were prospectively followed with serial blood collection between July 2021 and July 2022. Samples were screened to determine antibody titers, and patients were stratified by demographic and clinical characteristics, naturally occurring infection, vaccination schemes, and IBD medications. Anti-spike IgG antibody titers against the SARS-Cov-2 were determined by ELISA before and one month after the two doses of different vaccination schemes in patients with IBD, regularly followed-up at the outpatient unit. The results were compared with those of a healthy control group during the same period.
Results
In the IBD group (46 individuals), mean antibody titers were 430.3 AU/ml pre-vaccination and 8038.4 AU/ml after the two vaccine doses. In comparison, in the control group (92 individuals), mean antibody titers were 90.5 AU/ml pre-vaccination and 7697.5 AU/ml after the two doses. In both groups, there was a significant increase in the titer of antibodies after the two vaccine doses (p<0.001). When comparing antibody titers one month after the 2nd dose, there was no difference between the two groups (p=0.731). On the other hand, in the IBD group, there was a difference between the vaccination schemes, with higher titers in those who received Pfizer, as well as in younger patients (p<0.005) and in those with previous natural COVID-19 infection (p<0.012). Diagnosis of Crohn’s disease or ulcerative colitis, sex, race, smoking status, clinical variables related to disease localization, extension, behavior, clinical activity, and type of medical therapy did not significantly affect the immune response to vaccines.
Conclusion
The use of immunosuppressants and immunobiologicals does not affect the overall humoral response to the COVID-19 vaccination among patients with IBD. Nevertheless, specific vaccine schemes, age, and previous COVID-19 infection significantly affect antibody titers.
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