Year 2023 / Volume 115 / Number 6
Original
Impact of SARS-CoV-2 vaccination in inflammatory bowel disease patients with different biological agents: a systematic review and meta-analysis

306-314

DOI: 10.17235/reed.2022.9264/2022

Cong Dai, Zi-Yuan Dong, Yi-Nuo Wang, Yu-Hong Huang, Min Jiang,

Abstract
Background: There are concerns regarding the effect of biological agents on SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD). A systematic review and meta-analysis was performed about the serological responses, breakthrough infections and clinical relapse of IBD patients treated with biological agents following SARS-CoV-2 vaccination. Methods: Electronic databases were searched to identify relevant studies. Primary outcomes were the pooled seroconversion rates, breakthrough infection rates and clinical relapse rates after SARS-CoV-2 vaccination in IBD patients treated with biological agents. Secondary outcomes were the comparison of seroconversion rates, breakthrough infection rates and clinical relapse rates in IBD patients treated with biological agents and control cohort after SARS-CoV-2 vaccination. Results: Thirty-five studies were included in this meta-analysis. A high percentage of seroconversion (96.6%, 99% and 99.2%) was achieved in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab after SARS-CoV-2 vaccination, respectively. The pooled breakthrough infection rate was 2.5% and 3.9% in IBD patients treated with anti-TNF-α therapy and vedolizumab, respectively. The breakthrough infection rate in IBD patients treated with anti-TNF-α therapy was significantly lower than control cohort (RR 0.178, 95% CI 0.084–0.378). The pooled clinical relapse rate in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab was 6.9%, 5.4% and 5.3%, respectively. Conclusion: The overall seroconversion rate after SARS-CoV-2 vaccination in IBD patients treated with biological agents is high. The overall breakthrough infection rate and clinical relapse rate in IBD patients treated with biological agents were low.
Lay Summary
There are concerns regarding the effect of biological agents on SARS-CoV-2 vaccination in patients with inflammatory bowel disease. We performed a systematic review and meta-analysis about the serological responses, breakthrough infections and clinical relapse of inflammatory bowel disease patients treated with biological agents including anti-TNF-α therapy, vedolizumab, and ustekinumab following SARS-CoV-2 vaccination. Thirty-five studies were included in this meta-analysis. A high percentage of seroconversion (96.6%, 99% and 99.2%) was achieved in inflammatory bowel disease patients treated with anti-TNF-α therapy, vedolizumab, and ustekinumab after SARS-CoV-2 vaccination respectively. The pooled breakthrough infection rate was 2.5% and 3.9% in inflammatory bowel disease patients treated with anti-TNF-α therapy and vedolizumab respectively. The pooled clinical relapse rate in inflammatory bowel disease patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab was 6.9%, 5.4% and 5.3% respectively. Our study found that the overall seroconversion rate after SARS-CoV-2 vaccination in inflammatory bowel disease patients treated with biological agents is high. The overall breakthrough infection rate and clinical relapse rate in IBD patients treated with biological agents were low.
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Quality of care through the eyes of the patient in a Spanish inflammatory bowel disease unit

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Usefulness of therapeutic drug monitoring of infliximab during the induction period in patients with inflammatory bowel disease

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Diet as an environmental trigger in inflammatory bowel disease: a retrospective comparative study in two European cohorts

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Megacolon in inflammatory bowel disease: response to infliximab

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Status of transition care in inflammatory bowel disease in Spain. Different medical perspectives

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Case Report

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The use of a segmental endoscopic score may improve the prediction of clinical outcomes in acute severe ulcerative colitis

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Risk factors for tuberculosis in inflammatory bowel disease: anti-tumor necrosis factor and hospitalization

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Original

How is inflammatory bowel disease managed in Spanish gastroenterology departments? The results of the GESTIONA-EII survey

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Letter to the Editor

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Original

Idiopathic portal hypertension regarding thiopurine treatment in patients with inflammatory bowel disease

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Letter to the Editor

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Case Report

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Citation tools
Dai C, Dong Z, Wang Y, Huang Y, Jiang M. Impact of SARS-CoV-2 vaccination in inflammatory bowel disease patients with different biological agents: a systematic review and meta-analysis. 9264/2022


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Publication history

Received: 06/10/2022

Accepted: 02/11/2022

Online First: 10/11/2022

Published: 06/06/2023

Article revision time: 15 days

Article Online First time: 35 days

Article editing time: 243 days


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