COVID-19 vaccine response weakened by common IBD drug

COVID-19 vaccine response weakened by common IBD drug

Written by Charlotte Hartley on May 4, 2021 — Fact checked by Hilary Guite, FFPH, MRCGP
Share on PinterestA new study looked at the effects of certain drugs on the COVID-19 vaccine response. Marko Geber/Getty Images

  • A large-scale study has found that people using Remicade, which is a drug that treats a number of autoimmune conditions, have a lower antibody response after one dose of a COVID-19 vaccine.
  • Antibody levels were even lower after one vaccine dose in people using Remicade in combination with immunomodulatory drugs.
  • However, having had a previous SARS-CoV-2 infection or a second vaccine dose resulted in an improved antibody response.
  • The researchers recommend that healthcare professionals prioritize people using these types of drugs for second vaccine doses.

People who use a commonly prescribed drug for inflammatory bowel disease (IBD) may have limited protection after their first COVID-19 vaccine dose, according to a new study.

The research found that people using the biologic drug infliximab (Remicade), which belongs to the anti-tumor necrosis factor (anti-TNF) class of drugs, had significantly lower antibody concentrations after their first dose of a COVID-19 vaccine than people using an alternative biologic called vedolizumab (Entyvio). This drug has a different mode of action and belongs to the gut-specific integrin receptor antagonist class of drugs.

However, in a subgroup of people who had previously had SARS-CoV-2, and in a few people who had already had a second vaccine dose, the antibody response increased significantly.

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The findings have important implications for the many people around the world who are using anti-TNF drugs such as Remicade. Study co-author Dr. Nick Powell, of Imperial College London in the United Kingdom, told Medical News Today:

“Anti-TNF drugs are not just used for [people with] IBD, but also for millions of other [people] with arthritis, psoriasis, and other inflammatory diseases. Our data suggest that prompt access to a second dose of vaccine might be a better option for immunosuppressed [people].”

The study appears in the journal Gut. It used data from the CLARITY Study, which received funding from the National Institute for Health Research and Crohn’s and Colitis UK.

Immune suppression

Vaccines protect people from infectious diseases by stimulating the immune system to produce antibodies. For a vaccine to be effective, it must trigger sufficient antibodies to target the virus and prevent subsequent infections.

Anti-TNF drugs are effective treatments for immune-mediated inflammatory conditions such as IBD. They work by “tuning down” inflammation in the body, explains Prof. Duncan Richards, from the University of Oxford, also in the U.K. Prof. Richards was not involved in the study.

However, this tuning down of the immune system might also reduce the immune response to the vaccine.

“Many drugs in this group are associated with a small increased risk of infection, and a reduced antibody response to vaccines has also been observed before,” Prof. Richards told MNT.

“The key […] is the benefit-risk — these drugs are important to control these severe inflammatory conditions, and, overall, the benefit-risk is considered positive because the risks are small.”

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