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Deza DC, Julián Gomara AB, Biota EC, Beltrán B, Domènech E, Casbas AG, Mañosa M, Zabana Y, Alfaro LR, Romero EV, González EG, Sicilia B, Laredo V, Alcalá Escriche MJ, Velázquez LM, Iglesias RF, Pérez AP, Calafat M, Iturria SR, Yudego IM, Nieto YB, Mateo SG, Gisbert JP, Lidón RV, Arias L, Alfambra E, Roche PC, de Acosta MB, López SG. IMPACT OF MESALAZINE ON THE RESPONSE TO COVID-19 VACCINATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE. RESULTS OF A PROSPECTIVE MULTICENTRE STUDY OF GETECCU (VACOVEII STUDY). Gastroenterol Hepatol 2024:S0210-5705(24)00017-7. [PMID: 38219960 DOI: 10.1016/j.gastrohep.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE the recommendations of the Spanish Ministry of Health on vaccination in risk groups include mesalazine among the treatments with a possible negative effect on its effectiveness. However, this is not the recommendation of most experts. Our objective was to evaluate the effect of mesalazine on the humoral response to the SARS-CoV-2 vaccine in patients with inflammatory bowel disease (IBD). METHODS VACOVEII is a Spanish, prospective, multicenter study promoted by GETECCU, which evaluates the effectiveness of the SARS-CoV-2 vaccine in patients with IBD. This study includes IBD patients who have recieved the full vaccination schedule and without previous COVID-19 infection. Seroconversion was set at 260 BAU/mL (centralized determination) and was assessed 6 months after full vaccination. In this subanalysis of the study, we compare the effectivenes of the vaccine between patients treated with mesalazine and patients without treatment. RESULTS A total of 124 patients without immunosuppressive therapy were included, of which 32 did not receive any treatment and 92 received only mesalazine. Six months after full vaccination, no significant differences are observed in the mean concentrations of IgG anti-S between both groups. In the multivariate analysis, antibody titers were independently associated with the use of mRNA vaccines and with SARS-CoV-2 infection. CONCLUSION Mesalazine does not have a negative effect on the response to SARS-CoV-2 vaccines in IBD patients.
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Affiliation(s)
- Diego Casas Deza
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
| | | | | | - Belén Beltrán
- Servicio de Aparato Digestivo, Hospital Universitari i Politècnic La Fe de Valencia, Spain
| | - Eugeni Domènech
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Ana Gutiérrez Casbas
- Servicio de Aparato Digestivo, Hospital General Universitario Doctor Balmis de Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Spain
| | - Miriam Mañosa
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Yamile Zabana
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Servicio de Aparato Digestivo, Hospital Universitari Mútua Terrassa, Spain
| | - Lourdes Roc Alfaro
- Servicio de Microbiología, Hospital Universitario Miguel Servet de Zaragoza, Spain
| | | | | | - Beatriz Sicilia
- Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Spain
| | - Viviana Laredo
- Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | | | - Lucia Madero Velázquez
- Servicio de Aparato Digestivo, Hospital General Universitario Doctor Balmis de Alicante, Spain
| | - Rocío Ferreiro Iglesias
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago de Compostela, Spain
| | | | - Margalida Calafat
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | | | | | | | - Sandra García Mateo
- Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | - Javier P Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Spain; Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Spain
| | - Raquel Vicente Lidón
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain
| | - Lara Arias
- Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Spain
| | - Erika Alfambra
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | - Pilar Corsino Roche
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
| | | | - Santiago García López
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
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Casas Deza D, Julián Gomara AB, Caudevilla Biota E, Beltrán B, Domènech E, Gutiérrez Casbas A, Mañosa M, Zabana Y, Roc Alfaro L, Valverde Romero E, García González E, Sicilia B, Laredo V, Alcalá Escriche MJ, Madero Velázquez L, Ferreiro-Iglesias R, Palmero Pérez A, Calafat M, Rubio Iturria S, Moraleja Yudego I, Ber Nieto Y, García Mateo S, P Gisbert J, Vicente Lidón R, Arias L, Alfambra E, Doñate Borao AB, Peña González E, Corsino Roche P, Vicuña Arregui M, Elorza A, Domínguez Cajal M, Chaparro M, Barreiro-de Acosta M, García-López S. A booster dose of SARS-COV-2 vaccine improves suboptimal seroconversion rates in patients with inflammatory bowel disease. Results of a prospective multicenter study of GETECCU (VACOVEII study). Gastroenterol Hepatol 2023:S0210-5705(23)00474-0. [PMID: 38007154 DOI: 10.1016/j.gastrohep.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND The response to SARS-CoV-2 vaccination decreases in inflammatory bowel disease (IBD) patients, specially under anti-TNF treatment. However, data on medium-term effectiveness are limited, specially using new recommended seroconversion rate (>260BAU/mL). Our aim was to evaluate the 6-month>260 BAU-seroconversion rate after full vaccination and after booster-dose. METHODS VACOVEII is a Spanish multicenter, prospective study promoted by GETECCU. IBD patients full vaccinated against SARS-CoV-2 and without previous COVID-19 infection, treated or not with immunosuppressants, were included. The booster dose was administered 6 months after the full vaccination. Seroconversion was set at 260BAU/mL, according to most recent recommendations and was assessed 6 months after the full vaccination and 6 months after booster-dose. RESULTS Between October 2021 and March 2022, 313 patients were included (124 no treatment or mesalazine; 55 immunomodulators; 87 anti-TNF; 19 anti-integrin; and 28 ustekinumab). Most patients received mRNA-vaccines (86%). Six months after full vaccination, overall seroconversion rate was 44.1%, being significantly lower among patients on anti-TNF (19.5%, p<0.001) and ustekinumab (35.7%, p=0.031). The seroconversion rate after booster was 92%. Again, anti-TNF patients had a significantly lower seroconversion rate (67%, p<0.001). mRNA-vaccine improved seroconversion rate (OR 11.720 [95% CI 2.26-60.512]). CONCLUSION The full vaccination regimen achieves suboptimal response in IBD patients, specially among those anti-TNF or ustekinumab. The booster dose improves seroconversion rate in all patients, although it remains limited in those treated with anti-TNF. These results reinforce the need to prioritize future booster doses in patients on immunosuppressants therapy, specially under anti-TNF, and using mRNA-vaccines.
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Affiliation(s)
- Diego Casas Deza
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain.
| | | | | | - Belén Beltrán
- Servicio de Aparato Digestivo, Hospital Universitari i Politècnic La Fe de Valencia, Spain
| | - Eugeni Domènech
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Ana Gutiérrez Casbas
- Servicio de Aparato Digestivo, Hospital General Universitario Doctor Balmis de Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Spain
| | - Miriam Mañosa
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | - Yamile Zabana
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Servicio de Aparato Digestivo, Hospital Universitari Mútua Terrassa, Spain
| | - Lourdes Roc Alfaro
- Servicio de Microbiología, Hospital Universitario Miguel Servet de Zaragoza, Spain
| | | | | | - Beatriz Sicilia
- Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Spain
| | - Viviana Laredo
- Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | | | - Lucia Madero Velázquez
- Servicio de Aparato Digestivo, Hospital General Universitario Doctor Balmis de Alicante, Spain
| | - Rocío Ferreiro-Iglesias
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Spain
| | | | - Margalida Calafat
- Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol de Badalona, Universitat Autónoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
| | | | | | | | - Sandra García Mateo
- Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | - Javier P Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Spain
| | - Raquel Vicente Lidón
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain
| | - Lara Arias
- Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Spain
| | - Erika Alfambra
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa de Zaragoza, Spain
| | | | | | - Pilar Corsino Roche
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
| | | | - Ainara Elorza
- Servicio de Aparato Digestivo, Hospital Universitario de Galdakao, Spain
| | | | - María Chaparro
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain; Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Spain
| | - Manuel Barreiro-de Acosta
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago de Compostela, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Spain
| | - Santiago García-López
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet de Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain
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