Observational studyGut2021
Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab.
Observational study in Gut, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
103 citing papers in PubMed, 4 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis.Scientific reports · 2022Pooled it
- Potential plants for inflammatory dysfunction in the SARS-CoV-2 infection.Inflammopharmacology · 2022Pooled it
- Serologic Response to Coronavirus Disease 2019 (COVID-19) Vaccination in Patients With Immune-Mediated Inflammatory Diseases: A Systematic Review and Meta-analysis.Gastroenterology · 2022Pooled it
- Turkish IBD Organization's Position Statement on Inflammatory Bowel Disease Management Recommendations During COVID-19 Pandemic.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2021Guideline
- Interaction of TNFi and conventional synthetic DMARD in SARS-CoV-2 vaccine response in axial spondyloarthritis and psoriatic arthritis.Joint bone spine · 2023Trial
- Vaccination in Immune-Mediated Intestinal Diseases: Efficacy, Safety, and Future Directions.Vaccines · 2026Article
- Antibody Responses to SARS-CoV-2 in Cancer Patients in New York City During the 2020 Wave of the COVID-19 Pandemic.Cureus · 2026Article
- XBB.1.5 COVID-19 mRNA Vaccines Induce Inadequate Mucosal Immunity in Patients with Inflammatory Bowel Disease.Vaccines · 2025Article
- SARS-CoV-2 Variant-Specific Antibodies in Vaccinated Inflammatory Bowel Disease Patients.Vaccines · 2025Article
- Durability of Antibody Responses to SARS-CoV-2 Vaccination over 12 Months in Pediatric Inflammatory Bowel Disease.Vaccines · 2025Article
- A Systematic Review and Meta-Analysis: Adverse Inflammatory Bowel Disease Outcomes Following Acute COVID-19.Gastro hep advances · 2025Review
- Navigating SARS-CoV-2-related immunopathology in Crohn's disease: from molecular mechanisms to therapeutic challenges.Virology journal · 2024Review
- Article
- Clinical disease activity in autoimmune rheumatic patients receiving COVID-19 vaccines.BMC rheumatology · 2024Article
- Article
- A Practical Update on COVID-19 and Inflammatory Bowel Disease: COVID-19 Disease Risk and Vaccine Safety and Efficacy.Gastroenterology & hepatology · 2024Article
- Cytokine signature in convalescent SARS-CoV-2 patients with inflammatory bowel disease receiving vedolizumab.Scientific reports · 2024Article
- SARS-CoV-2 vaccination in inflammatory bowel disease (IBD) patients - does treatment for IBD negatively affect SARS-CoV-2 antibodies? A single-centre, prospective study.Przeglad gastroenterologiczny · 2024Article
- Unravelling the cellular response to the SARS-COV-2 vaccine in inflammatory bowel disease patients on biologic drugs.Scientific reports · 2023Observational
- An Update on SARS-CoV-2 Clinical Trial Results-What We Can Learn for the Next Pandemic.International journal of molecular sciences · 2023Review
43 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
32 authors at 20 institutions in 2 countries.
Funding
Abstract
objectiveAntitumour necrosis factor (anti-TNF) drugs impair protective immunity following pneumococcal, influenza and viral hepatitis vaccination and increase the risk of serious respiratory infections. We sought to determine whether infliximab-treated patients with IBD have attenuated serological responses to SARS-CoV-2 infections.
designAntibody responses in participants treated with infliximab were compared with a reference cohort treated with vedolizumab, a gut-selective anti-integrin α4β7 monoclonal antibody that is not associated with impaired vaccine responses or increased susceptibility to systemic infections. 6935 patients were recruited from 92 UK hospitals between 22 September and 23 December 2020.
resultsRates of symptomatic and proven SARS-CoV-2 infection were similar between groups. Seroprevalence was lower in infliximab-treated than vedolizumab-treated patients (3.4% (161/4685) vs 6.0% (134/2250), p<0.0001). Multivariable logistic regression analyses confirmed that infliximab (vs vedolizumab; OR 0.66 (95% CI 0.51 to 0.87), p=0.0027) and immunomodulator use (OR 0.70 (95% CI 0.53 to 0.92), p=0.012) were independently associated with lower seropositivity. In patients with confirmed SARS-CoV-2 infection, seroconversion was observed in fewer infliximab-treated than vedolizumab-treated patients (48% (39/81) vs 83% (30/36), p=0.00044) and the magnitude of anti-SARS-CoV-2 reactivity was lower (median 0.8 cut-off index (0.2-5.6) vs 37.0 (15.2-76.1), p<0.0001).
conclusionsInfliximab is associated with attenuated serological responses to SARS-CoV-2 that were further blunted by immunomodulators used as concomitant therapy. Impaired serological responses to SARS-CoV-2 infection might have important implications for global public health policy and individual anti-TNF-treated patients. Serological testing and virus surveillance should be considered to detect suboptimal vaccine responses, persistent infection and viral evolution to inform public health policy. TRIAL REGISTRATION NUMBER: ISRCTN45176516.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.