Evidence map›Paper›PMID 33903149›Full record

ArticleGut2021

Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD.

Nicholas A Kennedy, Simeng Lin, James R Goodhand, Neil Chanchlani, Benjamin Hamilton, Claire Bewshea, Rachel Nice, Desmond Chee, Jr Fraser Cummings, Aileen Fraser and 17 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Gut, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05081271 (COVID-19 Booster Vaccination in Persons With Multiple Sclerosis), which is not on this map. Cited by 168 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
168citing papers in PubMed, 9 pooled it
17.1field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT05081271 early_phase1terminatednot on this map

COVID-19 Booster Vaccination in Persons With Multiple Sclerosis

TypeinterventionalSponsorGriffin HospitalRan2021 to 2022Enrolled10ConditionsMultiple SclerosisArmsHomologous booster, Heterologous booster
3 · Its place in the literature

Who cites it

168 citing papers in PubMed, 9 syntheses or guidelines pooled it, 276 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Effectiveness and Durability of COVID-19 Vaccination in 9447 Patients With IBD: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022
    Pooled it
  4. Pooled it
  5. Pooled it
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  7. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
    Pooled it
  8. Pooled it
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  10. Trial
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  12. Article
  13. Vaccination Update and Specific Concerns for RA.Current rheumatology reports · 2025
    Review
  14. Article
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  16. Article
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  18. Article
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108 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 18 institutions in 6 countries.

Nicholas A Kennedy *Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0003-4368-1961
Simeng Lin *Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-4201-4879
James R Goodhand *Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0003-3112-376X
Neil ChanchlaniGastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0003-0207-6706
Benjamin HamiltonGastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-0349-278X
Claire BewsheaExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.ORCID 0000-0002-0965-9587
Rachel NiceExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Desmond CheeGastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0003-3473-9447
Jr Fraser CummingsGastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID 0000-0002-9659-3247
Aileen FraserGastroenterology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0001-6462-5091
Peter M IrvingGastroenterology, Guy's and St Thomas' Hospitals NHS Trust, London, UK.ORCID 0000-0003-0972-8148
Nikolaos KamperidisGastroenterology, St Marks Hospital and Academic Institute, London, UK, London, UK.
Klaartje B KokGastroenterology, Barts and The London NHS Trust, London, UK.ORCID 0000-0002-5942-9149
Christopher Andrew LambTranslational & Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-7271-4956
Jonathan MacdonaldGastroenterology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK.ORCID 0000-0003-0249-107X
Shameer MehtaGastroenterology, University College London Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-7002-293X
Richard Cg PollokGastroenterology, St George's University Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0001-6452-6763
Tim RaineGastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID 0000-0002-5855-9873
Philip J SmithGastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.ORCID 0000-0003-1568-3978
Ajay Mark VermaGastroenterology, Kettering General Hospital NHS Foundation Trust, Kettering, UK.ORCID 0000-0002-6432-3357
Simon JochumRoche Diagnostics GmbH, Mannheim, Baden-Württemberg, Germany.
Timothy J McDonaldBiochemistry, Exeter Clinical Laboratory International, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.ORCID 0000-0003-3559-6660
Shaji SebastianIBD Unit - Gastroenterology, Hull University Teaching Hospitals NHS Trust, Hull, UK.ORCID 0000-0002-3670-6545
Charlie W LeesGastroenterology, Western General Hospital, Edinburgh, Edinburgh, UK.ORCID 0000-0002-0732-8215
Nick Powell *Metabolism, Digestion and Reproduction, Imperial College London, London, UK.ORCID 0000-0003-3231-6950
Tariq Ahmad *Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK tariq.ahmad1@nhs.net.ORCID 0000-0002-6058-5528
Contributors to the CLARITY IBD study
University of Exeter · GBCambridge University Hospitals NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBKettering General Hospital · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBNHS Greater Glasgow and Clyde · GBQueen Mary University of London · GBRoche (Switzerland) · CHRoyal Devon & Exeter NHS Foundation Trust · GBSt George's, University of London · GBSt Thomas' Hospital · GBUniversity College London Hospitals NHS Foundation Trust · GBUniversity Gastroenterology · USUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity Hospital Southampton NHS Foundation Trust · GBUniversity of Hull · GBUniversity of Liverpool · GBWestern General Hospital · GB

Funding

Medical Research Council G0902022Medical Research Council MC_PC_14105Medical Research Council MR/S034919/1Medical Research Council MR/T005564/1
6 · The paper itself

Abstract

objectiveDelayed second dose SARS-CoV-2 vaccination trades maximal effectiveness for a lower level of immunity across more of the population. We investigated whether patients with inflammatory bowel disease treated with infliximab have attenuated serological responses to a single dose of a SARS-CoV-2 vaccine.

designAntibody responses and seroconversion rates in infliximab-treated patients (n=865) were compared with a cohort treated with vedolizumab (n=428), a gut-selective anti-integrin α4β7 monoclonal antibody. Our primary outcome was anti-SARS-CoV-2 spike (S) antibody concentrations, measured using the Elecsys anti-SARS-CoV-2 spike (S) antibody assay 3-10 weeks after vaccination, in patients without evidence of prior infection. Secondary outcomes were seroconversion rates (defined by a cut-off of 15 U/mL), and antibody responses following past infection or a second dose of the BNT162b2 vaccine.

resultsGeometric mean (SD) anti-SARS-CoV-2 antibody concentrations were lower in patients treated with infliximab than vedolizumab, following BNT162b2 (6.0 U/mL (5.9) vs 28.8 U/mL (5.4) p<0.0001) and ChAdOx1 nCoV-19 (4.7 U/mL (4.9)) vs 13.8 U/mL (5.9) p<0.0001) vaccines. In our multivariable models, antibody concentrations were lower in infliximab-treated compared with vedolizumab-treated patients who received the BNT162b2 (fold change (FC) 0.29 (95% CI 0.21 to 0.40), p<0.0001) and ChAdOx1 nCoV-19 (FC 0.39 (95% CI 0.30 to 0.51), p<0.0001) vaccines. In both models, age ≥60 years, immunomodulator use, Crohn's disease and smoking were associated with lower, while non-white ethnicity was associated with higher, anti-SARS-CoV-2 antibody concentrations. Seroconversion rates after a single dose of either vaccine were higher in patients with prior SARS-CoV-2 infection and after two doses of BNT162b2 vaccine.

conclusionInfliximab is associated with attenuated immunogenicity to a single dose of the BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines. Vaccination after SARS-CoV-2 infection, or a second dose of vaccine, led to seroconversion in most patients. Delayed second dosing should be avoided in patients treated with infliximab. TRIAL REGISTRATION NUMBER: ISRCTN45176516.

Indexed as

AdultAntibodies, Monoclonal, HumanizedAntibodies, ViralAntibody FormationBNT162 VaccineChAdOx1 nCoV-19COVID-19COVID-19 VaccinesFemaleGastrointestinal AgentsHumansInflammatory Bowel DiseasesInfliximabMaleMiddle AgedSARS-CoV-2Antibodies, Monoclonal, HumanizedAntibodies, ViralBNT162 VaccineChAdOx1 nCoV-19COVID-19 VaccinesGastrointestinal AgentsInfliximabvedolizumabautoimmune diseaseBNT162b2ChAdOx1 nCoV-19CLARITYCOVID-19inflammatory bowel diseaseinflammatory diseasesinfliximabTNFvaccinevedolizumab

Identifiers

PMID33903149
OpenAlexW3158750369

What OpenQuestion holds

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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.