Evidence map›Paper›PMID 37842172›Full record

ArticleEClinicalMedicine2023

Neutralising antibody responses against SARS-CoV-2 Omicron BA.4/5 and wild-type virus in patients with inflammatory bowel disease following three doses of COVID-19 vaccine (VIP): a prospective, multicentre, cohort study.

Zhigang Liu, James L Alexander, Kaixing Le, Xin Zhou, Hajir Ibraheim, Sulak Anandabaskaran, Aamir Saifuddin, Kathy Weitung Lin, Leon R McFarlane, Laura Constable and 28 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 17% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Immunology of RNA-based vaccines: The critical interplay between inflammation and expression.Molecular therapy : the journal of the American Society of Gene Therapy · 2025
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors at 13 institutions in 1 country.

Zhigang LiuDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
James L AlexanderDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Kaixing LeDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Xin ZhouDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Hajir IbraheimDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Sulak AnandabaskaranDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Aamir SaifuddinDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Kathy Weitung LinDepartment of Infectious Disease, Imperial College London, London, UK.
Leon R McFarlaneDepartment of Infectious Disease, Imperial College London, London, UK.
Laura ConstableDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Rocio Castro SeoaneDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Nikhil AnandDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Claire BewsheaExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Rachel NiceExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Andrea D'MelloDivision of Medicine & Integrated Care, Imperial College Healthcare NHS Trust, London, UK.
Gareth R JonesDepartment of Gastroenterology, Western General Hospital, NHS Lothian, Edinburgh, UK.
Sharmili BalarajahDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Francesca FiorentinoDepartment of Surgery and Cancer, Imperial College London, London, UK.
Shaji SebastianDepartment of Gastroenterology, Hull University Teaching Hospitals NHS Trust, Hull, UK.
Peter M IrvingDepartment of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Lucy C HicksDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Horace Rt WilliamsDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Alexandra J KentDepartment of Gastroenterology, King's College Hospital, London, UK.
Rachel LingerThe NIHR Bioresource, University of Cambridge, Cambridge, UK.
Miles ParkesThe NIHR Bioresource, University of Cambridge, Cambridge, UK.
Klaartje KokDepartment of Gastroenterology, Bart's Health NHS Trust, London, UK.
Kamal V PatelDepartment of Gastroenterology, St George's Hospital NHS Trust, London, UK.
Julian P TeareDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Daniel M AltmannDepartment of Immunology and Inflammation, Imperial College London, London, UK.
Rosemary J BoytonDepartment of Infectious Disease, Imperial College London, London, UK.
Ailsa L HartDepartment of Gastroenterology, St Marks Hospital and Academic Institute, Gastroenterology, London, UK.
Charlie W LeesDepartment of Gastroenterology, Western General Hospital, NHS Lothian, Edinburgh, UK.
James R GoodhandExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Nicholas A KennedyExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Katrina M PollockDepartment of Infectious Disease, Imperial College London, London, UK.
Tariq AhmadExeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter, Exeter, UK.
Nick PowellDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
VIP study investigators
Imperial College London · GBImperial College Healthcare NHS Trust · GBUniversity of Exeter · GBNHS Lothian · GBSt Mark's Hospital · GBKing's College London · GBNIHR Imperial Biomedical Research Centre · GBSt George's Hospital · GBUniversity of Cambridge · GBBarts Health NHS Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBKing's College Hospital · GBUniversity of Hull · GB

Funding

Medical Research Council MR/S019553/1Medical Research Council MR/S034919/1Medical Research Council MR/V036939/1Medical Research Council MR/W020610/1Wellcome Trust
6 · The paper itself

Abstract

Background: Patients with inflammatory bowel disease (IBD) receiving anti-TNF and JAK-inhibitor therapy have attenuated responses to COVID-19 vaccination. We aimed to determine how IBD treatments affect neutralising antibody responses against the Omicron BA.4/5 variant. Methods: In this multicentre cohort study, we prospectively recruited 340 adults (69 healthy controls and 271 IBD) at nine UK hospitals between May 28, 2021 and March 29, 2022. The IBD study population was established (>12 weeks therapy) on either thiopurine (n = 63), infliximab (n = 45), thiopurine and infliximab combination therapy (n = 48), ustekinumab (n = 45), vedolizumab (n = 46) or tofacitinib (n = 24). Patients were excluded if they were being treated with any other immunosuppressive therapies. Participants had two doses of either ChAdOx1 nCoV-19 or BNT162b2 vaccines, followed by a third dose of either BNT162b2 or mRNA1273. Pseudo-neutralisation assays against SARS-CoV-2 wild-type and BA.4/5 were performed. The half maximal inhibitory concentration (NT50) of participant sera was calculated. The primary outcome was anti-SARS-CoV-2 neutralising response against wild-type virus and Omicron BA.4/5 variant after the second and third doses of anti-SARS-CoV-2 vaccine, stratified by immunosuppressive therapy, adjusting for prior infection, vaccine type, age, and interval between vaccination and blood collection. This study is registered with ISRCTN (No. 13495664). Findings: Both heterologous (first two doses adenovirus vaccine, third dose mRNA vaccine) and homologous (three doses mRNA vaccine) vaccination strategies significantly increased neutralising titres against both wild-type SARS-CoV-2 virus and the Omicron BA.4/5 variant in healthy participants and patients with IBD. Antibody titres against BA.4/5 were significantly lower than antibodies against wild-type virus in both healthy participants and patients with IBD (p < 0.0001). Multivariable models demonstrated that neutralising antibodies against BA.4/5 after three doses of vaccine were significantly lower in patients with IBD on infliximab (Geometric Mean Ratio (GMR) 0.19 [0.10, 0.36], p < 0.0001), infliximab and thiopurine combination (GMR 0.25 [0.13, 0.49], p < 0.0001) or tofacitinib (GMR 0.43 [0.20, 0.91], p = 0.028), but not in patients on thiopurine monotherapy, ustekinumab, or vedolizumab. Breakthrough infection was associated with lower neutralising antibodies against wild-type (p = 0.037) and BA.4/5 (p = 0.045). Interpretation: A third dose of a COVID-19 mRNA vaccine based on the wild-type spike glycoprotein significantly boosts neutralising antibody titres in patients with IBD. However, responses are lower against the Omicron variant BA.4/5, particularly in patients taking anti-TNF and JAK-inhibitor therapy. Breakthrough infections are associated with lower neutralising antibodies and immunosuppressed patients with IBD may receive additional benefit from bivalent vaccine boosters which target Omicron variants. Funding: Pfizer.

Indexed as

Breakthrough infectionInflammatory bowel diseaseInfliximabSARS-CoV-2Tofacitinib

Identifiers

PMID37842172
PMCPMC10570718
OpenAlexW4387363084

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Registered trials

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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.