Infectious Disease

Infliximab treatment for IBD associated with attenuated anti-COVID-19 antibody responses

April 22, 2021

2 min read

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Hanauer SB. Gastrointestinal Aspects of SARS-CoV-2 (COVID-19) Infections: Before, During and After the Pandemic: Change is in the Wind (and Aerosols). Presented on: Interdisciplinary autoimmune summit. 15.-18. April 2021 (virtual meeting).

Disclosure:
Hanauer reports on consulting fees from AbbVie, Allergan, Amgen, Arena, Boehringer, Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Genentech, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Descendants, Prometheus, Protangonist, Receptos, Salix, Samsung Bioepis, Seres Therapeutics, Takeda, UCB, and VHsquared; clinical research for AbbVie, Allergan, Amgen, Celgene, Genentech, Gilead, GlaxoSmithKline, Janssen, Eli Lilly, Novartis, Pfizer, Prometheus, Receptos, Seres Therapeutics, Takeda and UCB; AbbVie, Janssen, Pfizer, and Takeda calling fees; and DSMB from Arena, Boehringer Ingelheim, Bristol Myers Squibb and Protangonist.

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Anti-COVID-19 antibody responses will be attenuated in patients receiving infliximab for inflammatory bowel disease, according to a spokesman for the 2021 Interdisciplinary Autoimmune Summit.

“In addition to the long-range COVID-19, I think another important aspect in the future will be whether or not our drugs influence the antibody response to the virus.” Stephen B. Hanauer, MD, The professor of medicine at Northwestern University’s Feinberg School of Medicine and the medical director of the Northwestern Medicine Digestive Health Center in Chicago reported to attendees at the virtual conference.

Anti-COVID-19 antibody responses are attenuated in patients receiving infliximab for inflammatory bowel disease, according to an IAS 2021 spokesperson. Source: Adobe Stock

During a training session on COVID-19 updates in the area of ​​immune-mediated inflammatory diseases, Hanauer discussed a study recently published in Gut von Nicholas A. Kennedy, MBBS, MA, Cantab, FRACP, from the University of Exeter in the UK and colleagues who concluded that infliximab (Remicade, Janssen) is associated with reduced serological responses to COVID-19 that were further blunted by immunomodulators used as adjunctive therapy.

“In inflammatory bowel disease, there are actually two different types of biological therapy – we have several biologics, but two discrete types,” said Hanauer. “There are systemic anti-TNF agents like infliximab versus vedolizumab, an intestinal-specific antibody that prevents leukocytes from entering the intestinal lining.”

Stephen B. Hanauer

Kennedy and colleagues enrolled a total of 6,935 patients with IBD from 92 centers in the UK and compared antibody responses in patients treated with infliximab to those treated with vedolizumab (Entyvio, Takeda). According to Hanauer, the rates of symptomatic and detected COVID-19 were similar between the two treatment groups. However, seroprevalence, seroconversion, and levels of anti-COVID-19 antibody reactivity were significantly decreased in patients receiving infliximab compared to patients receiving vedolizumab.

In addition, the use of concomitant immunomodulators with a thiopurine or methotrexate further weakened serological responses to COVID-19 in the infliximab-treated patients, with only a third of the patients having detectable anti-COVID-19 antibodies.

“What you can see when you compare the uptake of titers in patients taking infliximab versus patients taking vedolizumab, the systemic agent appears to hamper the immune response,” Hanauer said. “I think we’ll look at this next. We already have a consortium of IBD doctors from North Carolina where we will look at inflammatory bowel disease and the various drugs our patients are taking to study uptake. “

“We have heard before that it is understood that Johnson & Johnsons and other vaccines may need to be administered or determined after 6 or 12 months, but whether our drugs should be kept with these vaccines or whether patients will need additional vaccines, is also to be determined, ”he added. “I am aware of one of my patients who had a kidney transplant and actually did not respond to two of the Pfizer vaccines. I think medication may be a problem in the future and it definitely needs to be tested.”

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Interdisciplinary autoimmune summit

Interdisciplinary autoimmune summit

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