Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents: Effects of combined therapy with immunosuppressants

G. Andrisani, Daniela Frasca, M. Romero, A. Armuzzi, C. Felice, M. Marzo, D. Pugliese, A. Papa, G. Mocci, I. De Vitis, G. L. Rapaccini, Bonnie B Blomberg, L. Guidi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background and aims: Our first objective was to evaluate the immune response to the adjuvanted 2009 A/H1N1 pandemic (pH1N1) vaccine in inflammatory bowel disease (IBD) patients treated with anti-TNF-α alone or combined with immunosuppressants (IS). Second and third aims were the safety of pH1N1 vaccine and the effects on IBD clinical activity. Methods: 36 patients with Crohn's disease (CD) and 26 with ulcerative colitis (UC) and thirty-one healthy control (HC) subjects were enrolled. 47 patients were on anti TNF-α maintenance monotherapy and 15 on anti TNF-α combined with IS. Sera were collected at baseline (T0) and 4. weeks after the vaccination (T1) for antibody determination by hemagglutination inhibition (HAI). Disease activity was monitored at T0 and T1. Results: Seroprotective titers (≥1:40) in patients were comparable to HC. Seroconvertion rate (≥4 fold increase in HAI titer) was lower than HC in IBD patients (p = 0.009), either on anti TNF-α monotherapy (p = 0.034) or combined with IS (p = 0.011). Geometric mean titer (GMT) of antibodies at T1 was significantly lower in patients on combined therapy versus those on monotherapy (p = 0.0017) and versus HC (p = 0.011). The factor increase of GMT at T1 versus T0 was significantly lower in IBD patients versus HC (p = 0.042), and in those on combined immunosuppression, both versus monotherapy (p = 0.0048) and HC (p = 0.0015). None of the patients experienced a disease flare. Conclusion: Our study has shown a suboptimal response to pH1N1 vaccine in IBD patients on therapy with anti TNF-α and IS compared to those on anti-TNF-α monotherapy and HC.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalJournal of Crohn's and Colitis
Volume7
Issue number4
DOIs
StatePublished - May 1 2013

Fingerprint

Immunosuppressive Agents
Inflammatory Bowel Diseases
Human Influenza
Vaccines
Therapeutics
Hemagglutination
Antibodies
Pandemics
Ulcerative Colitis
Crohn Disease
Immunosuppression
Healthy Volunteers
Vaccination
Maintenance
Safety
Serum

Keywords

  • Anti TNF-α agents
  • H1N1 influenza vaccine
  • Immunosuppression
  • Inflammatory bowel disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents : Effects of combined therapy with immunosuppressants. / Andrisani, G.; Frasca, Daniela; Romero, M.; Armuzzi, A.; Felice, C.; Marzo, M.; Pugliese, D.; Papa, A.; Mocci, G.; De Vitis, I.; Rapaccini, G. L.; Blomberg, Bonnie B; Guidi, L.

In: Journal of Crohn's and Colitis, Vol. 7, No. 4, 01.05.2013, p. 301-307.

Research output: Contribution to journalArticle

Andrisani, G. ; Frasca, Daniela ; Romero, M. ; Armuzzi, A. ; Felice, C. ; Marzo, M. ; Pugliese, D. ; Papa, A. ; Mocci, G. ; De Vitis, I. ; Rapaccini, G. L. ; Blomberg, Bonnie B ; Guidi, L. / Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents : Effects of combined therapy with immunosuppressants. In: Journal of Crohn's and Colitis. 2013 ; Vol. 7, No. 4. pp. 301-307.
@article{cc6d2302c9cd4f9cad68518ec5e89625,
title = "Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents: Effects of combined therapy with immunosuppressants",
abstract = "Background and aims: Our first objective was to evaluate the immune response to the adjuvanted 2009 A/H1N1 pandemic (pH1N1) vaccine in inflammatory bowel disease (IBD) patients treated with anti-TNF-α alone or combined with immunosuppressants (IS). Second and third aims were the safety of pH1N1 vaccine and the effects on IBD clinical activity. Methods: 36 patients with Crohn's disease (CD) and 26 with ulcerative colitis (UC) and thirty-one healthy control (HC) subjects were enrolled. 47 patients were on anti TNF-α maintenance monotherapy and 15 on anti TNF-α combined with IS. Sera were collected at baseline (T0) and 4. weeks after the vaccination (T1) for antibody determination by hemagglutination inhibition (HAI). Disease activity was monitored at T0 and T1. Results: Seroprotective titers (≥1:40) in patients were comparable to HC. Seroconvertion rate (≥4 fold increase in HAI titer) was lower than HC in IBD patients (p = 0.009), either on anti TNF-α monotherapy (p = 0.034) or combined with IS (p = 0.011). Geometric mean titer (GMT) of antibodies at T1 was significantly lower in patients on combined therapy versus those on monotherapy (p = 0.0017) and versus HC (p = 0.011). The factor increase of GMT at T1 versus T0 was significantly lower in IBD patients versus HC (p = 0.042), and in those on combined immunosuppression, both versus monotherapy (p = 0.0048) and HC (p = 0.0015). None of the patients experienced a disease flare. Conclusion: Our study has shown a suboptimal response to pH1N1 vaccine in IBD patients on therapy with anti TNF-α and IS compared to those on anti-TNF-α monotherapy and HC.",
keywords = "Anti TNF-α agents, H1N1 influenza vaccine, Immunosuppression, Inflammatory bowel disease",
author = "G. Andrisani and Daniela Frasca and M. Romero and A. Armuzzi and C. Felice and M. Marzo and D. Pugliese and A. Papa and G. Mocci and {De Vitis}, I. and Rapaccini, {G. L.} and Blomberg, {Bonnie B} and L. Guidi",
year = "2013",
month = "5",
day = "1",
doi = "10.1016/j.crohns.2012.05.011",
language = "English",
volume = "7",
pages = "301--307",
journal = "Journal of Crohn's and Colitis",
issn = "1873-9946",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - Immune response to influenza A/H1N1 vaccine in inflammatory bowel disease patients treated with anti TNF-α agents

T2 - Effects of combined therapy with immunosuppressants

AU - Andrisani, G.

AU - Frasca, Daniela

AU - Romero, M.

AU - Armuzzi, A.

AU - Felice, C.

AU - Marzo, M.

AU - Pugliese, D.

AU - Papa, A.

AU - Mocci, G.

AU - De Vitis, I.

AU - Rapaccini, G. L.

AU - Blomberg, Bonnie B

AU - Guidi, L.

PY - 2013/5/1

Y1 - 2013/5/1

N2 - Background and aims: Our first objective was to evaluate the immune response to the adjuvanted 2009 A/H1N1 pandemic (pH1N1) vaccine in inflammatory bowel disease (IBD) patients treated with anti-TNF-α alone or combined with immunosuppressants (IS). Second and third aims were the safety of pH1N1 vaccine and the effects on IBD clinical activity. Methods: 36 patients with Crohn's disease (CD) and 26 with ulcerative colitis (UC) and thirty-one healthy control (HC) subjects were enrolled. 47 patients were on anti TNF-α maintenance monotherapy and 15 on anti TNF-α combined with IS. Sera were collected at baseline (T0) and 4. weeks after the vaccination (T1) for antibody determination by hemagglutination inhibition (HAI). Disease activity was monitored at T0 and T1. Results: Seroprotective titers (≥1:40) in patients were comparable to HC. Seroconvertion rate (≥4 fold increase in HAI titer) was lower than HC in IBD patients (p = 0.009), either on anti TNF-α monotherapy (p = 0.034) or combined with IS (p = 0.011). Geometric mean titer (GMT) of antibodies at T1 was significantly lower in patients on combined therapy versus those on monotherapy (p = 0.0017) and versus HC (p = 0.011). The factor increase of GMT at T1 versus T0 was significantly lower in IBD patients versus HC (p = 0.042), and in those on combined immunosuppression, both versus monotherapy (p = 0.0048) and HC (p = 0.0015). None of the patients experienced a disease flare. Conclusion: Our study has shown a suboptimal response to pH1N1 vaccine in IBD patients on therapy with anti TNF-α and IS compared to those on anti-TNF-α monotherapy and HC.

AB - Background and aims: Our first objective was to evaluate the immune response to the adjuvanted 2009 A/H1N1 pandemic (pH1N1) vaccine in inflammatory bowel disease (IBD) patients treated with anti-TNF-α alone or combined with immunosuppressants (IS). Second and third aims were the safety of pH1N1 vaccine and the effects on IBD clinical activity. Methods: 36 patients with Crohn's disease (CD) and 26 with ulcerative colitis (UC) and thirty-one healthy control (HC) subjects were enrolled. 47 patients were on anti TNF-α maintenance monotherapy and 15 on anti TNF-α combined with IS. Sera were collected at baseline (T0) and 4. weeks after the vaccination (T1) for antibody determination by hemagglutination inhibition (HAI). Disease activity was monitored at T0 and T1. Results: Seroprotective titers (≥1:40) in patients were comparable to HC. Seroconvertion rate (≥4 fold increase in HAI titer) was lower than HC in IBD patients (p = 0.009), either on anti TNF-α monotherapy (p = 0.034) or combined with IS (p = 0.011). Geometric mean titer (GMT) of antibodies at T1 was significantly lower in patients on combined therapy versus those on monotherapy (p = 0.0017) and versus HC (p = 0.011). The factor increase of GMT at T1 versus T0 was significantly lower in IBD patients versus HC (p = 0.042), and in those on combined immunosuppression, both versus monotherapy (p = 0.0048) and HC (p = 0.0015). None of the patients experienced a disease flare. Conclusion: Our study has shown a suboptimal response to pH1N1 vaccine in IBD patients on therapy with anti TNF-α and IS compared to those on anti-TNF-α monotherapy and HC.

KW - Anti TNF-α agents

KW - H1N1 influenza vaccine

KW - Immunosuppression

KW - Inflammatory bowel disease

UR - http://www.scopus.com/inward/record.url?scp=84875241300&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875241300&partnerID=8YFLogxK

U2 - 10.1016/j.crohns.2012.05.011

DO - 10.1016/j.crohns.2012.05.011

M3 - Article

C2 - 22673636

AN - SCOPUS:84875241300

VL - 7

SP - 301

EP - 307

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 4

ER -