Efficacy of COVID-19 vaccines in inflammatory bowel disease patients receiving anti-TNF therapy: A systematic review and meta-analysis

Dan Dou; Fangyi Zhang; Xin Deng; Yun Ma; Shuqing Wang; Xingyu Ji; Xihan Zhu; Dianpeng Wang; Shengsheng Zhang; Luqing Zhao

doi:10.1016/j.heliyon.2023.e19609

Efficacy of COVID-19 vaccines in inflammatory bowel disease patients receiving anti-TNF therapy: A systematic review and meta-analysis

Heliyon. 2023 Sep 5;9(9):e19609. doi: 10.1016/j.heliyon.2023.e19609. eCollection 2023 Sep.

Authors

Affiliations

¹ Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No.23, Back Street, Art Museum, Dongcheng District, Beijing, China.
² School of Mathematics and Statistics Beijing Institute of Technology, Beijing, China.
³ Beijing University of Chinese Medicine, Beijing, China.

Abstract

Background and objectives: There are concerns about the serological responses to Coronavirus disease 2019 (COVID-19) vaccines in inflammatory bowel disease (IBD) patients, particularly those receiving anti-TNF therapy. This study aimed to systematically evaluate the efficacy of COVID-19 vaccines in IBD patients receiving anti-TNF therapy.

Methods: Electronic databases were searched to identify relevant studies. We calculated pooled seroconversion rate after COVID-19 vaccination and subgroup analysis for vaccine types and different treatments were performed. Additionally, we estimated pooled rate of T cell response, neutralization response, and breakthrough infections in this population.

Results: 32 studies were included in the meta-analysis. IBD patients receiving anti-TNF therapy had relatively high overall seroconversion rate after complete vaccination, with no statistical difference in antibody responses associated with different drug treatments. The pooled positivity rate of T cell response was 0.85 in IBD patients receiving anti-TNF therapy. Compared with healthy controls, the positivity of neutralization assays was significantly lower in IBD patients receiving anti-TNF therapy. The pooled rate of breakthrough infections in IBD patients receiving anti-TNF therapy was 0.04.

Conclusions: COVID-19 vaccines have shown good efficacy in IBD patients receiving anti-TNF therapy. However, IBD patients receiving anti-TNF have a relatively high rate of breakthrough infections and a low level of neutralization response.

Keywords: Anti-TNF therapy; COVID-19 vaccines; Inflammatory bowel disease; Meta-analysis; Serological response.