オオモリ　テツペイ   Oomori Tetsupei   大森　鉄平    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Trajectory analyses to identify persistently low responders to COVID-19 vaccination in patients with inflammatory bowel disease: a prospective multicentre controlled study, J-COMBAT
掲載誌名	正式名：Journal of gastroenterology 略　 称：J Gastroenterol ISSNコード：14355922/09441174
掲載区分	国内
巻・号・頁	58(10),pp.1015-1029
著者・共著者	WATANABE Kenji,NOJIMA Masanori,NAKASE Hiroshi,SATO Toshiyuki,MATSUURA Minoru,AOYAMA Nobuo,KOBAYASHI Taku,SAKURADA Hirotake,NISHISHITA Masakazu,YOKOYAMA Kaoru,ESAKI Motohiro,HIRAI Fumihito,NAGAHORI Masakazu,NANJO Sohachi,OMORI Teppei,TANIDA Satoshi,YOKOYAMA Yoshihiro,MORIYA Kei,MAEMOTO Atsuo,HANDA Osamu,OHMIYA Naoki,TSUCHIDA Kiichiro,SHINZAKI Shinichiro,KATO Shingo,URAOKA Toshio,TANAKA Hiroki,TAKATSU Noritaka,NISHIDA Atsushi,UENO Junji,NAKAMURA Masanao,MISHIMA Yoshiyuki,FUJIYA Mikihiro,TSUCHIDA Kenji,HIRAOKA Sakiko,OKABE Makoto,TOYONAGA Takahiko,MATSUOKA Katsuyoshi,ANDOH Akira,HIROTA Yoshio,HISAMATSU Tadakazu
発行年月	2023/10
概要	BACKGROUND:The degree of immune response to COVID-19 vaccination in inflammatory bowel disease (IBD) patients based on actual changes in anti-SARS-CoV-2 antibody titres over time is unknown.METHODS:Data were prospectively acquired at four predetermined time points before and after two vaccine doses in a multicentre observational controlled study. The primary outcome was humoral immune response and vaccination safety in IBD patients. We performed trajectory analysis to identify the degree of immune response and associated factors in IBD patients compared with controls.RESULTS:Overall, 645 IBD patients and 199 control participants were analysed. At 3 months after the second vaccination, the seronegative proportions were 20.3% (combination of anti-tumour necrosis factor [TNF]α and thiopurine) and 70.0% (triple combination including steroids), despite that 80.0% receiving the triple combination therapy were seropositive at 4 weeks after the second vaccination. Trajectory analyses indicated three degrees of change in immune response over time in IBD patients: high (57.7%), medium (35.6%), and persistently low (6.7%). In the control group, there was only one degree, which corresponded with IBD high responders. Older age, combined anti-TNFα and thiopurine (odds ratio [OR], 37.68; 95% confidence interval [CI], 5.64-251.54), steroids (OR, 21.47; 95%CI, 5.47-84.26), and tofacitinib (OR, 10.66; 95%CI, 1.49-76.31) were factors associated with persistently low response. Allergy history (OR, 0.17; 95%CI, 0.04-0.68) was a negatively associated factor. Adverse reactions after the second vaccination were significantly fewer in IBD than controls (31.0% vs 59.8%; p < 0.001).CONCLUSIONS:Most IBD patients showed a sufficient immune response to COVID-19 vaccination regardless of clinical factors. Assessment of changes over time is essential to optimize COVID-19 vaccination, especially in persistently low responders.
DOI	10.1007/s00535-023-02029-z
PMID	37561155