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Año 2023 / Volumen 115 / Número 6
Original

Impact of SARS-CoV-2 vaccination in inflammatory bowel disease patients with different biological agents: a systematic review and meta-analysis

306-314

DOI: 10.17235/reed.2022.9264/2022

Cong Dai, Zi-Yuan Dong, Yi-Nuo Wang, Yu-Hong Huang, Min Jiang,

Resumen

Background: There are concerns regarding the effect of biological agents on SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD). A systematic review and meta-analysis was performed about the serological responses, breakthrough infections and clinical relapse of IBD patients treated with biological agents following SARS-CoV-2 vaccination. Methods: Electronic databases were searched to identify relevant studies. Primary outcomes were the pooled seroconversion rates, breakthrough infection rates and clinical relapse rates after SARS-CoV-2 vaccination in IBD patients treated with biological agents. Secondary outcomes were the comparison of seroconversion rates, breakthrough infection rates and clinical relapse rates in IBD patients treated with biological agents and control cohort after SARS-CoV-2 vaccination. Results: Thirty-five studies were included in this meta-analysis. A high percentage of seroconversion (96.6%, 99% and 99.2%) was achieved in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab after SARS-CoV-2 vaccination, respectively. The pooled breakthrough infection rate was 2.5% and 3.9% in IBD patients treated with anti-TNF-α therapy and vedolizumab, respectively. The breakthrough infection rate in IBD patients treated with anti-TNF-α therapy was significantly lower than control cohort (RR 0.178, 95% CI 0.084–0.378). The pooled clinical relapse rate in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab was 6.9%, 5.4% and 5.3%, respectively. Conclusion: The overall seroconversion rate after SARS-CoV-2 vaccination in IBD patients treated with biological agents is high. The overall breakthrough infection rate and clinical relapse rate in IBD patients treated with biological agents were low.

Resumen coloquial

There are concerns regarding the effect of biological agents on SARS-CoV-2 vaccination in patients with inflammatory bowel disease. We performed a systematic review and meta-analysis about the serological responses, breakthrough infections and clinical relapse of inflammatory bowel disease patients treated with biological agents including anti-TNF-α therapy, vedolizumab, and ustekinumab following SARS-CoV-2 vaccination. Thirty-five studies were included in this meta-analysis. A high percentage of seroconversion (96.6%, 99% and 99.2%) was achieved in inflammatory bowel disease patients treated with anti-TNF-α therapy, vedolizumab, and ustekinumab after SARS-CoV-2 vaccination respectively. The pooled breakthrough infection rate was 2.5% and 3.9% in inflammatory bowel disease patients treated with anti-TNF-α therapy and vedolizumab respectively. The pooled clinical relapse rate in inflammatory bowel disease patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab was 6.9%, 5.4% and 5.3% respectively. Our study found that the overall seroconversion rate after SARS-CoV-2 vaccination in inflammatory bowel disease patients treated with biological agents is high. The overall breakthrough infection rate and clinical relapse rate in IBD patients treated with biological agents were low.

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Recibido: 06/10/2022

Aceptado: 02/11/2022

Prepublicado: 10/11/2022

Publicado: 06/06/2023

Tiempo de revisión del artículo: 15 días

Tiempo de prepublicación: 35 días

Tiempo de edición del artículo: 243 días

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