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Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 6/2018

01-06-2018 | Original Article

Lower Sustained Diphtheria and Pertussis Antibody Concentrations in Inflammatory Bowel Disease Patients

Authors: Freddy Caldera, Sumona Saha, Arnold Wald, Christine A. Garmoe, Sue McCrone, Bryant Megna, Dana Ley, Mark Reichelderfer, Mary S. Hayney

Published in: Digestive Diseases and Sciences | Issue 6/2018

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Abstract

Background

Patients with inflammatory bowel disease (IBD) are often immunosuppressed, and those patients receiving anti-tumor necrosis factor α (TNF) therapy can have lower antibody responses to vaccines. Pertussis cases are at their highest levels in the post-vaccine era. There is little data regarding responses to the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine in IBD patients.

Aims

The aim of this study was to compare sustained vaccine-induced Tdap antibody concentrations in a cohort of IBD patients stratified by medication regimens with healthy controls (HC) who had received an adult Tdap booster.

Methods

We performed a cross-sectional study evaluating antibody responses to Tdap vaccine among IBD patients compared to HC. Our study consisted of three patient groups: adults with IBD stratified by maintenance medication regimen: (1) thiopurine monotherapy; (2) anti-TNF monotherapy; and (3) combination therapy (anti-TNF and immunomodulator (thiopurine or methotrexate)).

Results

Ninety IBD patients and 20 HC participated. Pertussis pertactin antibody concentrations were significantly lower in IBD patients (p = 0.021) compared to HC, and those on anti-TNF agents (monotherapy or combination) had lower antibody concentrations compared to those on thiopurine monotherapy (p = 0.028). Diphtheria antibody concentrations were also lower in IBD patients (p < 0.001), and those on anti-TNF agents (monotherapy or combination) had lower antibody concentrations compared to the thiopurine monotherapy group (p < 0.001).

Conclusion

IBD patients on anti-TNF agents had lower antibody concentrations to diphtheria and pertussis. These findings suggest a need for different Tdap booster schedules for IBD patients on anti-TNF therapy.
Clinical Trials Registry NCT02434133.
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Metadata
Title
Lower Sustained Diphtheria and Pertussis Antibody Concentrations in Inflammatory Bowel Disease Patients
Authors
Freddy Caldera
Sumona Saha
Arnold Wald
Christine A. Garmoe
Sue McCrone
Bryant Megna
Dana Ley
Mark Reichelderfer
Mary S. Hayney
Publication date
01-06-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 6/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5043-2

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