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Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial

  • Original Article—Alimentary Tract
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Abstract

Background

This research was conducted is to assess the effect of booster doses of the trivalent influenza vaccine in adult inflammatory bowel disease (IBD) patients treated with anti-tumor necrosis factor (TNF)-α agents and/or immunomodulators.

Methods

Adult IBD patients and healthy individuals were subcutaneously administered the trivalent influenza vaccine. They were randomized into two groups: the single vaccination group and the two vaccination booster group. Blood samples were collected, and the antibody titers against each influenza strain were determined by hemagglutination inhibition at 3 different time points (pre-vaccination, 3 weeks post-vaccination, and after the flu season) in the single vaccination group and at 4 time points (pre-vaccination, 3 weeks post-first vaccination, 3 weeks post-second vaccination, and after the flu season) in the booster vaccination group.

Results

Seventy-eight IBD patients and 11 healthy controls were randomized into the single vaccination group and the booster vaccination group. Twenty-nine patients received immunomodulators; 21 received anti-TNF-α agents; and 28 received a combination of both. No significant differences were observed in the evaluated immune response parameters between 3 weeks post-vaccination in the single vaccination group and 3 weeks post-second vaccination in the booster vaccination group (geometric mean titers: H1N1, p = 0.09; H3N2: p = 0.99; B: p = 0.94). A higher pre-vaccination titer was significantly associated with sufficient seroprotection rate after vaccination for the H1N1 strain (odds ratio 11.93, p = 0.03).

Conclusions

The second booster of trivalent influenza vaccination did not improve the immune response in adult IBD patients who were treated with immunomodulators and/or anti-TNF-α agents.

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Abbreviations

ADA:

Adalimumab

AZA:

Azathioprines

CD:

Crohn’s disease

GMT:

The geometric mean titer

HAI:

Hemagglutination inhibition

HBI:

Harvey–Bradshaw index

HBV:

Hepatitis B virus

IBD:

Inflammatory bowel disease

IFX:

Infliximab

OR:

Odds ratio

TNF-α:

Anti-tumor necrosis factor-α

UC:

Ulcerative colitis

UMIN-CTR:

University Hospital Medical Information Network Clinical Trial Registry

6MP:

6-Mercaptopurine

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Acknowledgments

This study was supported by a research grant from the Research on Emerging and Re-emerging Infectious Diseases and research grants from the Health and Labor Sciences Research Grants and Health and Labor Sciences Research Grants for research on intractable diseases from the Ministry of Health, Labor and Welfare in Japan.

Conflict of interest

Kenji Watanabe lectured for AbbVie Japan, Mitsubishi Tanabe Pharma Corporation, Eisai, and has received unrestricted research grants from AbbVie Japan, Mitsubishi Tanabe Pharma Corporation, and Eisai.

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Authors and Affiliations

  1. Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Hiroko Matsumoto, Kenji Watanabe, Hirokazu Yamagami, Noriko Kamata, Mitsue Sogawa, Masatsugu Shiba, Tetsuya Tanigawa, Kazunari Tominaga, Toshio Watanabe, Yasuhiro Fujiwara & Tetsuo Arakawa

  2. Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan

    Satoko Ohfuji, Wakaba Fukushima & Yoshio Hirota

  3. Research Foundation for Microbial Disease of Osaka University, Osaka, Japan

    Kazuhiro Maeda

  4. Clinical Epidemiology Research Center, Medical Co. LTA, Fukuoka, Japan

    Yoshio Hirota

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  1. Hiroko Matsumoto
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  2. Satoko Ohfuji
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  3. Kenji Watanabe
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  4. Hirokazu Yamagami
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  14. Yoshio Hirota
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Corresponding author

Correspondence to Kenji Watanabe.

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Matsumoto, H., Ohfuji, S., Watanabe, K. et al. Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial. J Gastroenterol 50, 876–886 (2015). https://doi.org/10.1007/s00535-015-1042-7

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  • DOI: https://doi.org/10.1007/s00535-015-1042-7

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