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Infliximab May Impede Serologic Response to SARS-CoV-2

TUESDAY, March 23, 2021 -- For patients with inflammatory bowel disease (IBD), infliximab is associated with attenuated serological responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to a study published online March 22 in Gut.

Nicholas A. Kennedy, M.B.B.S., from the Royal Devon and Exeter NHS Foundation Trust in the United Kingdom, and colleagues compared antibody responses in patients with IBD treated with infliximab compared to a reference cohort treated with vedolizumab. Between Sept. 22 and Dec. 23, 2020, 6,935 patients were recruited from 92 U.K. hospitals.

The researchers found that between the groups, the rates of symptomatic and proven SARS-CoV-2 infection were similar. Compared with vedolizumab-treated patients, infliximab-treated patients had lower seroprevalence (3.4 versus 6.0 percent). Infliximab and immunomodulatory use were independently associated with lower seropositivity in multivariable analyses (odds ratios, 0.66 and 0.70, respectively). Seroconversion occurred in fewer infliximab-treated versus vedolizumab-treated patients among those with confirmed SARS-CoV-2 infection (48 versus 83 percent), and the magnitude of anti-SARS-CoV-2 reactivity was lower (median, 0.8 versus 37.0 cutoff index).

"Impaired serological responses to SARS-CoV-2 infection might have important implications for global public health policy and millions of anti-tumor necrosis factor treated patients," the authors write. "Serological testing and virus surveillance should be considered to detect suboptimal vaccine responses, persistent infection and viral evolution to inform public health policy."

Several authors disclosed financial ties to the biopharmaceutical industry; F. Hoffmann-La Roche, Biogen GmbH, and Celltrion Healthcare funded the study.

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