Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has complicated the management of inflammatory bowel diseases (IBD). Objectives This study aimed to assess the efficacy of different anti-SARS-CoV-2 vaccines under different treatments in IBD patients and identify predictive factors associated with lower serological response, including anti-tumor necrosis factor (anti-TNF) drug levels. Design A prospective, double-center study of IBD patients was conducted following messenger ribonucleotide acid (mRNA) and non-mRNA anti-SARS-CoV-2 vaccination. Methods Healthy control (HC) patients were enrolled to reduce bias. Baseline and control samples were obtained 14 days after the second dose to assess the impact of conventional and biological treatments. Clinical and biochemical activity, serological response level, and anti-TNF drug levels were measured. Results This study included 199 IBD (mean age, 40.9 ± 12.72 years) and 77 HC participants (mean age, 50.3 ± 12.36 years). Most patients (76.9%) and all HCs received mRNA vaccines. Half of the IBD patients were on biological treatment (anti-TNF 68.7%). Biological and thiopurine combined immunomodulation and biological treatment were associated with lower serological response (p < 0.001), and mRNA vaccination promoted better antibody levels (p < 0.001). Higher adalimumab levels caused lower serological response (p = 0.006). W8 persistence of anti-SARS-CoV-2 level was equal in IBD and HC groups. Vaccination did not aggravate clinical disease activity (p = 0.65). Conclusion Anti-SARS-CoV-2 vaccination is considerably efficacious in IBD patients, with mRNA vaccines promoting better antibody levels. The negative impact of combined biological treatment, especially with high adalimumab drug levels, on serological response to vaccination should be considered. Although midterm durability of vaccination is encouraging, more data are needed to expand the existing understanding on this issue.

中文翻译：

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全国范围内炎症性肠病患者在接种 COVID-19 疫苗后的谷值、持久性和疾病活动性方面的经验。

背景 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 大流行使炎症性肠病 (IBD) 的治疗变得复杂。目的 本研究旨在评估不同治疗下不同抗 SARS-CoV-2 疫苗对 IBD 患者的疗效，并确定与较低血清学反应相关的预测因素，包括抗肿瘤坏死因子（抗 TNF）药物水平。设计 在信使核糖核苷酸 (mRNA) 和非 mRNA 抗 SARS-CoV-2 疫苗接种后，对 IBD 患者进行了一项前瞻性、双中心研究。方法 招募健康对照（HC）患者以减少偏差。在第二次给药后 14 天获取基线和对照样本，以评估常规和生物治疗的影响。测量临床和生化活性、血清学反应水平和抗TNF药物水平。结果 本研究包括 199 名 IBD（平均年龄，40.9 ± 12.72 岁）和 77 名 HC 参与者（平均年龄，50.3 ± 12.36 岁）。大多数患者 (76.9%) 和所有 HC 都接受了 mRNA 疫苗。一半的 IBD 患者接受生物治疗（抗 TNF 治疗，占 68.7%）。生物和硫嘌呤联合免疫调节和生物治疗与较低的血清学反应相关（p < 0.001），并且 mRNA 疫苗接种可促进更好的抗体水平（p < 0.001）。较高的阿达木单抗水平导致较低的血清学反应（p = 0.006）。IBD 组和 HC 组中第 8 周抗 SARS-CoV-2 水平的持久性相同。疫苗接种不会加重临床疾病活动性（p = 0.65）。结论 抗 SARS-CoV-2 疫苗接种对 IBD 患者相当有效，mRNA 疫苗可促进更好的抗体水平。应考虑联合生物治疗（尤其是高阿达木单抗药物水平）对疫苗接种血清学反应的负面影响。尽管疫苗接种的中期持久性令人鼓舞，但仍需要更多数据来扩大对此问题的现有认识。