1
|
Beniwal-Patel P, Waclawik G, Browning K, Urmat A, Schell TL, Smith R, Huerta A, Hipp L, Dave S, Shah N, Dillon KE, Reiter-Schreurs K, Russ RK, Mailig MA, Osman F, Farraye FA, Weiss J, Hayney MS, Caldera F. Racial, Ethnic, and Geographic Disparities in Immunization Rates Among Patients With Inflammatory Bowel Disease. CROHN'S & COLITIS 360 2023; 5:otad078. [PMID: 38130948 PMCID: PMC10734681 DOI: 10.1093/crocol/otad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims Racial and ethnic disparities exist in the treatment of IBD. These disparities exist in adult vaccine uptake among the general population and may extend to patients with IBD. The primary aim of this study was to determine whether racial, ethnic, or geographic disparities existed in influenza vaccine uptake among patients with IBD. Methods We performed a multicenter, retrospective cohort study evaluating adult vaccine uptake among patients with IBD seen at two tertiary referral centers between September 2019 and February 2020. The primary outcome was to determine if racial/ethnic and geographic disparities existed in influenza vaccine uptake for the two prior seasons. Our secondary outcomes were to determine if disparities existed for pneumococcal, zoster, or hepatitis B vaccines. Results Among the 2453 patients who met the inclusion criteria, most identified as non-Hispanic White (89.9%), were on immunosuppressive therapy (74.5%), and received the influenza vaccine in both seasons (56.0%). Older age (prevalence ratio (PR) 0.98; 95% confidence interval (95%CI) 0.98-0.99; P < .001) and non-Hispanic White patients (PR 0.76, 95%CI 0.59-0.98, P < 0.03) were significantly more likely to be immunized. Black patients (PR 1.37; 95%CI 1.18-1.59; P < .001) and those living in underserved geographic areas (PR 1.35; 95%CI 1.17-1.56; P < 0.001) were less likely to be immunized. Racial/ethnic and geographic disparities were identified for pneumococcal, zoster, and hepatitis B vaccine uptake. Conclusions Racial and ethnic vaccination uptake disparities exist among patients with IBD; patients from medically underserved areas are also vulnerable to these disparities Studies identifying patient, provider, and system-level opportunities to address these disparities are needed.
Collapse
Affiliation(s)
- Poonam Beniwal-Patel
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Gabrielle Waclawik
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Keely Browning
- Medical College of Wisconsin, Division of Gastroenterology and Hepatology, Milwaukee, WI, USA
| | - Aijan Urmat
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Trevor L Schell
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Ryan Smith
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Antonio Huerta
- University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Lauren Hipp
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sonya Dave
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Neemit Shah
- Depatrment of Medicine, Medical College of Wisconsin School of Medicine, Milwaukee, WI, USA
| | - Kayla E Dillon
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Rachel K Russ
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Miguel A Mailig
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer Weiss
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| |
Collapse
|
2
|
Singer D, Thompson-Leduc P, Gupta D, Poston S, Cheng WY, Ma S, Pawlowski JE, Duh MS, Devine F, Banatwala A, Bernstein E, Farraye FA. Economic and Clinical Burden of Herpes Zoster Among Patients With Inflammatory Bowel Disease in the United States. CROHN'S & COLITIS 360 2023; 5:otad033. [PMID: 37497018 PMCID: PMC10368335 DOI: 10.1093/crocol/otad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Indexed: 07/28/2023] Open
Abstract
Background Patients with ulcerative colitis (UC) or Crohn's disease (CD) are at increased risk of herpes zoster (HZ); however, relevant cost and healthcare resource utilization (HCRU) data are limited. Methods We estimated HCRU (hospitalization, emergency department [ED], and outpatient visits) and costs in patients with UC or CD, with and without HZ, using administrative claims data (October 2015-February 2020). HCRU and costs (2020 US dollars) were compared at 1 month, 1 quarter, and 1 year after the index date, using propensity score adjustment and generalized linear models. Results In total, 20 948 patients were included: UC+/HZ+ (n = 431), UC+/HZ- (n = 10 285), CD+/HZ+ (n = 435), and CD+/HZ- (n = 9797). Patients with HZ had higher all-cause HCRU rates and all-cause total healthcare costs relative to those without HZ. In the first month, adjusted incidence rate ratios (aIRRs) for hospitalizations and ED visits for patients with UC and HZ compared with UC alone were 2.87 (95% confidence interval [CI], 1.93-4.27) and 2.66 (95% CI,1.74-4.05), respectively; for those with CD and HZ, aIRRs were 3.34 (95% CI, 2.38-4.70) and 3.31 (95% CI, 2.32-4.71), respectively, compared with CD alone (all P < .001). Adjusted cost differences in UC and CD cohorts with HZ over the first month were $2189 and $3774, respectively, chiefly driven by higher inpatient costs. The incremental impact on HCRU and costs in cohorts with HZ predominantly occurred during the first quarter following diagnosis. Conclusions HZ is associated with increased HCRU and costs in patients with UC and CD, especially shortly after diagnosis.
Collapse
Affiliation(s)
- David Singer
- Address correspondence to: David Singer, PharmD, MS, GSK, US Health Outcomes and Epidemiology—Vaccines, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA 19104, USA. Phone: +16465995595 ()
| | - Philippe Thompson-Leduc
- Analysis Group, Inc., Health Economics and Outcomes Research, 1190 Avenue des Canadiens-de-Montréal, Suite 1500, Montréal, QC H3B 0G7, Canada
| | - Deepshekhar Gupta
- Analysis Group, Inc., Health Economics and Outcomes Research, 1010 El Camino Real, Suite 310, Menlo Park, CA 94025, USA
| | - Sara Poston
- GSK, US Health Outcomes and Epidemiology—Vaccines, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA 19104, USA
| | - Wendy Y Cheng
- Analysis Group, Inc., Health Economics and Outcomes Research, 111 Huntington Avenue, 14 Floor, Boston, MA 02199, USA
| | - Siyu Ma
- GSK, US Health Outcomes and Epidemiology—Vaccines, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA 19104, USA
- Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA
| | - John E Pawlowski
- GSK, Medical Affairs, FMC Tower Suite 1700, 2929 Walnut Street, Philadelphia, PA 19104, USA
| | - Mei Sheng Duh
- Analysis Group, Inc., Health Economics and Outcomes Research, 111 Huntington Avenue, 14 Floor, Boston, MA 02199, USA
| | - Francesca Devine
- Analysis Group, Inc., Health Economics and Outcomes Research, 151 West 42 Street, 23rd Floor, New York, NY 10036, USA
| | - Azeem Banatwala
- Analysis Group, Inc., Health Economics and Outcomes Research, 333 South Hope Street, 27 Floor, Los Angeles, CA 90071, USA
| | - Emma Bernstein
- Analysis Group, Inc., Health Economics and Outcomes Research, 111 Huntington Avenue, 14 Floor, Boston, MA 02199, USA
- Baylor University, Department of Political Science, One Bear Place #97276, Waco, TX 76798-7276, USA
| | - Francis A Farraye
- Mayo Clinic, Division of Gastroenterology and Hepatology, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| |
Collapse
|
3
|
Almasry M, Caldera F. Taking a JAB at How Gastroenterologists Can Increase Vaccination Rates in Patients with Inflammatory Bowel Disease. Dig Dis Sci 2023:10.1007/s10620-023-07905-5. [PMID: 37024742 PMCID: PMC10079154 DOI: 10.1007/s10620-023-07905-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/24/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Mazen Almasry
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA.
| |
Collapse
|
4
|
Shiga H, Takahashi T, Shiraki M, Kojima Y, Tsuji T, Takagi S, Hiramoto K, Yokoyama N, Sugimura M, Iwabuchi M, Endo K, Onodera M, Sato Y, Shimodaira Y, Nomura E, Kikuchi T, Chiba H, Oomori S, Kudo H, Kumada K, Nagaie S, Ogishima S, Nagami F, Shimoyama Y, Moroi R, Kuroha M, Kakuta Y, Ishige T, Kinouchi Y, Masamune A. Reduced antiviral seropositivity among patients with inflammatory bowel disease treated with immunosuppressive agents. Scand J Gastroenterol 2023; 58:360-367. [PMID: 36222610 DOI: 10.1080/00365521.2022.2132831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although live-attenuated vaccines are contraindicated under immunosuppression, the immune status of patients with inflammatory bowel disease (IBD) has not been fully assessed prior to immunosuppressive therapy. AIMS To investigate antiviral serostatus against viruses requiring live vaccines for prevention in IBD patients undergoing immunosuppressive therapy. METHODS This multicenter study included IBD patients who were aged <40 years and were treated with thiopurine monotherapy, molecular-targeted monotherapy, or combination therapy. Gender- and age-matched healthy subjects (HS) living in the same areas were included as control group. Antibody titers against measles, rubella, mumps, and varicella were measured by enzyme-linked immunosorbent assays. RESULTS A total of 437 IBD patients (163 ulcerative colitis [UC] and 274 Crohn's disease [CD]) and 225 HS were included in the final analysis. Compared with HS, IBD patients had lower seropositivity rates for measles (IBD vs. HS = 83.91% vs. 85.33%), rubella (77.55% vs. 84.89%), mumps (37.50% vs. 37.78%), and varicella (91.26% vs. 96.44%). Gender- and age-adjusted seropositivity rates were lower in UC patients than in both CD patients and HS for measles (UC, CD, and HS = 81.60%, 85.29%, and 85.33%), rubella (76.40%, 78.23%, and 84.89%), mumps (27.16%, 43.70%, and 37.78%), and varicella (90.80%, 91.54%, and 96.44%); the difference was significant for all viruses except measles. Divided by the degree of immunosuppression, there were no significant differences in seropositivity rates among IBD patients. CONCLUSIONS IBD patients, especially those with UC, exhibit reduced seropositivity rates and may benefit from screening prior to the initiation of immunosuppressive therapy.
Collapse
Affiliation(s)
- Hisashi Shiga
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Takahashi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Manabu Shiraki
- Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
| | - Yasuhiro Kojima
- Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | | | - Keiichiro Hiramoto
- Department of Gastroenterology, South Miyagi Medical Center, Ohgawara, Japan
| | - Naonobu Yokoyama
- Department of Gastroenterology, Iwate Prefectural Iwai Hospital, Ichinoseki, Japan
| | - Mikako Sugimura
- Department of Gastroenterology, NHO Sendai Medical Center, Sendai, Japan
| | - Masahiro Iwabuchi
- Department of Gastroenterology, NHO Sendai Medical Center, Sendai, Japan
| | - Katsuya Endo
- Department of Gastroenterology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Motoyuki Onodera
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Yuichirou Sato
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Eiki Nomura
- Department of Gastroenterology, Sendai City Hospital, Sendai, Japan
| | - Tatsuya Kikuchi
- Department of Gastroenterology, Sendai City Hospital, Sendai, Japan
| | - Hirofumi Chiba
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Shinya Oomori
- Department of Gastroenterology, Japanese Red Cross Sendai Hospital, Sendai, Japan
| | - Hisaaki Kudo
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kazuki Kumada
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
| | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
| | - Yusuke Shimoyama
- Department of Gastroenterology, Iwate Prefectural Isawa Hospital, Oshu, Japan
| | - Rintaro Moroi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatake Kuroha
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Ishige
- Department of Pediatrics, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshitaka Kinouchi
- Student Health Care Center, Institute for Excellence in Higher Education, Tohoku University, Sendai, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
5
|
Ferreiro-Iglesias R, Piqueras M, Ricart E, Sempere L, Roca M, Martín de Carpi J, Benítez O, Zabana Y, Mañosa M, Rodríguez-Moranta F, Barreiro-de Acosta M. Recommendations of the Spanish Group on Crohn's Disease and Ulcerative Colitis on the importance, screening and vaccination in inflammatory bowel disease patients. GASTROENTEROLOGIA Y HEPATOLOGIA 2022; 45:805-818. [PMID: 35577225 DOI: 10.1016/j.gastrohep.2022.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
Abstract
Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.
Collapse
Affiliation(s)
- Rocío Ferreiro-Iglesias
- Servicio de Gastroenterología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
| | - Marta Piqueras
- Servicio de Gastroenterología, Consorci Sanitari de Terrassa (CST), Terrassa, Barcelona, España.
| | - Elena Ricart
- Servicio de Gastroenterología, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España
| | - Laura Sempere
- Servicio de Gastroenterología, Hospital General Universitario de Alicante, Alicante, España
| | - Mariona Roca
- Servicio de Farmacia, Consorci Sanitari de Terrassa (CST), Terrassa, Barcelona, España
| | - Javier Martín de Carpi
- Unidad para el Cuidado Integral de la Enfermedad Inflamatoria Intestinal Pediátrica (UCIEII-P), Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona, España
| | - Olga Benítez
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Mútua de Terrassa (HMT), Terrassa, Barcelona, España
| | - Yamile Zabana
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Mútua de Terrassa (HMT), Terrassa, Barcelona, España
| | - Míriam Mañosa
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Francisco Rodríguez-Moranta
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Manuel Barreiro-de Acosta
- Servicio de Gastroenterología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
| |
Collapse
|
6
|
Lee YJ, Kim ES. Vaccination strategies for Korean patients with inflammatory bowel disease. Korean J Intern Med 2022; 37:920-930. [PMID: 35934888 PMCID: PMC9449215 DOI: 10.3904/kjim.2022.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/10/2022] [Indexed: 11/27/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD) are vulnerable to vaccine-preventable infectious diseases. Immunosuppressive drugs, which are often used to manage IBD, may increase this vulnerability and attenuate vaccine efficacy. Thus, healthcare providers should understand infectious diseases and schedule vaccinations for them to reduce the infection-related burden of patients with IBD. All patients with IBD should be assessed in terms of immunity to vaccine-preventable diseases at the time of IBD diagnosis, and be vaccinated appropriately. Vaccination is becoming more important because of the unprecedented coronavirus disease 2019 (COVID-19) global health crisis. This review focuses on recent updates to vaccination strategies for Korean patients with IBD.
Collapse
Affiliation(s)
- Yoo Jin Lee
- Department of Internal Medicine, School of Medicine & Institute for Medical Science, Keimyung University, Daegu,
Korea
| | - Eun Soo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu,
Korea
| |
Collapse
|
7
|
Crosby S, Schuh MJ, Becker M, Ivanov M, Caldera F, Farraye FA. New Pneumococcal Vaccines for Prevention of Invasive Pneumococcal Disease in Adult Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 29:661-664. [PMID: 35830419 DOI: 10.1093/ibd/izac150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Indexed: 04/05/2023]
Abstract
Patients with inflammatory bowel disease (IBD) are at a high risk of developing invasive pneumococcal infection both before and after they are diagnosed. The Advisory Committee on Immunization Practices now endorses use of 2 new pneumococcal conjugate vaccines, PCV15 (Vaxneuvance) and PCV20 (Prevnar 20), for patients who have never received a pneumococcal conjugate vaccine or those with unknown vaccination history. Previous studies have shown that pneumococcal vaccination can decrease the risk of developing severe pneumococcal disease; therefore, it is important that patients with IBD receive pneumococcal vaccination. This report aims to inform clinicians who care for patients with IBD about the changes in immunization practices, as it pertains to pneumococcal vaccination and provides appropriate direction on administering vaccination series.
Collapse
Affiliation(s)
- Sheena Crosby
- Department of Pharmacy, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Marina Ivanov
- Department of Pharmacy, Mayo Clinic, Scottsdale, AZ, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
8
|
Rolak S, Caldera F. The Current Knowns and Unknowns of COVID-19 Vaccine-Induced Immunity in Patients With Inflammatory Bowel Disease. Am J Gastroenterol 2022; 117:731-732. [PMID: 35288512 DOI: 10.14309/ajg.0000000000001729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/27/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Stacey Rolak
- Department of Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota, USA
| | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| |
Collapse
|
9
|
Humoral Immunogenicity of mRNA COVID-19 Vaccines Among Patients With Inflammatory Bowel Disease and Healthy Controls. Am J Gastroenterol 2022; 117:176-179. [PMID: 34797219 DOI: 10.14309/ajg.0000000000001570] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Patients with inflammatory bowel disease (IBD) on immune-modifying therapies may have a lower vaccine response to certain vaccines. The aim of our study was to evaluate humoral immunogenicity of mRNA coronavirus disease 2019 (COVID-19) vaccines among patients with IBD and healthy controls (HCs). METHODS We performed a prospective study to evaluate humoral immunogenicity among patients with IBD and HCs after completion of mRNA COVID-19 vaccines. RESULTS One hundred twenty-two patients with IBD and 60 HCs were enrolled. All HCs and 97% of patients with IBD developed antibodies. Antibody concentrations were lower in patients with IBD compared with those in HCs (median 31 vs 118 μg/mL; P < 0.001). Those who received the mRNA-1273 (Moderna) COVID-19 (median 38; interquartile range [IQR] 24-75 vs μg/mL) had higher antibody concentrations compared with those who received the Pfizer-BNT vaccine series (median 22; IQR 11-42 μg/mL; P < 0.001). Patients on immune-modifying therapy (median 26; IQR 13-50 μg/mL) had lower antibody concentrations compared with those who were on no treatment, aminosalicylates, or vedolizumab (median 59; IQR 31-75 μg/mL; P = 0.003). DISCUSSION Almost all patients with IBD in our study mounted an antibody response. Future studies are needed in evaluating sustained humoral immunity and the impact of booster dosing in patients with IBD.
Collapse
|
10
|
A Brighter Red Section. Am J Gastroenterol 2021; 116:2316-2317. [PMID: 34797220 DOI: 10.14309/ajg.0000000000001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022]
|
11
|
Hashash JG, Farraye FA. On-site Availability Improves Vaccination Rates in Patients With Inflammatory Bowel Disease. CROHN'S & COLITIS 360 2021; 3:otab068. [PMID: 36777281 PMCID: PMC9802186 DOI: 10.1093/crocol/otab068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jana G Hashash
- Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA,Address correspondence to: Jana G. Hashash, MD, MSc, Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA ()
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| |
Collapse
|
12
|
Hashash JG, Picco MF, Farraye FA. Health Maintenance for Adult Patients with Inflammatory Bowel Disease. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2021; 19:583-596. [PMID: 34840495 PMCID: PMC8608358 DOI: 10.1007/s11938-021-00364-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW This review serves as a summary of healthcare maintenance items that should be addressed when managing patients with inflammatory bowel disease (IBD). This manuscript discusses vaccine-preventable illnesses, cancer prevention recommendations, and other screenings that are important to gastroenterologists and primary care physicians caring for patients with IBD. RECENT FINDINGS Patients with IBD often require immunomodulator agents and/or biologics to induce and maintain disease remission which can increase the risk of developing several infections. Also, subsets of patients with IBD are at an increased risk for a number of malignancies including colon, cervical, and skin cancers. SUMMARY Staying up-to-date with health care maintenance of patients with IBD is critical, especially given their increased risk for vaccine-preventable infections as well as comorbidities such as cancers, bone health, and mood disorders. Gastroenterologists and primary care physicians should familiarize themselves with the required screenings and vaccines that are recommended for adult patients with IBD, particularly those who are immunosuppressed.
Collapse
Affiliation(s)
- Jana G. Hashash
- grid.417467.70000 0004 0443 9942Inflammatory Bowel Disease Center, Division of Gastroenterology, Mayo Clinic, Jacksonville, FL USA
| | - Michael F. Picco
- grid.417467.70000 0004 0443 9942Inflammatory Bowel Disease Center, Division of Gastroenterology, Mayo Clinic, Jacksonville, FL USA
| | - Francis A. Farraye
- grid.417467.70000 0004 0443 9942Inflammatory Bowel Disease Center, Division of Gastroenterology, Mayo Clinic, Jacksonville, FL USA
| |
Collapse
|