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Cited 21 time in webofscience Cited 42 time in scopus
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Patients with Crohn's disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccineopen access

Authors
Lee, Chang KyunKim, Hyun-SooYe, Byong DukLee, Kang-MoonKim, You SunRhee, Sang YoulKim, Hyo-JongYang, Suk-KyunMoon, WonKoo, Ja-SeolLee, Suck-HoSeo, Geom SeogPark, Soo JungChoi, Chang HwanJung, Sung-AeHong, Sung NohIm, Jong PilKim, Eun Soo
Issue Date
1-May-2014
Publisher
OXFORD UNIV PRESS
Keywords
Crohn' s disease; Inflammatory bowel disease; Innnnunosuppressive agents; Pneumococcal vaccine
Citation
JOURNAL OF CROHNS & COLITIS, v.8, no.5, pp.384 - 391
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CROHNS & COLITIS
Volume
8
Number
5
Start Page
384
End Page
391
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/9312
DOI
10.1016/j.crohns.2013.09.022
ISSN
1873-9946
Abstract
Background/aims: The effect of immunosuppressants on the efficacy of a variety of vaccines is a controversial issue in patients with inflammatory bowel disease (IBD). In this study we determined whether specific imnnunosuppressants impair the serological response to the standard 23-valent pneumococcal polysaccharide vaccine (PPSV23) in a large cohort of patients with Crohn's disease (CD). Methods: This was a multi-center, prospective observational study of adult patients with CD at 15 academic teaching hospitals in Korea. The study population received one intramuscular injection of PPSV23. Anti-pneumococcal IgG antibody titers were measured by immunoassay prior to and 4 weeks after vaccination. All vaccination-related adverse events and the effect of the vaccine on disease activity were also evaluated. Results: The overall serological response rate was 67.5% (133/197). The serological response rate was significantly lower in patients on anti-tumor necrosis factor (anti-TNF) therapy (50.0% on anti-TNF atone; 58.0% on anti-TNF combined with an immunomodulator, IM) than patients on 5-aminosalicylate (78.4%; all P-values vs. 5-aminosalicylate < 0.05); 45.6% (41/90) of patients on anti-TNF therapy were not protected against PPSV23. IM did not affect the immunologic response to the vaccine. Female gender and anti-TNF therapy were significant predictors of non-response to the vaccine (odds ratio [OR] 2.316, P = 0.015; OR 2.582, P = 0.048, respectively). Vaccination was generally safe and tolerated by all patients. Conclusions: Patients with CD on anti-TNF therapy are at significant risk of an inadequate response to PPSV23. The pneumococcal vaccination strategy should be optimized for patients with CD on anti-TNF therapy. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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Koo, Ja Seol
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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