Impact of Biologic and Immunomodulatory Therapy on SARS-CoV-2 Infection and Immunity in Patients with Inflammatory Bowel Disease
CLARITY IBD
First data released
9/05/2021
The first 2 papers from the CLARITY IBD study have been published.
First results: We found that fewer than half of people with IBD who were treated with infliximab had detectable antibodies after SARS-CoV-2 infection, the coronavirus that causes COVID-19.
Second results: After a single dose of vaccine, only about one third of participants (103 of 328) treated exclusively with infliximab generated adequate levels of antibodies to the virus for the vaccine to be considered effective. However, in a sub-group of people who had previously been infected with COVID-19, and also in the few patients studied who had already had a second dose of vaccine, the vaccine-triggered antibody responses rose significantly, indicating an effective response after two exposures. Based on these observations, we conclude that people taking anti-TNF drugs should be considered a priority for a second vaccination.
Charlie Lees, Professor of Gastroenterology at the Univerisity of Edinburgh, discussed what these results mean for IBD patients.
“The CLARITY IBD study will continue to follow participants for 40 weeks to investigate important questions regarding the impact of immunosuppressive drugs on immunity to SARS-CoV-2 infection and COVID-19. Modified vaccine schedules may be required if impaired antibody responses are also observed following vaccination. However, because the overall risk of COVID-19 is low in this patient group, we would still strongly encourage patients to continue to take anti-TNF medicines.”
Professor Tariq Ahmad
Royal Devon and Exeter NHS Foundation Trust
“The CLARITY team is now exploring the role of other elements of the immune system, which may still protect against reinfection. “Although we clearly observed diminished antibody responses in patients taking infliximab, we haven’t yet completed our investigation of T-cell and other protective immune responses against the virus. I would expect that even in the presence of less efficient antibody production, infliximab-treated patients will mobilise some protective aspect of their immune system to defend themselves”
Dr Nick Powell
Imperial College, London
“The CLARITY results are an important first step in helping us understand how different medicines for Crohn’s and Colitis affect a person’s response to coronavirus. At this stage the key message is people with Crohn’s and Colitis should keep taking their medication to stay well and take the vaccine when offered. But we also need research like this to continue. A huge number of people with Crohn’s and Colitis have had to contend with the stresses of shielding and social distancing, and it’s vital this group is prioritised in research.”