IBD therapies do not increase risk of contracting COVID-19 after immunization

Using biologic/small molecules*, systemic steroids, or other agents** to treat patients with inflammatory bowel disease (IBD) does not increase the rate of SARS-CoV-2 infection at 3 and 6 months post-immunization, according to a study presented at AIBD 2021.

“Studies have shown that COVID-19 immunization among patients with IBD is safe and efficacious,… and recent studies have [also] shown that the outcomes of patients with IBD and COVID-19 infection vs the general population are similar,” said the researchers. [Dig Dis Sci 2018;63:209-217; Arq Gastroenterol 2019;56:124-130]        

The study involved 821,744 individuals without IBD and 143,248 patients with IBD (aged 18–90 years) who were receiving biologic/small molecule, systemic steroids, or other agents in the TriNetX Research Network. Of these, only 9,405 participants were fully vaccinated with two doses of BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna), or one dose of Ad26.COV2.S (Johnson & Johnson), while 873 patients were partially vaccinated with BNT162b2 and mRNA-1273, with one dose of each. [AIBD 2021, abstract P058]

The results showed no difference in the rate of SARS-CoV-2 infection between those treated with biologic/small molecule regimen in the IBD group and the non-IBD group at 3 months (1.3 percent vs 0.97 percent; p=0.30) and 6 months (2.2 percent vs 1.7 percent; p=0.19).

Similar rates of SARS-CoV-2 infection were also observed among patients on systemic steroids in the IBD group vs the non-IBD group at 3 months (1.6 percent vs 1.6 percent; p=1.00) and 6 months (2.6 percent vs 2.9 percent; p=0.50).

Among patients on other therapies, the rate of SARS-CoV-2 infection was also comparable between the IBD and non-IBD groups at 3 months (0.79 percent vs 1.13 percent; p=0.23) and 6 months (1.44 percent vs 1.75 percent; p=0.41).

Overall, the results showed no increase in SARS-CoV-2 infection rates, which suggests a durable protection, after immunization for up to 6 months in patients with IBD, the researchers concluded.

“[However,] only 6.6 percent of IBD patients with full immunization against COVID-19 were found in our study, even though multiple authors have demonstrated that COVID-19 immunization is safe among these patients,” the researchers noted. “[Therefore,] vaccination against COVID-19 in IBD patients should be encouraged by providers.”

*certolizumab, ustekinumab, infliximab, adalimumab, vedolizumab, or tofacitinib

**mesalamine, sulfasalazine, balsalazide, or budesonide