Patients with irritable bowel disease (IBD) receiving immunosuppressive treatment, mainly combination therapy, exhibited an impaired immune response to pneumococcal vaccination compared with untreated patients with IBD, according to a study published in Clinical Infectious Diseases.

A team of researchers evaluated the immunogenicity of vaccination with the 13-valent pneumococcal conjugated vaccine followed by the 23-valent pneumococcal polysaccharide vaccine, normally administered 2 months after, in adults with IBD. The investigators measured serotype specific pneumococcal immunoglobulin G antibody concentrations at baseline and 4 to 8 weeks post-vaccination to determine response, which was defined as post-vaccination concentrations ≥1.3mcg/mL for 70% of measured serotypes.

Of the 141 patients with IBD, 104 patients were treated with conventional immunomodulators, anti-tumor necrosis factor agents, or combination therapy; 37 patients received no immunosuppressive treatment (control group).

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Of the patients receiving immunosuppressive drugs, 59% responded adequately to vaccination compared with 81% of patients in the control cohort (odds ratio, 0.33), suggesting that patients with IBD should be vaccinated before initiating any immunosuppressive treatment.

“Further studies are needed to assess the response to pneumococcal vaccination at additional time points, to explore the possibility of hypo-responsiveness, to investigate alternative vaccination strategies and to provide more information on the duration of protection after vaccination,” the authors concluded.

Disclosure: An author discloses research grants from Takeda and speaker’s fees from Takeda, Tillotts, and Abbvie.

Reference van Aalst M, Garcia Garrido HM, van der Leun J, et al. Immunogenicity of the currently recommended pneumococcal vaccination schedule in patients with inflammatory bowel disease.[published online March 22, 2019]. Clin Infect Dis. doi:10.1093/cid/ciz226