IBD: high-dose flu shot better for patients receiving anti-TNF agents

  • Inflamm Bowel Dis
  • 24 Aug 2019

  • International Clinical Digest
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Takeaway

  • Patients with IBD treated with antitumor necrosis factor alpha (anti-TNF) monotherapy develop higher influenza antibody levels after receiving the high-dose (HD) vs standard dose (SD) vaccine.

Why this matters

  • "Immunosuppressed populations, including patients with IBD, are at higher risk for severe complications from influenza," say researchers. "Patients with IBD on anti-TNF therapy may have improved protection against influenza with HD rather than SD vaccine."

Study design

  • Researchers in this double-blind clinical trial studied patients with IBD receiving anti-TNF therapy who were randomly assigned to receive either the HD or SD vaccine (HD: n=25; median age, 29 years; 64% men; 100% white; SD: n=15; median age, 43 years; 67% men; 93% white).
  • The researchers measured influenza antibody concentrations before immunisation and 2-4 weeks and 6 months after immunisation.
  • Funding: University of Wisconsin-Madison.

Key results

  • The HD group had higher median H3N2 antibody levels compared with the SD group (160 [interquartile range (IQR), 80-320] vs 80 [IQR, 40-160]; P=.003).
  • Median H1N1 antibody levels were not significantly higher in the HD group (320 [IQR, 150-320] vs 160 [IQR, 80-320]; P=.18).
  • Antibody concentrations in the HD group were equivalent to those of healthy volunteers who received the SD.

Limitations

  • Monocentric design with a small sample size, spanning 2 influenza seasons.