De antistof respons na pneumokokkenvaccinatie bij IBD-patiënten die behandeld worden met immunosuppressiva – de PNEUMOREACT studie

This study aims to study the immunogenicity of pneumococcal vaccination with prevenar-13 and two months later, pneumovax-23 in IBD patients on immunosuppressive treatment. To evaluate immunogenicity antibody titers are measured at inclusion and 4-8 weeks after administration of pneumovax-23. Patiets are divided in different groups of immunosuppressive treatment to assess how different immunosuppressives affect immunogenicity of pneumococcal vaccination. Furhtermore, patients will be included who start anti-TNF treatment in the period before, between or after the 2 pneumococcal vaccines, in order to assess whether the starting time of immunosuppressives related to the vaccination schedule further affects immunogenicity. We plan to include 188 participants.

1. IBD patients treated with immunosuppressive agents have a diminished anti-pneumococcal antibody response to pneumococcal vaccination.

2. (A) Use of a TNF-alpha inhibitor is associated with a lower antibody response after pneumococcal vaccination than after use of DMARDs and/or corticosteroids. Use of either high-dose monotherapy with a TNF-alpha inhibitor; and (B) use of standard dose TNF-alpha inhibitor plus additional immunosuppressive drugs are associated with an even lower antibody response after pneumococcal vaccination.

3. A longer time-interval between pneumococcal vaccination and treatment initiation with TNF-alpha inhibitors is associated with an enhanced antibody response.

Not applicable

Pneumococcal vaccination with Prevenar-13 and Pneumovax-23, which is recommended for patients with auto-immune disease.