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Immunosuppression Does Not Affect Antibody Concentrations to Measles, Mumps, and Rubella in Patients with Inflammatory Bowel Disease

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Abstract

Background

The Advisory Committee on Immunization Practices (ACIP) recommends using the immunization record and not serologic testing to determine immunity against measles and rubella in the general population, due to potential false negatives. However, it is unknown whether the immune response is less durable among patients who are immunosuppressed.

Aims

The primary aim of this study was to evaluate sustained vaccine-induced measles, mumps, and rubella (MMR) antibody concentrations in immunosuppressed patients with inflammatory bowel disease (IBD).

Methods

We performed a cross-sectional study to compare antibody concentrations following the two-dose (MMR) vaccine among 46 patients with IBD and 20 healthy controls (HC). Three IBD groups stratified by the immunosuppressive regimen that preceded study entry for at least 3 months: (1) thiopurine monotherapy, (2) anti-TNF monotherapy, or (3) combination therapy (anti-TNF agent combined with an immunomodulator) were enrolled.

Results

All subjects had measurable antibody concentrations to the three vaccine viruses. Age and time since receipt of MMR series were similar in both groups. There were no difference in the antibody concentration of measles (IBD 667 mIU/ml vs HC 744 mIU/ml; p = 0.45), mumps (IBD 339 EU/ml vs HC 402 EU/ml; p = 0.62), or rubella (IBD 25 mIU/ml vs HC 62 mIU/ml; p = 0.11) among the groups. No differences in antibody concentrations were found among the IBD treatment groups.

Conclusion

Immunosuppressed patients with IBD have sustained antibody concentrations comparable to healthy controls. Thus, gastroenterologist should follow the ACIP recommendations and use the immunization record when available to determine immunity to measles and rubella in patients with IBD.

Clinical Trials Registry # NCT02434133.

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Acknowledgment

This work was supported by Judy L. and Sal A. Troia, University of Wisconsin Division of Gastroenterology and Hepatology and the University of Wisconsin School of Pharmacy.

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin—Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA

    Freddy Caldera, Sumona Saha, Arnold Wald, Jeffrey Hubers & Mark Reichelderfer

  2. Department of Medicine, Division of Infectious Disease, School of Medicine and Public Health, University of Wisconsin—Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA

    Elizabeth Ann Misch

  3. School of Medicine and Public Health, University of Wisconsin—Madison, 750 Highland Avenue, Madison, WI, 53705, USA

    Bryant Megna & Dana Ley

  4. School of Pharmacy, School of Medicine and Public Health, University of Wisconsin—Madison, 777 Highland Avenue, Madison, WI, 53705, USA

    Youqi Zhang & Mary S. Hayney

Authors
  1. Freddy Caldera
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  2. Elizabeth Ann Misch
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  3. Sumona Saha
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  4. Arnold Wald
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  5. Youqi Zhang
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  6. Jeffrey Hubers
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  7. Bryant Megna
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  8. Dana Ley
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  9. Mark Reichelderfer
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  10. Mary S. Hayney
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Corresponding author

Correspondence to Freddy Caldera.

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Conflict of interest

Drs. Caldera, Misch, Wald, and Reichelderfer and Ms. McCrone, Ms. Garmoe, Mr. Megna, and Miss Ley declare that they have no competing interests/financial disclosures. Dr. Hayney served on the speakers’ bureau for Sanofi Pasteur Vaccines and an advisory board for GlaxoSmithKline Vaccines. Dr. Saha is a consultant with UCB Biosciences.

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Caldera, F., Misch, E.A., Saha, S. et al. Immunosuppression Does Not Affect Antibody Concentrations to Measles, Mumps, and Rubella in Patients with Inflammatory Bowel Disease. Dig Dis Sci 64, 189–195 (2019). https://doi.org/10.1007/s10620-018-5321-z

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  • DOI: https://doi.org/10.1007/s10620-018-5321-z

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