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Dig Dis Sci. 2019 Jan;64(1):189-195. doi: 10.1007/s10620-018-5321-z. Epub 2018 Oct 13.

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

Author information

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. fcaldera@medicine.wisc.edu.
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.
3
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.
4
School of Pharmacy, School of Medicine and Public Health, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA.
5
School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI, 53705, USA.

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.

KEYWORDS:

Immunity; Immunization; Inflammatory bowel disease; Measles; Mumps; Rubella

PMID:
30317494
DOI:
10.1007/s10620-018-5321-z
[Indexed for MEDLINE]

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