Clin Gastroenterol Hepatol. in IBD patients after one and two doses of SARS\CoV\2 vaccine respectively. Sub\group analysis revealed non\statistically significant differences between different immunosuppressive regimens for seroconversion. Meta\regression revealed that this vaccine type and study location independently influenced seroconversion rates. There was no statistically significant difference in breakthrough contamination in IBD patients as compared to control after vaccination. Conclusion In summary, the systematic review and meta\analysis suggest that SARS\CoV\2 vaccine is usually safe and effective in IBD patients. 1.?INTRODUCTION Corona Virus Disease 19 (COVID\19), caused by Severe Acute Respiratory Syndrome\COronaVirus\2 (SARS\CoV\2), has been associated with greater than 2 million deaths worldwide as well as significant economic and social upheaval. 1 One of the most significant efforts to reduce SARS\CoV\2 infections and COVID\19 morbidity has been the development of SARS\CoV\2 vaccines. Pharmaceutical companies and academic institutes have rapidly generated several vaccine candidates after sequencing the SARS\CoV\2 virus. 2 , 3 In December 2020, two messenger RNA (mRNA) vaccines (BNT 162b2 and mRNA\1273) and one adenovirus vector vaccine (JNJ\78436735) were approved for use in the United States and multiple other countries. The safety and efficacy of ChAdOx1 nCoV\19 vaccine, based on replication\incompetent chimpanzee adenovirus vector expressing the spike protein, was first described in 2020. 4 Since then, there are indications that these vaccines could play a substantial role in curbing the SARS\CoV\2 pandemic, and decrease morbidity and mortality among those with breakthrough infections. Inflammatory Bowel Disease (IBD), chronic inflammatory diseases of the intestinal Risarestat tract with two major phenotypes, Crohns disease (CD) and ulcerative colitis (UC), is usually increasing in incidence and prevalence worldwide. 5 IBD can significantly impact the quality of life of those affected, and also have marked effects on societies and healthcare systems as a whole. 6 , 7 Immunosuppressive therapies are commonly used in the management of IBD and promote an increased risk of infections. 8 Despite this, current evidence demonstrates that patients with IBD do not have an increased risk of developing SARS\CoV\2 contamination. 9 , 10 , 11 However, a significant proportion of the IBD patients have comorbidities Risarestat (eg pulmonary, cardiovascular and thromboembolic Risarestat diseases) that can increase the risk of adverse outcomes from COVID\19. 11 Therefore, current professional society guidelines recommend that patients with IBD should receive two doses of SARS\CoV\2 vaccination along with an additional booster dose regardless of immune\modifying therapy. 12 , 13 , 14 RGS20 The efficacy of the SARS\CoV\2 vaccines has been demonstrated in several clinical trials; however, patients with IBD or those treated with immunosuppressive medications were excluded from these studies. 15 Therefore, multiple questions regarding the effectiveness of the SARS\CoV\2 vaccination in IBD have emerged. For example, it is unknown if the underlying immune dysregulation characteristic of IBD, or the immunosuppressive therapies used in IBD management, cause an attenuated response to the SARS\CoV\2 vaccination. 16 While several studies have reported the effectiveness of the SARS\CoV\2 vaccine in IBD patients, 17 , 18 , 19 , 20 , 21 the majority of the studies had a small sample size and are underpowered to accurately predict outcomes. This systematic review and meta\analysis summarises the available evidence regarding the effectiveness of SARS\CoV\2 vaccination in patients with IBD to fill this knowledge gap. A subgroup analysis was also performed to evaluate the impact of immunosuppressive medications on the effectiveness of the two\dose SARS\CoV\2 vaccination schedule. 2.?METHODS The study has been.
Clin Gastroenterol Hepatol