A study published in Alimentary Pharmacology and Therapeutics shows that, in patients with IBD, administration of a double dose of HBV vaccine markedly increases the response rate compared with the standard dose.

“Little is known about the efficacy of standard HBV vaccination in patients with IBD, although it does seem to be quite low,” explains Javier Gisbert, one of the authors of the study. This situation is not ideal, as reactivation of HBV infection is an important concern in patients taking immunosuppressants (which includes many patients with IBD), as it can lead to fulminant hepatic failure and even death.

Gisbert and colleagues compared two HBV vaccination protocols—a standard and double-dose protocol—in patients with IBD. 148 patients were enrolled in the trial. Overall response rate to the vaccine was low, although administration of the double dose was found to greatly increase response with respect to the standard dose. Multivariate analysis demonstrated that vaccination with the double dose was the only factor associated with an improved response to the vaccine. The authors suggest that this double-dose protocol is, therefore, suitable for patients with IBD.

“We believe that, in the future, randomized trials should compare double-dosage protocols with more effective strategies (for example, a four-dose protocol),” concludes Gisbert.