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AS03佐剂的甲型H1N1流感大流行病毒和H5N1流感病毒灭活裂解疫苗在成人中的安全性:28项临床试验的汇总分析

Safety of AS03-adjuvanted inactivated split virion A(H1N1)pdm09 and H5N1 influenza virus vaccines administered to adults: pooled analysis of 28 clinical trials.

作者信息

Vaughn David W, Seifert Harry, Hepburn Anne, Dewe Walthere, Li Ping, Drame Mamadou, Cohet Catherine, Innis Bruce L, Fries Louis F

机构信息

a GlaxoSmithKline Vaccines ; Rixensart , Belgium.

出版信息

Hum Vaccin Immunother. 2014;10(10):2942-57. doi: 10.4161/21645515.2014.972149. Epub 2014 Nov 21.

Abstract

Clinical trials have shown that AS03-adjuvanted H5N1 and A(H1N1)pdm09 vaccines are highly immunogenic, although with an increased reactogenicity profile relative to non-adjuvanted vaccines in terms of the incidence of common injection site and systemic adverse events (AEs). We evaluated pooled safety data from 22,521 adults who had received an AS03-adjuvanted H5N1 or A(H1N1)pdm09 influenza or control vaccine with the purpose to identify medically-attended AEs (MAEs), including subsets of serious AEs (SAEs), potentially immune-mediated diseases (pIMDs), and AEs of special interest (AESI), and to explore a potential association of these AEs with the administration of an AS03-adjuvanted influenza vaccine. For participants who had received an AS03-adjuvanted vaccine, the relative risks (RRs) for experiencing a MAE or a SAE compared to control group (participants who had received a non-adjuvanted vaccine or saline placebo) were 1.0 (95% confidence interval [CI]: 0.9; 1.1) and 1.1 (95% CI: 0.9; 1.4), respectively. The overall RRs for experiencing an AESI or a pIMD (AS03-adjuvanted vaccine/control) were 1.2 (95% CI: 0.9; 1.6) and 1.7 (95% CI: 0.8; 3.8), respectively. Thirty-8 participants in the AS03-adjuvanted vaccine group had a pIMD reported after vaccine administration, yielding an incidence rate (IR) of 351.9 (95% CI: 249.1; 483.1) per 100,000 person-years. The estimated IRs in the AS03-adjuvanted vaccine group were greater than the literature reported rates for: facial paresis/VIIth nerve paralysis, celiac disease, thrombocytopenia and ulcerative colitis. These results do not support an association between AS03-adjuvanted H5N1 and A(H1N1)pdm09 vaccines and the AEs collected in the trials included in the analysis.

摘要

临床试验表明,AS03佐剂的H5N1和A(H1N1)pdm09疫苗具有高度免疫原性,尽管就常见注射部位和全身不良事件(AE)的发生率而言,相对于非佐剂疫苗,其反应原性有所增加。我们评估了22521名成年人的汇总安全性数据,这些成年人接种了AS03佐剂的H5N1或A(H1N1)pdm09流感疫苗或对照疫苗,目的是确定需要就医的不良事件(MAE),包括严重不良事件(SAE)、潜在免疫介导疾病(pIMD)和特别关注的不良事件(AESI)的子集,并探讨这些不良事件与接种AS03佐剂流感疫苗之间的潜在关联。对于接种AS03佐剂疫苗的参与者,与对照组(接种非佐剂疫苗或生理盐水安慰剂的参与者)相比,发生MAE或SAE的相对风险(RR)分别为1.0(95%置信区间[CI]:0.9;1.1)和1.1(95%CI:0.9;1.4)。发生AESI或pIMD(AS03佐剂疫苗/对照)的总体RR分别为1.2(95%CI:0.9;1.6)和1.7(95%CI:0.8;3.8)。AS03佐剂疫苗组有38名参与者在接种疫苗后报告了pIMD,发病率为每10万人年351.9(95%CI:249.1;483.1)。AS03佐剂疫苗组的估计发病率高于文献报道的以下疾病的发病率:面瘫/第七颅神经麻痹、乳糜泻、血小板减少症和溃疡性结肠炎。这些结果不支持AS03佐剂的H5N1和A(H1N1)pdm09疫苗与分析中纳入试验收集的不良事件之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb3/5443104/9dcd88393981/khvi-10-10-972149-g001.jpg

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