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13价肺炎球菌结合疫苗(PCV13)联合23价肺炎球菌多糖疫苗(PPSV23)在降低老年人肺炎发病率或严重程度方面是否优于单独使用PPSV23?一项临床智能研究。

Is 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Combined With 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23) Superior to PPSV23 Alone for Reducing Incidence or Severity of Pneumonia in Older Adults? A Clin-IQ.

作者信息

Hayward Starla, Thompson Lou Ann, McEachern Andrea

机构信息

Family Medicine Residency Program, Department of Family Medicine, Oklahoma State University Medical Center, 2345 Southwest Blvd, Tulsa, OK, 74107.

L.C. Baxter Library, Oklahoma State University Medical Center, 744 W. 9 St., Tulsa, OK 74127.

出版信息

J Patient Cent Res Rev. 2016;3(2):111-115. doi: 10.17294/2330-0698.1214. Epub 2016 Apr 22.

Abstract

Pneumonia infection is a significant cause of morbidity and mortality worldwide. In addition to the public health concerns, pneumonia also accounts for a significant cost to the health care system. Currently there are two leading vaccines targeted against S. pneumoniae: 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13). Until recently the recommendation for adult pneumonia vaccination has been a single dose of PPSV23 for all adults 65 years and older. However, concerns were raised regarding the vaccine's efficacy due to the persistent burden of pneumococcal disease in the elderly population. This paper focuses on two trials which evaluate the safety and efficacy of PCV13 in the adult population. The first study reveals improved immune response with the addition of PCV13 to PPSV23, while the second shows PCV13 was effective in the prevention of vaccine-type community-acquired pneumonia. The two studies observed adequate safety profiles for PCV13 in series with PPSV23 and with PCV13 compared to placebo.

摘要

肺炎感染是全球发病和死亡的重要原因。除了公共卫生问题外,肺炎还给医疗保健系统带来了巨大成本。目前有两种主要的针对肺炎链球菌的疫苗:23价肺炎球菌多糖疫苗(PPSV23)和13价肺炎球菌结合疫苗(PCV13)。直到最近,成人肺炎疫苗接种的建议还是对所有65岁及以上的成年人接种单剂PPSV23。然而,由于老年人群中肺炎球菌疾病的持续负担,人们对该疫苗的有效性提出了担忧。本文重点关注两项评估PCV13在成人人群中的安全性和有效性的试验。第一项研究表明,在PPSV23基础上加用PCV13可改善免疫反应,而第二项研究表明PCV13在预防疫苗型社区获得性肺炎方面有效。两项研究观察到,与安慰剂相比,PCV13与PPSV23联用以及单独使用PCV13时都具有足够的安全性。

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