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AS03 佐剂流感疫苗的安全性:证据回顾。

Safety of AS03-adjuvanted influenza vaccines: A review of the evidence.

机构信息

Clinical R&D, GSK, Wavre, Belgium.

Translational Science, GSK, Wavre, Belgium.

出版信息

Vaccine. 2019 May 21;37(23):3006-3021. doi: 10.1016/j.vaccine.2019.04.048. Epub 2019 Apr 25.

Abstract

Clinical and post-licensure data have demonstrated that AS03-adjuvanted inactivated split virion vaccines, many with reduced antigen content, are effective against influenza infection. The objective of this review is to provide a comprehensive assessment of the safety of trivalent seasonal, monovalent pre-pandemic and pandemic AS03-adjuvanted influenza vaccines, based on non-clinical, clinical and post-licensure data in various populations. Non-clinical studies on local tolerance, toxicology and safety pharmacology did not raise any safety concerns with AS03 administered alone or combined with various influenza antigens. Data from clinical trials with over 55,000 vaccinated subjects showed that AS03-adjuvanted influenza vaccines were generally well tolerated and displayed an acceptable safety profile, although the power to detect rare events was limited. Approximately 90 million doses of A/H1N1pdm09 pandemic influenza vaccines (Pandemrix and Arepanrix H1N1) were administered worldwide, which contributed post-licensure data to the collective safety data for AS03-adjuvanted influenza vaccines. An association between Pandemrix and narcolepsy was observed during the A/H1N1pdm09 pandemic, for which a role of a CD4 T cell mimicry sequence in the haemagglutinin protein of A/H1N1pdm09 cannot be excluded. Provided that future AS03-adjuvanted influenza vaccines do not contain this putative mimicry sequence, this extensive safety experience supports the further development and use of AS03-adjuvanted inactivated split virion candidate vaccines against seasonal and pandemic influenza infections.

摘要

临床和上市后数据表明,含有佐剂的灭活分片段病毒流感疫苗(许多抗原含量降低)可有效预防流感感染。本综述的目的是根据非临床、临床和上市后数据,对三价季节性、单价季节性流感疫苗和单价大流行流感疫苗的安全性进行全面评估。非临床局部耐受性、毒理学和安全药理学研究未发现 AS03 单独或与各种流感抗原联合使用存在安全性问题。在超过 55000 名接种受试者的临床试验中获得的数据表明,AS03 佐剂流感疫苗通常具有良好的耐受性,且具有可接受的安全性特征,尽管检测罕见事件的能力有限。全世界已接种约 9000 万剂 A/H1N1pdm09 大流行流感疫苗(Pandemrix 和 Arepanrix H1N1),为 AS03 佐剂流感疫苗的上市后数据提供了补充。在 A/H1N1pdm09 大流行期间,观察到 Pandemrix 与嗜睡症之间存在关联,但不能排除 A/H1N1pdm09 血凝素蛋白中的 CD4 T 细胞模拟序列在其中的作用。如果未来的 AS03 佐剂流感疫苗不包含该假定的模拟序列,则这种广泛的安全性经验支持进一步开发和使用 AS03 佐剂灭活分片段候选疫苗来预防季节性和大流行流感感染。

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