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C1抑制剂缺乏的血管性水肿患者接种新型冠状病毒肺炎疫苗的安全性和耐受性多中心观察性研究:来自意大利遗传性和获得性血管性水肿网络(ITACA)的数据。

Multicentric Observational Study on Safety and Tolerability of COVID-19 Vaccines in Patients with Angioedema with C1 Inhibitor Deficiency: Data from Italian Network on Hereditary and Acquired Angioedema (ITACA).

作者信息

Parente Roberta, Sartorio Silvio, Brussino Luisa, De Pasquale Tiziana, Zoli Alessandra, Agolini Stefano, Di Agosta Ester, Quattrocchi Paolina, Borrelli Paolo, Bignardi Donatella, Petraroli Angelica, Senter Riccardo, Popescu Janu Valentina, Cogliati Chiara, Guarino Maria Domenica, Rossi Oliviero, Firinu Davide, Pucci Stefano, Spadaro Giuseppe, Triggiani Massimo, Cancian Mauro, Zanichelli Andrea

机构信息

Division of Allergy and Clinical Immunology, University of Salerno, 84131 Salerno, Italy.

Referral Centre for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy.

出版信息

Vaccines (Basel). 2023 Apr 16;11(4):852. doi: 10.3390/vaccines11040852.

Abstract

Angioedema due to C1 inhibitor deficiency (AE-C1-INH) is a rare disease characterized by recurrent and unpredictable attacks of angioedema. Multiple trigger factors, including trauma, emotional stress, infectious diseases, and drugs, could elicit angioedema attacks. The aim of this study was to collect data on the safety and tolerability of COVID-19 vaccines in a population of patients affected by AE-C1-INH. Adult patients with AE-C1-INH, followed by Reference Centers belonging to the Italian Network for Hereditary and Acquired Angioedema (ITACA), were enrolled in this study. Patients received nucleoside-modified mRNA vaccines and vaccines with adenovirus vectors. Data on acute attacks developed in the 72 h following COVID-19 vaccinations were collected. The frequency of attacks in the 6 months after the COVID-19 vaccination was compared with the rate of attacks registered in the 6 months before the first vaccination. Between December 2020 and June 2022, 208 patients (118 females) with AE-C1-INH received COVID-19 vaccines. A total of 529 doses of the COVID-19 vaccine were administered, and the majority of patients received mRNA vaccines. Forty-eight attacks of angioedema (9%) occurred within 72 h following COVID-19 vaccinations. About half of the attacks were abdominal. Attacks were successfully treated with on-demand therapy. No hospitalizations were registered. There was no increase in the monthly attack rate following the vaccination. The most common adverse reactions were pain at the site of injection and fever. Our results show that adult patients with angioedema due to C1 inhibitor deficiency can be safely vaccinated against SARS-CoV-2 in a controlled medical setting and should always have available on-demand therapies.

摘要

C1 抑制剂缺乏所致血管性水肿(AE-C1-INH)是一种罕见疾病,其特征为血管性水肿反复发作且不可预测。多种触发因素,包括创伤、情绪应激、传染病和药物等,均可引发血管性水肿发作。本研究的目的是收集关于 COVID-19 疫苗在 AE-C1-INH 患者群体中的安全性和耐受性数据。本研究纳入了由意大利遗传性和获得性血管性水肿网络(ITACA)下属参考中心随访的成年 AE-C1-INH 患者。患者接种了核苷修饰的 mRNA 疫苗和腺病毒载体疫苗。收集了 COVID-19 疫苗接种后 72 小时内发生的急性发作数据。将 COVID-19 疫苗接种后 6 个月内的发作频率与首次接种前 6 个月记录的发作率进行比较。在 2020 年 12 月至 2022 年 6 月期间,208 例(118 例女性)AE-C1-INH 患者接种了 COVID-19 疫苗。共接种了 529 剂 COVID-19 疫苗,大多数患者接种的是 mRNA 疫苗。48 次血管性水肿发作(9%)发生在 COVID-19 疫苗接种后 72 小时内。约一半的发作发生在腹部。发作通过按需治疗成功得到控制。未记录到住院情况。接种疫苗后每月发作率未增加。最常见的不良反应是注射部位疼痛和发热。我们的结果表明,C1 抑制剂缺乏所致血管性水肿的成年患者在可控的医疗环境中可以安全接种 SARS-CoV-2 疫苗,并且应随时备有按需治疗药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7675/10145557/f3b7b0ea1455/vaccines-11-00852-g001.jpg

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