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九价人乳头瘤病毒疫苗的长期有效性:斯堪的纳维亚女性 12 年随访的中期结果。

Long-term effectiveness of the nine-valent human papillomavirus vaccine: Interim results after 12 years of follow-up in Scandinavian women.

机构信息

Unit of Virus, Lifestyle & Genes, Danish Cancer Institute, Copenhagen, Denmark.

Department of Gynecology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

出版信息

Hum Vaccin Immunother. 2024 Dec 31;20(1):2377903. doi: 10.1080/21645515.2024.2377903. Epub 2024 Oct 7.

Abstract

A pivotal study in women aged 16-26 years demonstrated that the nine-valent human papillomavirus (9vHPV) vaccine was efficacious against high-grade cervical dysplasia related to the HPV types covered by the vaccine. To evaluate whether effectiveness remains above 90% for up to 14 years post-vaccination, a long-term follow-up (LTFU) extension of the study was conducted in Denmark, Norway, and Sweden ( = 2,029). Interim findings at 12 years post-vaccination are reported. Effectiveness of the vaccine was measured by comparing the percentage reduction in incidence of HPV16/18/31/33/45/52/58-related high-grade cervical dysplasia in the LTFU cohort with the expected incidence in an unvaccinated cohort. Cervical pre-cancer/cancer diagnoses were identified using national health registries. Tissue samples were obtained from national and regional biobanks for polymerase chain reaction HPV testing, and pathology diagnosis adjudication. Potential waning of vaccine effectiveness and statistical significance were assessed using a control chart method. During LTFU, there were no cases of HPV16/18/31/33/45/52/58-related high-grade cervical dysplasia over 10,396.2 person-years' follow-up in the per-protocol effectiveness population ( = 1,628). No signals indicated vaccine effectiveness decreasing below 90%. Statistically significant protection was provided by the 9vHPV vaccine through at least 10 years, with complete, although not statistically significant, effectiveness through 12 years.

摘要

一项针对 16-26 岁女性的关键性研究表明,九价人乳头瘤病毒(HPV)疫苗对于与疫苗涵盖的 HPV 类型相关的高级别宫颈发育不良具有疗效。为了评估在接种疫苗后长达 14 年的时间内,疫苗的有效性是否仍保持在 90%以上,对丹麦、挪威和瑞典进行了一项研究的长期随访(LTFU)扩展(n=2029)。现将接种疫苗 12 年后的中期发现报告如下。通过比较 LTFU 队列中 HPV16/18/31/33/45/52/58 相关高级别宫颈发育不良发病率的降低百分比与未接种疫苗队列中的预期发病率,来衡量疫苗的有效性。通过国家卫生登记处确定宫颈癌前病变/癌症的诊断。使用聚合酶链反应 HPV 检测和病理学诊断裁决,从国家和区域生物库中获取组织样本。使用控制图方法评估疫苗有效性的潜在衰减和统计学意义。在 LTFU 期间,在符合方案有效性人群(n=1628)的 10396.2 人年随访中,未发生 HPV16/18/31/33/45/52/58 相关高级别宫颈发育不良病例。没有迹象表明疫苗有效性下降到 90%以下。9vHPV 疫苗至少提供了 10 年的统计学显著保护,12 年时的保护效果完全,但没有统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7de0/11459749/0088d0785437/KHVI_A_2377903_F0001_B.jpg

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