Abstract
Background: Exacerbations in COPD or Asthma patients have a negative effect on life expectancy, lung function and patient prognosis. S. pneumoniae is a major cause of exacerbations in some subgroups. This study aimed to assess the effectiveness of PCV13 in reducing exacerbations in Asthma or COPD patients.
Methods: This quasi-experimental study with pre-post paired data included 90 COPD and 32 Asthma patients with different severity degrees, who were vaccinated with PCV13 and followed for two years. Incidence density was calculated from the exacerbations by patient and month of observation. All patients were vaccinated and treated based on current clinical guidelines.
Results: In COPD patients, 216 exacerbations were recorded in the pre-vaccination year (cumulative incidence: 2.4) versus 167 in the first year after vaccination [cumulative incidence: 1.8; RR = 0.75 +/- 0.38 (95%; CI 0.37 to 1.13, p = 0.0047), ARR (absolute risk reduction) = 0.23 +/- 0.38 and NNT=2]. In the second year after vaccination, 89 exacerbations were observed [cumulative incidence = 1, RR = 0.42 +/- 0.42 (95%; CI 0 to 0.84, p = 0.0005), ARR = 0.59 + / - 0.42 and NNT=1]. In Asthma patients, in the pre-vaccination year, 64 exacerbations were recorded versus 46 in the first year after vaccination (Fig. 1) [RR=0.73 (CI 0.61 to 0.82); p = 0.0008, ARR = 24.1 and NNT = 5].
Conclusion: This study shows PCV13 effectiveness in reducing exacerbations in patients with COPD or Asthma. This effect was obseved more clearly in the second year after vaccination.
- Copyright ©the authors 2016