COPD Exacerbations and Airflow Obstruction Severity Pre- and Post-Pneumococcal Vaccination: A post hoc Analysis of the RETRIEVE Real-World Study.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2025-04-17 DOI:10.1159/000545232

Stavros Tryfon, Efthymia Papadopoulou, Polyanthi Papanastasiou, Alexandros Ginis, Konstantinos Kostikas

{"title":"COPD Exacerbations and Airflow Obstruction Severity Pre- and Post-Pneumococcal Vaccination: A post hoc Analysis of the RETRIEVE Real-World Study.","authors":"Stavros Tryfon, Efthymia Papadopoulou, Polyanthi Papanastasiou, Alexandros Ginis, Konstantinos Kostikas","doi":"10.1159/000545232","DOIUrl":null,"url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Prevention of exacerbations is fundamental to COPD management.Methods: The RETRIEVE study was a multicenter, 7-year retrospective study (NCT03858348) of patients with spirometry confirmation of COPD, who received LABA/ICS for at least 1 year and either continued or escalated to open triple therapy, according to their physicians' judgment. In this post hoc analysis, we explored exacerbation rate and lung function pre- and post-pneumococcal vaccination in a real-world setting.Results: Among 466 COPD patients, 48.1% received LABA/ICS for a mean 32 months, while 51.9% received LABA/ICS for a mean 21 months and then escalated to open triple therapy. Patients treated solely with LABA/ICS presented a significant reduction in COPD exacerbations (incidence rate ratio 0.66, 95% confidence interval [0.56, 0.78]) and related hospitalizations (0.43 [0.25, 0.72]) after pneumococcal vaccination compared to pre-vaccination. High-risk patients, who ultimately escalated to triple therapy, presented no reduction in exacerbations post-vaccination compared to pre-vaccination, and their airflow obstruction tended to deteriorate over time post-vaccination while they received LABA/ICS. However, after escalation to open triple therapy, there was significant reduction in exacerbations (0.78 [0.66, 0.94]) and related hospitalizations (0.41 [0.26, 0.66]) post-vaccination compared to pre-vaccination. Pneumococcal vaccination rates increased from 2012 to 2018 in our study, exceeding 90% from 2015 onward. Preserved lung function potentially delayed vaccination.Conclusion: This post hoc analysis of the RETRIEVE real-world study highlights the importance of appropriate, personalized maintenance COPD treatment, along with pneumococcal vaccination, for the prevention of COPD exacerbations.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.5000,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiration","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545232","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Prevention of exacerbations is fundamental to COPD management.

Methods: The RETRIEVE study was a multicenter, 7-year retrospective study (NCT03858348) of patients with spirometry confirmation of COPD, who received LABA/ICS for at least 1 year and either continued or escalated to open triple therapy, according to their physicians' judgment. In this post hoc analysis, we explored exacerbation rate and lung function pre- and post-pneumococcal vaccination in a real-world setting.

Results: Among 466 COPD patients, 48.1% received LABA/ICS for a mean 32 months, while 51.9% received LABA/ICS for a mean 21 months and then escalated to open triple therapy. Patients treated solely with LABA/ICS presented a significant reduction in COPD exacerbations (incidence rate ratio 0.66, 95% confidence interval [0.56, 0.78]) and related hospitalizations (0.43 [0.25, 0.72]) after pneumococcal vaccination compared to pre-vaccination. High-risk patients, who ultimately escalated to triple therapy, presented no reduction in exacerbations post-vaccination compared to pre-vaccination, and their airflow obstruction tended to deteriorate over time post-vaccination while they received LABA/ICS. However, after escalation to open triple therapy, there was significant reduction in exacerbations (0.78 [0.66, 0.94]) and related hospitalizations (0.41 [0.26, 0.66]) post-vaccination compared to pre-vaccination. Pneumococcal vaccination rates increased from 2012 to 2018 in our study, exceeding 90% from 2015 onward. Preserved lung function potentially delayed vaccination.

Conclusion: This post hoc analysis of the RETRIEVE real-world study highlights the importance of appropriate, personalized maintenance COPD treatment, along with pneumococcal vaccination, for the prevention of COPD exacerbations.

查看原文本刊更多论文

肺炎球菌接种前后COPD加重和气流阻塞严重程度：检索现实世界研究的事后分析

慢性阻塞性肺疾病（COPD）是世界范围内死亡率和发病率的主要原因。预防恶化是慢性阻塞性肺病管理的基础。方法：RETRIEVE研究是一项多中心、为期7年的回顾性研究（NCT03858348），研究对象是肺活量测定证实为COPD的患者，这些患者接受LABA/ICS治疗至少一年，根据医生的判断继续或升级为开放三联治疗。在这个事后分析中，我们在现实世界中探讨了肺炎球菌接种前后的加重率和肺功能。结果466例COPD患者中，48.1%的患者接受LABA/ICS治疗的平均时间为32个月，51.9%的患者接受LABA/ICS治疗的平均时间为21个月，然后升级为开放三联治疗。与疫苗接种前相比，单纯接受LABA/ICS治疗的患者在肺炎球菌疫苗接种后COPD加重发生率（发病率比0.66,95%可信区间[0.56,0.78]）和相关住院率（0.43[0.25,0.72]）显著降低。高风险患者最终升级到三联治疗，与接种前相比，接种疫苗后病情恶化没有减少，接种LABA/ICS后，他们的气流阻塞倾向于随着接种后时间的推移而恶化。然而，在升级到开放三联治疗后，与接种前相比，疫苗接种后的恶化发生率（0.78[0.66,0.94]）和相关住院率（0.41[0.26,0.66]）显著降低。在我们的研究中，肺炎球菌疫苗接种率从2012年到2018年有所增加，从2015年起超过90%。保留的肺功能可能会延迟疫苗接种。这项对RETRIEVE真实世界研究的事后分析强调了适当的、个性化的COPD维持治疗以及肺炎球菌疫苗接种对于预防COPD恶化的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.