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Seasonal influenza vaccination in patients with COPD: a systematic literature review.
BMC Pulm Med. 2017 May 03; 17(1):79.BP

Abstract

BACKGROUND

Influenza is a frequent cause of exacerbations of chronic obstructive pulmonary disease (COPD). Exacerbations are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression, death, and ultimately, substantial healthcare-related costs. Despite longstanding recommendations to vaccinate vulnerable high-risk groups against seasonal influenza, including patients with COPD, vaccination rates remain sub-optimal in this population.

METHODS

We conducted a systematic review to summarise current evidence from randomised controlled trials (RCTs) and observational studies on the immunogenicity, safety, efficacy, and effectiveness of seasonal influenza vaccination in patients with COPD. The selection of relevant articles was based on a three-step selection procedure according to predefined inclusion and exclusion criteria. The search yielded 650 unique hits of which 48 eligible articles were screened in full-text.

RESULTS

Seventeen articles describing 13 different studies were found to be pertinent to this review. Results of four RCTs and one observational study demonstrate that seasonal influenza vaccination is immunogenic in patients with COPD. Two studies assessed the occurrence of COPD exacerbations 14 days after influenza vaccination and found no evidence of an increased risk of exacerbation. Three RCTs showed no significant difference in the occurrence of systemic effects between groups receiving influenza vaccine or placebo. Six out of seven studies on vaccine efficacy or effectiveness indicated long-term benefits of seasonal influenza vaccination, such as reduced number of exacerbations, reduced hospitalisations and outpatient visits, and decreased all-cause and respiratory mortality.

CONCLUSIONS

Additional large and well-designed observational studies would contribute to understanding the impact of disease severity and patient characteristics on the response to influenza vaccination. Overall, the evidence supports a positive benefit-risk ratio for seasonal influenza vaccination in patients with COPD, and supports current vaccination recommendations in this population.

Authors+Show Affiliations

GSK, Wavre, Belgium. Rafik.X.Bekkat-Berkani@gsk.com. Present address: GSK, 5 Crescent Drive, Philadelphia, PA, 19112, USA. Rafik.X.Bekkat-Berkani@gsk.com.Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.GSK, Singapore, Singapore.Business & Decision Life Sciences, Brussels, Belgium. Present address: GSK, Wavre, Belgium.GSK, Wavre, Belgium. Present address: Boehringer-Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.GSK, Rixensart, Belgium.GSK, Wavre, Belgium.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

28468650

Citation

Bekkat-Berkani, Rafik, et al. "Seasonal Influenza Vaccination in Patients With COPD: a Systematic Literature Review." BMC Pulmonary Medicine, vol. 17, no. 1, 2017, p. 79.
Bekkat-Berkani R, Wilkinson T, Buchy P, et al. Seasonal influenza vaccination in patients with COPD: a systematic literature review. BMC Pulm Med. 2017;17(1):79.
Bekkat-Berkani, R., Wilkinson, T., Buchy, P., Dos Santos, G., Stefanidis, D., Devaster, J. M., & Meyer, N. (2017). Seasonal influenza vaccination in patients with COPD: a systematic literature review. BMC Pulmonary Medicine, 17(1), 79. https://doi.org/10.1186/s12890-017-0420-8
Bekkat-Berkani R, et al. Seasonal Influenza Vaccination in Patients With COPD: a Systematic Literature Review. BMC Pulm Med. 2017 May 3;17(1):79. PubMed PMID: 28468650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seasonal influenza vaccination in patients with COPD: a systematic literature review. AU - Bekkat-Berkani,Rafik, AU - Wilkinson,Tom, AU - Buchy,Philippe, AU - Dos Santos,Gael, AU - Stefanidis,Dimitris, AU - Devaster,Jeanne-Marie, AU - Meyer,Nadia, Y1 - 2017/05/03/ PY - 2016/11/03/received PY - 2017/04/25/accepted PY - 2017/04/21/revised PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2018/3/13/medline KW - COPD KW - Effectiveness KW - Efficacy KW - Immunogenicity KW - Influenza KW - Systematic review KW - Vaccination SP - 79 EP - 79 JF - BMC pulmonary medicine JO - BMC Pulm Med VL - 17 IS - 1 N2 - BACKGROUND: Influenza is a frequent cause of exacerbations of chronic obstructive pulmonary disease (COPD). Exacerbations are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression, death, and ultimately, substantial healthcare-related costs. Despite longstanding recommendations to vaccinate vulnerable high-risk groups against seasonal influenza, including patients with COPD, vaccination rates remain sub-optimal in this population. METHODS: We conducted a systematic review to summarise current evidence from randomised controlled trials (RCTs) and observational studies on the immunogenicity, safety, efficacy, and effectiveness of seasonal influenza vaccination in patients with COPD. The selection of relevant articles was based on a three-step selection procedure according to predefined inclusion and exclusion criteria. The search yielded 650 unique hits of which 48 eligible articles were screened in full-text. RESULTS: Seventeen articles describing 13 different studies were found to be pertinent to this review. Results of four RCTs and one observational study demonstrate that seasonal influenza vaccination is immunogenic in patients with COPD. Two studies assessed the occurrence of COPD exacerbations 14 days after influenza vaccination and found no evidence of an increased risk of exacerbation. Three RCTs showed no significant difference in the occurrence of systemic effects between groups receiving influenza vaccine or placebo. Six out of seven studies on vaccine efficacy or effectiveness indicated long-term benefits of seasonal influenza vaccination, such as reduced number of exacerbations, reduced hospitalisations and outpatient visits, and decreased all-cause and respiratory mortality. CONCLUSIONS: Additional large and well-designed observational studies would contribute to understanding the impact of disease severity and patient characteristics on the response to influenza vaccination. Overall, the evidence supports a positive benefit-risk ratio for seasonal influenza vaccination in patients with COPD, and supports current vaccination recommendations in this population. SN - 1471-2466 UR - https://www.unboundmedicine.com/medline/citation/28468650/Seasonal_influenza_vaccination_in_patients_with_COPD:_a_systematic_literature_review_ L2 - https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0420-8 DB - PRIME DP - Unbound Medicine ER -