既発性動脈硬化性心血管疾患を有する人における高用量対標準用量無活性化インフルエンザワクチンおよび心血管的アウトカム: DANFLU-2 試験
Manan Pareek1,2, Niklas Dyrby Johansen1,2, Daniel Modin1,2
1Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 8, 3.th., Hellerup 2900, Denmark.
European heart journal
|August 30, 2025
まとめ
高用量不活性型インフルエンザワクチン (HD- IIV) は,既往の動脈硬化性心血管疾患 (ASCVD) にかかわらず,高齢者において標準用量 (SD- IIV) と同様の有効性を示した. この発見は,この集団における両種のワクチンの呼吸器系および心血管疾患に対する同様の保護を裏付けている.
科学分野:
- 高齢者医療
- ワクチン学
- 心血管医学
背景:
- インフルエンザワクチン接種は,高齢者,特に動脈硬化性心血管疾患 (ASCVD) の患者にとって極めて重要です.
- 高用量不活性化インフルエンザワクチン (HD-IIV) と標準用量不活性化インフルエンザワクチン (SD-IIV) の比較は,この脆弱な群の保護を最適化するために重要です.
研究 の 目的:
- HD- IIV と SD- IIV の相対的なワクチンの有効性を評価し比較する.
- 65歳以上の成人の呼吸器系および心血管疾患に対するワクチンの有効性に対する既存のASCVDの影響を評価する.
主な方法:
- 65歳以上の成人がHD-IIVまたはSD-IIVにランダムに割り当てられた実用的な,オープンラベルのランダム化試験です.
- 3つのインフルエンザシーズンのベースラインとアウトカム情報を収集するために,全国的なレジストリデータを使用しました.
- インフルエンザや肺炎で入院 二次的アウトカム: 重大心血管疾患 (MACE)
主要な成果:
- ASCVDを持つ参加者は,ASCVDのない参加者と比較して,すべてのアウトカムの発生率が高かった.
- HD- IIVとSD- IIVに対するワクチンの相対的な有効性は,ASCVDとASCVDのない参加者間で,主および二次的アウトカムにおいて一致した.
- rVEのASCVD状態とワクチンタイプとの間に有意な相互作用は見つかりませんでした.
結論:
- HD- IIVとSD- IIVは,65歳以上の成人の相対的な有効性を示しています.
- この効果の類似性は,既にあるASCVDに関係なく,呼吸器系と心血管系の両方のアウトカムに及ぶ.
- 発見は,ASCVDを含む高齢者のHD-IIVとSD-IIVの両方の使用を支持しています.
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