在生物药物治疗炎症性肠病患者中比较标准与强化肺炎球菌疫苗接种方案:一个前性,多中心,随机的开放性研究
Xavier Roblin1,2,3,4, Sophie Vieujean5,6, Stéphane Nancey7
1Department of Gastroenterology, Saint-Etienne University Hospital, Saint-Etienne, France.
Journal of Crohn's & colitis
|August 25, 2025
概括
在接受生物治疗的炎症性肠病 (IBD) 患者中,强化肺炎球菌疫苗接种计划显著改善了免疫反应. 这种强化反应持续36个月,为IBD患者提供更好的保护.
科学领域:
- 免疫学
- 胃肠病学
- 疫苗学
背景情况:
- 肺炎球菌疫苗接种对于炎症性肠病患者至关重要.
- 在接受抗瘤坏死因子 (TNF) 或免疫抑制治疗的IBD患者中,肺炎球菌疫苗的有效性降低.
- 维多利祖马布提供一种具有潜在不同的免疫调节作用的替代生物疗法.
研究的目的:
- 在接受抗TNF (含或不含免疫抑制剂) 或vedolizumab治疗的IBD患者中,比较标准与强化肺炎球菌疫苗接种策略的免疫性.
- 评估不同疫苗接种方案的持续免疫反应和安全性.
主要方法:
- 一项前性多中心随机开放性研究,涉及104名在生物治疗中临床缓解的IBD患者.
- 患者被随机分配到强化 (PCV13/ PCV13/ PPSV23) 或标准 (PCV13/ PPSV23) 肺炎球菌疫苗接种方案中.
- 通过ELISA和opsonophagocytic测试 (OPA) 在多个时间点评估免疫反应,最长为36个月.
主要成果:
- 与标准方案相比,强化疫苗接种方案在5个月后显著提高了疫苗反应率,这种反应率通过ELISA和OPA测量.
- 在12个月,18个月和36个月后,强化治疗组中观察到持续较高的OPA反应.
- 减少的疫苗反应与抗TNF治疗,联合免疫抑制治疗和克罗恩病有关,但这两种疗法都能耐受,安全性或IBD复发率没有显著差异.
结论:
- 强化肺炎球菌疫苗接种策略在36个月内显著增强和维持IBD患者的免疫反应.
- 这种强化方法对接受抗TNF治疗的克罗恩病患者尤为有益.
- 标准和强化疫苗接种方案都显示出良好的安全性,并没有增加IBD复发率.
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