Vaccines for preventing influenza in people with asthma

Christopher J Cates; Tom Jefferson; Anna Bara; Brian H Rowe

doi:10.1002/14651858.CD000364.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Analysis 1.1

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 1 Patients with an exacerbation of asthma.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 2 Patients with a fall in PEF of over 30%.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 3 Fall in mean Peak Flow (% baseline) days 2‐4.

Ir a la figura de la revisiónAbrir en una pestaña nueva


Study
Kut 1999	No significant change in PC20 following either placebo or vaccine. PC20 (SD) in the placebo group was 7.02 (9.3) before challenge and 7.3 (3.6) after 24 hours. In the vaccine group PC20 was 9.5(10.6) before vaccine and 9.8(9.3) afterwards. (P>0.05)
Reid 1998	No significant difference found in placebo group (n=5) or vaccination group (n=17) in either mean PD20 or mean FEV1 (tested by analysis of variance ANOVA). No individual patient in either group showed a change of PD20 of more than two‐fold.
Sener 1999	No significant difference between placebo and vaccine in PD20 at 2 weeks. Vaccine 2.96(SD 3.2) and placebo 2.76 (SD 2.91)

Analysis 1.4

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 4 Change in airways responsiveness.

Ir a la figura de la revisión

Analysis 1.5

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 5 Increased nebuliser usage (days 1‐3).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 6 Increased use of bronchodilators following vaccination (days 1‐3).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.7

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 7 Hospital admission (0‐14 days post‐immunisation).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.8

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 8 Medical consultation (0‐14 days after immunisation).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.9

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 9 New or increased oral steroid use (0‐14 days after immunisation).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.10

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 10 One or more day off school or work.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.11

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 11 Number of symptom free days in fortnight after vaccination.

Ir a la figura de la revisiónAbrir en una pestaña nueva


Study
Govaert 1992	No adverse reactions on asthma symptoms reported from any of the 14 asthmatics immunised with split‐virus vaccine or the 11 astmatics given placebo. (Communication from author)
Hahn 1980	No significant deterioration in home Peak Flow measurement in the split vaccine (25 patients), subunit vaccine (25 patients) or placebo group (16 patients) in the two weeks following vaccination. No numerical data given.
Sener 1999	No significant difference in symptom scores in the week after vaccine. Placebo mean score 4.66 (SD 7.3), vaccine mean score 4.92 (SD 7.56)
Stenius 1986	Similar in the vaccine and placebo groups. No numerical data provided.

Analysis 1.12

Comparison 1 Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes), Outcome 12 Change in asthma symptoms in the week following vaccination..

Ir a la figura de la revisión

Analysis 2.1

Comparison 2 Split virus or Surface Antigen vaccine v. Placebo (Late Outcomes), Outcome 1 Influenza related asthma exacerbations.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Split virus or Surface Antigen vaccine v. Placebo (Late Outcomes), Outcome 2 Duration of influenza related asthma exacerbation (days).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Split virus or Surface Antigen vaccine v. Placebo (Late Outcomes), Outcome 3 Severity of influenza related asthma exacerbation (symptom score).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 1 Hospital admission for asthma exacerbation.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 2 Asthma exacerbations in the month after vaccination.

Ir a la figura de la revisiónAbrir en una pestaña nueva


Study
Miyazaki 1993	No asthma attacks were apparent following vaccination. Evaluation was made difficult by an Adenovirus outbreak during the study period. No defintion of asthma attack provided by the authors.
Tanaka 1993	No asthma attacks were observed following vaccination (20 patients given CR vaccine and 25 given placebo). No defintion of asthma attack provided by the authors.

Analysis 3.3

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 3 Asthma exacerbations in the week following vaccination.

Ir a la figura de la revisión

Analysis 3.4

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 4 Mean FEV1 at 2‐5 days post vaccination (% predicted).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 5 Numer of patients with significant fall in FEV1 (over 12%‐15% or 50mls) on day 2‐4.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 6 Fall in mean FEV1 in litres (day 2‐4).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.7

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 7 Number of puffs of beta‐2 agonist per day (in month following vaccination).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.8

Comparison 3 Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes), Outcome 8 Morning Peak Flow of >30% below baseline at least once in the 4 weeks after vaccination.

Ir a la figura de la revisiónAbrir en una pestaña nueva


Study
Ortwein 1987	No significant differences found in home Peak Flow measurements in the three days following vaccination in any of the vaccine groups individually or together. No numerical data provided in the paper.

Analysis 5.1

Comparison 5 Immunisation with Whole virus v. Split virus v. Subunit vaccine (Early outcomes), Outcome 1 Home Peak Flow measurements before and after vaccination.

Ir a la figura de la revisión


Study
Ortwein 1987	No deterioration in Lung Function measured in the laboratory in the 3 days following immunisation (either no change or small improvements seen.) No numerical data provided.

Analysis 5.2

Comparison 5 Immunisation with Whole virus v. Split virus v. Subunit vaccine (Early outcomes), Outcome 2 Lung function measurements.

Ir a la figura de la revisión

Comparison 1. Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Patients with an exacerbation of asthma Show forest plot	2	4412	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.02, 0.02]

1.1 First‐time vaccinees	2	948	Risk Difference (M‐H, Fixed, 95% CI)	0.02 [‐0.03, 0.07]
1.2 Repeat vaccinees	2	3464	Risk Difference (M‐H, Fixed, 95% CI)	‐0.01 [‐0.03, 0.02]
2 Patients with a fall in PEF of over 30% Show forest plot	2	4252	Risk Difference (M‐H, Fixed, 95% CI)	0.00 [‐0.02, 0.03]

2.1 First‐time vaccinees	1	194	Risk Difference (M‐H, Fixed, 95% CI)	0.06 [0.01, 0.11]
2.2 Repeat vacinees	1	328	Risk Difference (M‐H, Fixed, 95% CI)	0.01 [‐0.01, 0.03]
2.3 Vaccination status unspecified	1	3730	Risk Difference (M‐H, Fixed, 95% CI)	0.00 [‐0.02, 0.02]
3 Fall in mean Peak Flow (% baseline) days 2‐4 Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

4 Change in airways responsiveness Show forest plot			Other data	No numeric data

5 Increased nebuliser usage (days 1‐3) Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

6 Increased use of bronchodilators following vaccination (days 1‐3) Show forest plot	3	4228	Risk Difference (M‐H, Fixed, 95% CI)	‐0.00 [‐0.02, 0.01]

7 Hospital admission (0‐14 days post‐immunisation) Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

8 Medical consultation (0‐14 days after immunisation) Show forest plot	2	4396	Risk Difference (M‐H, Fixed, 95% CI)	0.00 [‐0.01, 0.02]

9 New or increased oral steroid use (0‐14 days after immunisation) Show forest plot	2	4419	Risk Difference (M‐H, Fixed, 95% CI)	0.00 [‐0.01, 0.01]

10 One or more day off school or work Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

11 Number of symptom free days in fortnight after vaccination Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

12 Change in asthma symptoms in the week following vaccination. Show forest plot			Other data	No numeric data

Comparison 1. Split virus or Surface Antigen vaccine v. Placebo (Early Outcomes)

Ir a la tabla de la revisión

Comparison 2. Split virus or Surface Antigen vaccine v. Placebo (Late Outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Influenza related asthma exacerbations Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Subtotals only

1.1 Number of participants with influenza related exacerbations	1	696	Risk Difference (M‐H, Fixed, 95% CI)	0.01 [‐0.02, 0.04]
1.2 Number of patients with any asthma exacerbation	1	696	Risk Difference (M‐H, Fixed, 95% CI)	‐0.04 [‐0.09, 0.00]
2 Duration of influenza related asthma exacerbation (days) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Severity of influenza related asthma exacerbation (symptom score) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

Comparison 2. Split virus or Surface Antigen vaccine v. Placebo (Late Outcomes)

Ir a la tabla de la revisión

Comparison 3. Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Hospital admission for asthma exacerbation Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

2 Asthma exacerbations in the month after vaccination Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

3 Asthma exacerbations in the week following vaccination Show forest plot			Other data	No numeric data

4 Mean FEV1 at 2‐5 days post vaccination (% predicted) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 Numer of patients with significant fall in FEV1 (over 12%‐15% or 50mls) on day 2‐4 Show forest plot	2	65	Risk Difference (M‐H, Fixed, 95% CI)	0.01 [‐0.12, 0.15]

6 Fall in mean FEV1 in litres (day 2‐4) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

7 Number of puffs of beta‐2 agonist per day (in month following vaccination) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

8 Morning Peak Flow of >30% below baseline at least once in the 4 weeks after vaccination Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 3. Live Attenuated Cold Recombinant vaccine v. Placebo (Early Outcomes)

Ir a la tabla de la revisión

Comparison 4. Live Attenuated Cold Recombinant vaccine v. Placebo (Late Outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 All outcomes			Other data	No numeric data

Comparison 4. Live Attenuated Cold Recombinant vaccine v. Placebo (Late Outcomes)

Ir a la tabla de la revisión

Comparison 5. Immunisation with Whole virus v. Split virus v. Subunit vaccine (Early outcomes)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Home Peak Flow measurements before and after vaccination Show forest plot			Other data	No numeric data

2 Lung function measurements Show forest plot			Other data	No numeric data

Comparison 5. Immunisation with Whole virus v. Split virus v. Subunit vaccine (Early outcomes)

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet