An observational study in Pneumococcal Infections and COPD, sponsored by Pfizer. Terminated at 11 sites in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-08-19.
Sponsored by Pfizer · Observational
Prospective multicenter observational study, to evaluate the impact of routine clinical practice vaccination with PCV13 on the reduction of the risk of moderate/severe COPD exacerbations
Patients with chronic obstructive pulmonary disease (COPD) have been demonstrated to have an increased risk of pneumococcal disease. Pneumonia is frequent among patients hospitalized for COPD exacerbations and is associated with increased health care utilization and higher mortality. Up to 50%-70% of exacerbations can be attributed to respiratory infections by viruses or bacteria, even more in the most severe patients. They are often associated with the colonization of airways by multiple bacteria or viruses of low virulence that in normal conditions are parts of the normal flora of the upper airway. Current recommendations for immunization of patients with COPD include vaccination against influenza and Streptococcus pneumoniae. The aim of this study is to evaluate the potential benefits of immunization of COPD patients with PCV13 and/or against influenza in terms of clinical benefits and quality of life.
286 studies on the registry are indexed under Pneumococcal Infections; 27 are open to participants now.
This study's enrollment of 530 is below the median of 659 across 49 observational studies indexed under Pneumococcal Infections.
Browse Pneumococcal Infections studies →Pfizer is the lead sponsor of 3,323 studies on the registry; 145 are open to participants now.
Of its 597 completed or terminated interventional studies of FDA-regulated products, 391 (65%) have results posted.
Counted across the registry records on this site, refreshed daily.
Subjects ≥18 years diagnosed with COPD, followed up at the Pulmonology Department of the partipant centres
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion criteria:
Change in Adjusted Rate of Moderate/Severe COPD Exacerbations at Month 24 in PCV 13 Population
COPD exacerbations were defined as a complex of two or more respiratory symptoms (worsening dyspnea, cough, sputum production, chest tightness, or wheezing) related to the underlying COPD, with duration of 3 days or more, that required a change in treatment. Moderate exacerbations were those that required antibiotics and/or systemic corticosteroids without hospitalization. Severe exacerbations were those that lead to hospitalization. Adjusted rate of exacerbation was calculated as (Total number of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months.
Time frame: Baseline and Month 24
Change in Adjusted Rate of Moderate/Severe Exacerbations by COPD Severity at Month 24 in PCV13 Population
Moderate exacerbations were those that required antibiotics and/or systemic corticosteroids without hospitalization. Severe exacerbations were those that lead to hospitalization. COPD severity was graded as per GOLD criteria. Grade 1 mild/unknown: (FEV1 \>= 80 %, FEV1/ FVC \< 0.7 or no spirometry data). Grade 2: Moderate: (50% \<= FEV1\< 80%, FEV1/FVC \< 0.7), Grade 3: Severe (30% \<=FEV1 \< 50%, FEV1/FVC \< 0.7), Grade 4: Very severe (FEV1\< 30% or FEV1\< 50% plus respiratory failure, FEV1/FVC \< 0.7). Adjusted rate of exacerbation was calculated as (total no. of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months. Change in adjusted rate of moderate/severe exacerbations by COPD severity (Grade 1 and Grade \>1) at Month 24 is reported.
Time frame: Baseline and Month 24
Change in Rate of Moderate/Severe COPD Exacerbations at Month 24 in PCV13 Population by History of Influenza Vaccination
Evaluate the impact of influenza and PCV13 vaccination on the reduction of COPD exacerbations. Adjusted rate of exacerbation was calculated as (total number of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months. Change in rate of moderate/severe exacerbations with and without history of influenza vaccination is presented in this outcome measure.
Time frame: Month 24
Change From Baseline in Saint George Respiratory Questionnaire (SGRQ) Score at Month 12 and 24 in PCV13 Population
To evaluate the impact of vaccination with PCV13 on patients quality of life SGRQ form was used. It is a self-administered questionnaire developed to measure health status (quality of life) in participants with chronic airflow limitation. The SGRQ consisted of 50 items, where 10 of them were multiple choice and 40 were true or false. Scores were calculated for three domains: Symptoms (eight items; including cough, sputum production, dyspnea or shortness of breath or breathlessness and wheezing, as well as duration, frequency and severity); Activity (16 true or false questions; refers to activities that are limited due to dyspnea);Impacts (26 items; referred to other situations or aspects related to social or psychological functioning affected by the respiratory problems that may alter the participants lifestyle). The total score and scores for each domain ranged from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status).
Time frame: Baseline, Month 12 and 24
Change From Baseline in COPD Assessment Test (CAT) Score at Month 12 and 24 in PCV13 Population
To evaluate the impact of vaccination with PCV13 on patients quality of life ,CAT questionnaire is used. It is used to measure the impact COPD on the participant's wellbeing and daily life and severity of symptoms. The CAT has 8 questions, with score ranging from 0 to 5 for each question, where 0 = no impairment and 5=severe impairment. Total score was calculated as the sum of scores of individual questions and ranged from 0 to 40 with higher scores indicating more severe disease.
Time frame: Baseline, Month 12 and 24
Change From Baseline in Forced Expiratory Volume (FEV1) at Month 24 in PCV13 Population
To evaluate the impact of vaccination with PCV13 on the decrease of FEV1 was evaluated. FEV1 is the maximal volume of air exhaled in the first second of a forced expiration from a position of full inspiration.
Time frame: Baseline, Month 24
Percentage of Participants With COPD Vaccinated With PCV13
Percentage of evaluable study participants vaccinated with PCV13 prior or after inclusion in the study.
Time frame: Up to Month 24
Mean Cost Saving Per COPD Participant With PCV13
Overall cost of hospitalization and/or treatment of exacerbation episode based on days of hospitalization or Intensive care unit and treatment received were planned to be analyzed in this outcome measure.
Time frame: Up to Month 24
Participants diagnosed with Chronic Obstructive Pulmonary Disease (COPD) across 11 hospitals in Spain were followed up during their routine follow-up visits in this prospective observational study. Participants were prescribed therapies in line with routine clinical practice.
| Milestone | Participants With COPD |
|---|---|
| Started | 530 |
| Without pneumococcal vaccination | 126 |
| With pneumococcal vaccination | 404 |
| 13-valent pneumococcal conjugate vaccine (pcv13) population | 114 |
| Completed | 421 |
| Not completed | 109 |
| Withdrew: Withdrawal of informed consent | 4 |
| Withdrew: Presence of any immunosuppressive condition | 8 |
| Withdrew: Lost to follow-up | 27 |
| Withdrew: No data reported at month 24 | 31 |
| Withdrew: Death | 39 |
COPD exacerbations were defined as a complex of two or more respiratory symptoms (worsening dyspnea, cough, sputum production, chest tightness, or wheezing) related to the underlying COPD, with duration of 3 days or more, that required a change in treatment. Moderate exacerbations were those that required antibiotics and/or systemic corticosteroids without hospitalization. Severe exacerbations were those that lead to hospitalization. Adjusted rate of exacerbation was calculated as (Total number of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months.
| Exacerbation per participant in 24 month | Participants With COPD |
|---|---|
| Change in Adjusted Rate of Moderate/Severe COPD Exacerbations at Month 24 in PCV 13 Population | -1.1 ± 2.5 |
Moderate exacerbations were those that required antibiotics and/or systemic corticosteroids without hospitalization. Severe exacerbations were those that lead to hospitalization. COPD severity was graded as per GOLD criteria. Grade 1 mild/unknown: (FEV1 \>= 80 %, FEV1/ FVC \< 0.7 or no spirometry data). Grade 2: Moderate: (50% \<= FEV1\< 80%, FEV1/FVC \< 0.7), Grade 3: Severe (30% \<=FEV1 \< 50%, FEV1/FVC \< 0.7), Grade 4: Very severe (FEV1\< 30% or FEV1\< 50% plus respiratory failure, FEV1/FVC \< 0.7). Adjusted rate of exacerbation was calculated as (total no. of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months. Change in adjusted rate of moderate/severe exacerbations by COPD severity (Grade 1 and Grade \>1) at Month 24 is reported.
| Exacerbation per participant in 24 month | Participants With COPD |
|---|---|
| Grade 1: Mild/unknown | -1.5 ± 0.9 |
| Grade >1: Moderate to Very Severe | -1.1 ± 2.6 |
Evaluate the impact of influenza and PCV13 vaccination on the reduction of COPD exacerbations. Adjusted rate of exacerbation was calculated as (total number of moderate or severe exacerbations) divided by participant follow-up time in months\*24 months. Change in rate of moderate/severe exacerbations with and without history of influenza vaccination is presented in this outcome measure.
| Exacerbation per participant in 24 month | Participants With COPD |
|---|---|
| Influenza vaccination: No | -0.7 ± 2.2 |
| Influenza vaccination: Yes | -1.2 ± 2.6 |
To evaluate the impact of vaccination with PCV13 on patients quality of life SGRQ form was used. It is a self-administered questionnaire developed to measure health status (quality of life) in participants with chronic airflow limitation. The SGRQ consisted of 50 items, where 10 of them were multiple choice and 40 were true or false. Scores were calculated for three domains: Symptoms (eight items; including cough, sputum production, dyspnea or shortness of breath or breathlessness and wheezing, as well as duration, frequency and severity); Activity (16 true or false questions; refers to activities that are limited due to dyspnea);Impacts (26 items; referred to other situations or aspects related to social or psychological functioning affected by the respiratory problems that may alter the participants lifestyle). The total score and scores for each domain ranged from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status).
| Units on a scale | Participants With COPD |
|---|---|
| Baseline: QOL | 45.7 ± 15.4 |
| Change at Month 12: QOL | -5.6 ± 17.4 |
| Change at Month 24: QOL | -6.0 ± 13.8 |
| Baseline: Symptoms | 47.4 ± 18.9 |
| Change at Month 12: Symptoms | -9.0 ± 26.2 |
| Change at Month 24: Symptoms | -16.3 ± 23.4 |
| Baseline: Activity | 56.3 ± 21.2 |
| Change at Month 12: Activity | -4.6 ± 19.9 |
| Change at Month 24: Activity | -4.2 ± 17.3 |
| Baseline: Impacts | 39.7 ± 15.4 |
| Change at Month 12: Impacts | -5.6 ± 19.1 |
| Change at Month 24: Impacts | -6.5 ± 15.5 |
To evaluate the impact of vaccination with PCV13 on patients quality of life ,CAT questionnaire is used. It is used to measure the impact COPD on the participant's wellbeing and daily life and severity of symptoms. The CAT has 8 questions, with score ranging from 0 to 5 for each question, where 0 = no impairment and 5=severe impairment. Total score was calculated as the sum of scores of individual questions and ranged from 0 to 40 with higher scores indicating more severe disease.
| Units on a scale | Participants With COPD |
|---|---|
| Baseline | 15.5 ± 7.5 |
| Change at Month 12 | -1.7 ± 6.3 |
| Change at Month 24 | -1.8 ± 6.1 |
To evaluate the impact of vaccination with PCV13 on the decrease of FEV1 was evaluated. FEV1 is the maximal volume of air exhaled in the first second of a forced expiration from a position of full inspiration.
| Percentage | Participants With COPD |
|---|---|
| Baseline | 51.9 ± 19.0 |
| Change at Month 24 | -1.7 ± 10.9 |
Percentage of evaluable study participants vaccinated with PCV13 prior or after inclusion in the study.
| Percentage of Participants | Participants With COPD |
|---|---|
| Percentage of Participants With COPD Vaccinated With PCV13 | 46.8 |
Overall cost of hospitalization and/or treatment of exacerbation episode based on days of hospitalization or Intensive care unit and treatment received were planned to be analyzed in this outcome measure.
| Euro per participant per year | Participants With COPD |
|---|---|
| Mean Cost Saving Per COPD Participant With PCV13 | NA |
Collected over Up to 24 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Participants With COPD | 39/530 (7.4%) | 78/530 (14.7%) | 10/530 (1.9%) |
| Event | Participants With COPD |
|---|---|
| PneumoniaInfections and infestations | 17/530 |
| COVID-19 pneumoniaInfections and infestations | 10/530 |
| DeathGeneral disorders | 9/530 |
| Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders | 7/530 |
| Cardio-respiratory arrestCardiac disorders | 6/530 |
| Cardiac failureCardiac disorders | 4/530 |
| COVID-19Infections and infestations | 3/530 |
| Acute myocardial infarctionCardiac disorders | 3/530 |
| PneumothoraxRespiratory, thoracic and mediastinal disorders | 3/530 |
| Abdominal sepsisInfections and infestations | 1/530 |
| Event | Participants With COPD |
|---|---|
| Chest painGeneral disorders | 1/530 |
| Local reactionGeneral disorders | 1/530 |
| Vaccination site reactionGeneral disorders | 1/530 |
| COVID-19Infections and infestations | 1/530 |
| COVID-19 pneumoniaInfections and infestations | 1/530 |
| TachyarrhythmiaCardiac disorders | 1/530 |
| ImmunosuppressionImmune system disorders | 1/530 |
| Procedural pneumothoraxInjury, poisoning and procedural complications | 1/530 |
| Chronic obstructive pulmonary diseaseRespiratory, thoracic and mediastinal disorders | 1/530 |
| Pulmonary resectionSurgical and medical procedures | 1/530 |
Analysis population included all evaluable participants whose data were included and prospectively observed in the study.
| Age, Continuous(Years) | Participants With COPD |
|---|---|
| Overall | 70.2 ± 7.9 |
| Without pneumococcal vaccination | 68.2 ± 8.4 |
| With pneumococcal vaccination | 70.8 ± 7.7 |
| PCV13 Population | 69.2 ± 7.9 |
| Sex: Female, Male(Participants) | Participants With COPD |
|---|---|
| Overall — Female | 133 |
| Overall — Male | 397 |
| Without pneumococcal vaccination — Female | 42 |
| Without pneumococcal vaccination — Male | 84 |
| With pneumococcal vaccination — Female | 91 |
| With pneumococcal vaccination — Male | 313 |
| PCV13 Population — Female | 26 |
| PCV13 Population — Male | 88 |
| Race and Ethnicity Not Collected(Participants) | Participants With COPD |
|---|
| Weight(Kilogram) | Participants With COPD |
|---|---|
| Overall | 75.0 ± 16.1 |
| Without pneumococcal vaccination | 74.1 ± 18.9 |
| With pneumococcal vaccination | 75.2 ± 15.1 |
| PCV13 Population | 75.2 ± 14.1 |
| Height(Centimeters) | Participants With COPD |
|---|---|
| Overall | 164.7 ± 8.4 |
| Without pneumococcal vaccination | 163.8 ± 9.2 |
| With pneumococcal vaccination | 164.9 ± 8.1 |
| PCV13 Population | 164.9 ± 7.9 |
| Body Mass Index(Kilograms per meter square) | Participants With COPD |
|---|---|
| Overall | 27.5 ± 5.1 |
| Without pneumococcal vaccination | 27.4 ± 5.8 |
| With pneumococcal vaccination | 27.6 ± 4.8 |
| PCV13 Population | 27.7 ± 4.8 |
| Waist circumference(Centimeters) | Participants With COPD |
|---|---|
| Overall | 98.4 ± 16.4 |
| Without pneumococcal vaccination | 99.1 ± 17.5 |
| With pneumococcal vaccination | 98.2 ± 16.1 |
| PCV13 Population | 100.1 ± 17.0 |
| Relevant Medical History(Participants) | Participants With COPD |
|---|---|
| Overall: Medical History- No | 39 |
| Overall: Medical History- Yes | 491 |
| Overall: Medical History- Yes (Arterial hypertension) | 279 |
| Overall: Medical History- Yes (Dyslipidemia) | 241 |
| Overall: Medical History- Yes (Diabetes mellitus) | 112 |
| Overall: Medical History- Yes (History of neoplasm) | 78 |
| Overall: Medical History- Yes (Ischemic heart disease) | 53 |
| Overall: Medical History- Yes (Cardiac failure) | 37 |
| Overall: Medical History- Yes (Pneumonias in the last year) | 36 |
| Overall: Medical History- Yes (Chronic renal failure) | 27 |
| Overall: Medical History- Yes (Metabolic syndrome) | 2 |
| Without Pneumococcal Vaccination: No | 12 |
| Without Pneumococcal Vaccination: Yes | 114 |
| Without Pneumococcal Vaccination: Yes (Arterial hypertension) | 60 |
| Without Pneumococcal Vaccination: Yes (Dyslipidemia) | 53 |
| Without Pneumococcal Vaccination: Yes (Diabetes mellitus) | 27 |
| Without Pneumococcal Vaccination: Yes (History of neoplasm) | 10 |
| Without Pneumococcal Vaccination: Yes (Ischemic heart disease) | 6 |
| Without Pneumococcal Vaccination: Yes (Cardiac failure) | 11 |
| Without Pneumococcal Vaccination: Yes (Pneumonias in the last year) | 9 |
| Without Pneumococcal Vaccination: Yes (Chronic renal failure) | 1 |
| Without Pneumococcal Vaccination: Yes (Metabolic syndrome) | 0 |
| With Pneumococcal Vaccination: No | 27 |
| With Pneumococcal Vaccination: Yes | 377 |
| With Pneumococcal Vaccination: Yes (Arterial hypertension) | 219 |
| With Pneumococcal Vaccination: Yes (Dyslipidemia) | 188 |
| With Pneumococcal Vaccination: Yes (Diabetes mellitus) | 85 |
| With Pneumococcal Vaccination: Yes (History of neoplasm) | 68 |
| With Pneumococcal Vaccination: Yes (Ischemic heart disease) | 47 |
| With Pneumococcal Vaccination: Yes (Cardiac failure) | 26 |
| With Pneumococcal Vaccination: Yes (Pneumonias in the last year) | 27 |
| With Pneumococcal Vaccination: (Chronic renal failure) | 26 |
| With Pneumococcal Vaccination: (Metabolic syndrome) | 2 |
| PCV 13 Population: No | 13 |
| PCV 13 Population: Yes | 101 |
| PCV 13 Population: Yes (Arterial hypertension) | 56 |
| PCV 13 Population: Yes (Dyslipidemia) | 53 |
| PCV 13 Population: Yes (Diabetes mellitus) | 23 |
| PCV 13 Population: Yes (History of neoplasm) | 13 |
| PCV 13 Population: Yes (Ischemic heart disease) | 11 |
| PCV 13 Population: Yes (Pneumonias in the last year) | 9 |
| PCV 13 Population: Yes (Cardiac failure) | 2 |
| PCV 13 Population: Yes (Chronic renal failure) | 1 |
11 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
Plan to share: No — Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
Ran from Nov 2017 to primary completion in Jun 2022, 54 months.
Results were first posted in Aug 2024, 2 years 2 months after primary completion.
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