Abstract

ABSTRACTBackground: No head-to-head studies are currently available comparing pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with 13-valent pneumococcal conjugate vaccine (PCV-13). This study explored the feasibility of using network meta-analysis (NMA) to conduct an indirect comparison of the relative efficacy or effectiveness of the two vaccines.Methods: A systematic literature search was conducted for published randomized controlled trials (RCTs) and non-RCT studies reporting data on vaccine efficacy or effectiveness against invasive pneumococcal disease in children aged <5 years receiving 7-valent pneumococcal conjugate vaccine (PCV-7), PHiD-CV or PCV-13. Study quality was evaluated using published scales. NMA feasibility was assessed by considering whether a connected network could be constructed by examining published studies for differences in study or patient characteristics that could act as potential treatment effect modifiers or confounding variables.Results: A total of 26 publications were included; 2 RCTs (4 publications), 7 indirect cohort studies, and 14 case-control studies (15 publications). Study quality was generally good. The RCTs could not be connected in a network as there was no common comparator. The studies differed considerably in design, dose number, administration schedules, and subgroups analyzed. Reporting of exposure status and subject characteristics was inconsistent.Conclusion: NMA to compare the relative efficacy or effectiveness of PHiD-CV and PCV-13 is not feasible on the current evidence base, due to the absence of a connected network across the two RCTs and major heterogeneity between studies. NMA may be possible in future if sufficient RCTs become available to construct a connected network.

Highlights

  • Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae

  • Two additional publications were added from the International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD) 2016 conference abstracts and other systematic literature reviews

  • While there is a need for information on the comparative efficacy or effectiveness of PHiD-CV versus pneumococcal conjugate vaccines (PCVs)-13, the current data do not support the use of network meta-analysis (NMA) methodology

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Summary

Introduction

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae. Over 90 serotypes of S. pneumoniae have been identified;[1] the 10 most common serotypes account for approximately 62% of invasive pneumococcal disease (IPD) worldwide.[2]. This study explored the feasibility of using network meta-analysis (NMA) to conduct an indirect comparison of the relative efficacy or effectiveness of the two vaccines. Methods: A systematic literature search was conducted for published randomized controlled trials (RCTs) and non-RCT studies reporting data on vaccine efficacy or effectiveness against invasive pneumococcal disease in children aged

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