Vaccination as a tool for influencing the course of chronic obstructive pulmonary disease in patients with diabetes mellitus

Abstract

Introduction. Repeated exacerbations play a leading role in the progression of chronic obstructive pulmonary disease (COPD), contributing to an increase in the number of hospitalizations, a decrease in ventilation function of the lungs, and an increase in deaths.Aim. To analyze the clinical efficacy of pneumococcal disease vaccine prophylaxis in patients with COPD in combination with type 2 diabetes mellitus (DM) during 5 years of follow-up.Materials and methods. The study included patients (n = 113) with COPD and type 2 DM. The main parameters for evaluating the effectiveness of vaccination were the number of COPD exacerbations, including severe, requiring hospitalization of patients, the incidence of pneumonia, the dynamics of the severity of shortness of breath using the Modified Medical Research Council questionnaire – mMRC, the volume of forced exhalation in 1 second (FEV1), the dynamics of changes in laboratory indicators and prognostic indices BODEX, e-BODE, DOSE, ADO, CODEX. Pneumococcal conjugate 13-valent vaccine was used for vaccinoprophylaxis.Results. It has been established that vaccination against pneumococcal disease in patients with COPD and type 2 DM allows not only to significantly reduce the number of COPD exacerbations (by 2.7 times), reduce the frequency of episodes of community-acquired pneumonia (by 8 times) and significantly reduce the number of hospitalizations, but also stabilize the main functional indicators of the respiratory system while maintaining clinical effectiveness during the 5-year follow-up period. The dynamics of prognostic indices in the group of vaccinated patients reliably confirms the effectiveness of pneumococcal disease vaccine prophylaxis programs and the survival rate of patients with a combination of COPD and type 2 DM.Conclusion. The results of the study confirm that the vaccine prophylaxis of pneumococcal infection significantly reduces the risk of such undesirable events as exacerbations of COPD, pneumonia, hospitalization, and allows to stabilize the course of not only COPD, but also concomitant type 2 diabetes mellitus and thereby improve the prognosis for patients.