登革热疫苗有效性及安全性的贝叶斯网状荟萃分析.

Objective To evaluate the efficacy and safety of five live attenuated dengue vaccines and one inactivated dengue vaccine using Bayesian network meta-analysis, providing a scientific basis for dengue epidemic prevention and control as well as vaccine development. Methods A systematic search was conducted in various Chinese and English databases, including PubMedL, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan fang Database, based on predefined inclusion and exclusion criteria. Randomized controlled trials (RCTs) assessing the efficacy and safety of six dengue vaccines were selected. The quality of the literature was evaluated using RevMan 54 software, and Bayesian network meta-analysis of relevant outcome indicators from the included RCTs was performed using R 43.1 software. Results A total of 20 studies involving 120 909 participants were included. The results of the Bayesian network meta-analysis indicated that the efficacy of three live attenuated vaccines was notable and the ranking from highest to lowest efficacy was as follows: Butantan-DV > TAK-003 > CYD-TDV, Among these, the dengue vaccine combining serotype 4 non-structural genes and serotype 2 structural genes (Butantan-DV) showed the best preventive effect, with a risk probability of dengue infection post-vaccination lower than that of other vaccines (Oi=0.22, 95%CI: 0.09-0.45). In terms of safety, the six vaccines showed varying risks of adverse events and ranked as follows: V180 > CYD-TDV > TV003 > TV005 > Butantan-DV > TAK-003. Notably, the inactivated vaccine (V180) presented a higher risk of adverse events (OR =2,2& 95%Cf: 1.02-5.15). Conclusion Based on the quantity and quality of the included studies, Butantan-DV exhibited the best efficacy among the three live attenuated vaccines, while CYD-TDV demonstrated the weakest efficacy, TAK-003 showed relatively better safety. The literature on the efficacy of the VI80, TV003, and TV005 vaccines is quite limited, suggesting potential directions for future research. [ABSTRACT FROM AUTHOR]