TY  - JOUR
A1  - Rose, Markus A.
A1  - Damm, Oliver
A1  - Greiner, Wolfgang
A1  - Knuf, Markus
A1  - Wutzler, Peter
A1  - Liese, Johannes G.
A1  - Krüger, Hagen
A1  - Wahn, Ulrich
A1  - Schaberg, Tom
A1  - Schwehm, Markus
A1  - Kochmann, Thomas F.
A1  - Eichner, Martin
T1  - The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study
JF  - BMC Infectious Diseases
N2  - Background: Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany.
Methods: A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. 
Results: In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. 
Conclusions: Our results demonstrate that vaccinating children 2-17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany.
KW  - vaccination
KW  - live-attenuated influenza vaccine
KW  - children
KW  - transmission model
KW  - metanalysis
KW  - recommendations
KW  - hospitalizations
KW  - burden
KW  - infection
KW  - young children
KW  - seasonal influenza
KW  - United States
KW  - disease
KW  - efficacy
KW  - Germany
KW  - influenza
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117563
SN  - 1471-2334
VL  - 14
IS  - 40
ER  - 
TY  - JOUR
A1  - Stephan, Marlene
A1  - Tascilar, Koray
A1  - Yalcin-Mutlu, Melek
A1  - Hagen, Melanie
A1  - Haschka, Judith
A1  - Reiser, Michaela
A1  - Hartmann, Fabian
A1  - Kleyer, Arnd
A1  - Hueber, Axel J.
A1  - Manger, Bernhard
A1  - Figueiredo, Camille
A1  - Cobra, Jayme Fogagnolo
A1  - Tony, Hans-Peter
A1  - Finzel, Stephanie
A1  - Kleinert, Stefan
A1  - Wendler, Jörg
A1  - Schuch, Florian
A1  - Ronneberger, Monika
A1  - Feuchtenberger, Martin
A1  - Fleck, Martin
A1  - Manger, Karin
A1  - Ochs, Wolfgang
A1  - Schmitt-Haendle, Matthias
A1  - Lorenz, Hannes Martin
A1  - Nüsslein, Hubert
A1  - Alten, Rieke
A1  - Henes, Joerg
A1  - Krüger, Klaus
A1  - Schett, Georg
A1  - Rech, Jürgen
T1  - Physical function of RA patients tapering treatment — a post hoc analysis of the randomized controlled RETRO trial
JF  - Journal of Clinical Medicine
N2  - Several studies have shown that tapering or stopping disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) patients in sustained remission is feasible. However, tapering/stopping bears the risk of decline in physical function as some patients may relapse and face increased disease activity. Here, we analyzed the impact of tapering or stopping DMARD treatment on the physical function of RA patients. The study was a post hoc analysis of physical functional worsening for 282 patients with RA in sustained remission tapering and stopping DMARD treatment in the prospective randomized RETRO study. HAQ and DAS-28 scores were determined in baseline samples of patients continuing DMARD (arm 1), tapering their dose by 50% (arm 2), or stopping after tapering (arm 3). Patients were followed over 1 year, and HAQ and DAS-28 scores were evaluated every 3 months. The effect of treatment reduction strategy on functional worsening was assessed in a recurrent-event Cox regression model with a study-group (control, taper, and taper/stop) as the predictor. Two-hundred and eighty-two patients were analyzed. In 58 patients, functional worsening was observed. The incidences suggest a higher probability of functional worsening in patients tapering and/or stopping DMARDs, which is likely due to higher relapse rates in these individuals. At the end of the study, however, functional worsening was similar among the groups. Point estimates and survival curves show that the decline in functionality according to HAQ after tapering or discontinuation of DMARDs in RA patients with stable remission is associated with recurrence, but not with an overall functional decline.
KW  - HAQ
KW  - Rheumatoid Arthritis
KW  - PROM’s
KW  - DMARD
KW  - DAS28
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-319349
SN  - 2077-0383
VL  - 12
IS  - 11
ER  -