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Retrospective multicenter matched case-control study on the risk factors for narcolepsy with special focus on vaccinations (including pandemic influenza vaccination) and infections in Germany.

Identifieur interne : 000054 ( Main/Exploration ); précédent : 000053; suivant : 000055

Retrospective multicenter matched case-control study on the risk factors for narcolepsy with special focus on vaccinations (including pandemic influenza vaccination) and infections in Germany.

Auteurs : Doris Oberle [Allemagne] ; Jutta Pavel [Allemagne] ; Geert Mayer [Allemagne] ; Peter Geisler [Allemagne] ; Brigitte Keller-Stanislawski [Allemagne]

Source :

RBID : pubmed:28522102

Descripteurs français

English descriptors

Abstract

OBJECTIVE

Studies associate pandemic influenza vaccination with narcolepsy. In Germany, a retrospective, multicenter, matched case-control study was performed to identify risk factors for narcolepsy, particularly regarding vaccinations (seasonal and pandemic influenza vaccination) and infections (seasonal and pandemic influenza) and to quantify the detected risks.

METHODS

Patients with excessive daytime sleepiness who had been referred to a sleep center between April 2009 and December 2012 for multiple sleep latency test (MSLT) were eligible. Case report forms were validated according to the criteria for narcolepsy defined by the Brighton Collaboration (BC). Confirmed cases of narcolepsy (BC level of diagnostic certainty 1-4a) were matched with population-based controls by year of birth, gender, and place of residence. A second control group was established including patients in whom narcolepsy was definitely excluded (test-negative controls).

RESULTS

A total of 103 validated cases of narcolepsy were matched with 264 population-based controls. The second control group included 29 test-negative controls. A significantly increased odd ratio (OR) to develop narcolepsy (crude OR [cOR] = 3.9, 95% confidence interval [CI] = 1.8-8.5; adjusted OR [aOR] = 4.5, 95% CI = 2.0-9.9) was detected in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset as compared to nonvaccinated individuals. Using test-negative controls, in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset, a nonsignificantly increased OR of narcolepsy was detected when compared to nonvaccinated individuals (whole study population, BC levels 1-4a: cOR = 1.9, 95% CI = 0.5-6.9; aOR = 1.8, 95% CI = 0.3-10.1).

CONCLUSIONS

The findings of this study support an increased risk for narcolepsy after immunization with pandemic influenza A/H1N1/v vaccine.


DOI: 10.1016/j.sleep.2017.02.026
PubMed: 28522102


Affiliations:


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<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Case-Control Studies (MeSH)</term>
<term>Child (MeSH)</term>
<term>Child, Preschool (MeSH)</term>
<term>Female (MeSH)</term>
<term>Germany (epidemiology)</term>
<term>Humans (MeSH)</term>
<term>Infection Control (MeSH)</term>
<term>Infections (epidemiology)</term>
<term>Logistic Models (MeSH)</term>
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<term>Middle Aged (MeSH)</term>
<term>Narcolepsy (epidemiology)</term>
<term>Odds Ratio (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
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<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Allemagne (épidémiologie)</term>
<term>Enfant (MeSH)</term>
<term>Enfant d'âge préscolaire (MeSH)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Modèles logistiques (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Narcolepsie (épidémiologie)</term>
<term>Odds ratio (MeSH)</term>
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<term>Sujet âgé (MeSH)</term>
<term>Vaccination (effets indésirables)</term>
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<term>Allemagne</term>
<term>Narcolepsie</term>
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<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Case-Control Studies</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Female</term>
<term>Humans</term>
<term>Infection Control</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Odds Ratio</term>
<term>Retrospective Studies</term>
<term>Risk Factors</term>
<term>Young Adult</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
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<b>OBJECTIVE</b>
</p>
<p>Studies associate pandemic influenza vaccination with narcolepsy. In Germany, a retrospective, multicenter, matched case-control study was performed to identify risk factors for narcolepsy, particularly regarding vaccinations (seasonal and pandemic influenza vaccination) and infections (seasonal and pandemic influenza) and to quantify the detected risks.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Patients with excessive daytime sleepiness who had been referred to a sleep center between April 2009 and December 2012 for multiple sleep latency test (MSLT) were eligible. Case report forms were validated according to the criteria for narcolepsy defined by the Brighton Collaboration (BC). Confirmed cases of narcolepsy (BC level of diagnostic certainty 1-4a) were matched with population-based controls by year of birth, gender, and place of residence. A second control group was established including patients in whom narcolepsy was definitely excluded (test-negative controls).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>A total of 103 validated cases of narcolepsy were matched with 264 population-based controls. The second control group included 29 test-negative controls. A significantly increased odd ratio (OR) to develop narcolepsy (crude OR [cOR] = 3.9, 95% confidence interval [CI] = 1.8-8.5; adjusted OR [aOR] = 4.5, 95% CI = 2.0-9.9) was detected in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset as compared to nonvaccinated individuals. Using test-negative controls, in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset, a nonsignificantly increased OR of narcolepsy was detected when compared to nonvaccinated individuals (whole study population, BC levels 1-4a: cOR = 1.9, 95% CI = 0.5-6.9; aOR = 1.8, 95% CI = 0.3-10.1).</p>
</div>
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<p>
<b>CONCLUSIONS</b>
</p>
<p>The findings of this study support an increased risk for narcolepsy after immunization with pandemic influenza A/H1N1/v vaccine.</p>
</div>
</front>
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<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Studies associate pandemic influenza vaccination with narcolepsy. In Germany, a retrospective, multicenter, matched case-control study was performed to identify risk factors for narcolepsy, particularly regarding vaccinations (seasonal and pandemic influenza vaccination) and infections (seasonal and pandemic influenza) and to quantify the detected risks.</AbstractText>
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<DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
</MeshHeading>
</MeshHeadingList>
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<Keyword MajorTopicYN="N">Germany</Keyword>
<Keyword MajorTopicYN="N">Narcolepsy</Keyword>
<Keyword MajorTopicYN="N">Pandemic influenza A/H1N1/v vaccine</Keyword>
<Keyword MajorTopicYN="N">Risk factors</Keyword>
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</MedlineCitation>
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<Year>2016</Year>
<Month>09</Month>
<Day>12</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised">
<Year>2017</Year>
<Month>01</Month>
<Day>23</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2017</Year>
<Month>02</Month>
<Day>14</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2017</Year>
<Month>5</Month>
<Day>20</Day>
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<PubMedPubDate PubStatus="medline">
<Year>2018</Year>
<Month>3</Month>
<Day>8</Day>
<Hour>6</Hour>
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<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="pubmed">28522102</ArticleId>
<ArticleId IdType="pii">S1389-9457(17)30126-0</ArticleId>
<ArticleId IdType="doi">10.1016/j.sleep.2017.02.026</ArticleId>
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</PubmedData>
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<affiliations>
<list>
<country>
<li>Allemagne</li>
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</list>
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<country name="Allemagne">
<noRegion>
<name sortKey="Oberle, Doris" sort="Oberle, Doris" uniqKey="Oberle D" first="Doris" last="Oberle">Doris Oberle</name>
</noRegion>
<name sortKey="Geisler, Peter" sort="Geisler, Peter" uniqKey="Geisler P" first="Peter" last="Geisler">Peter Geisler</name>
<name sortKey="Keller Stanislawski, Brigitte" sort="Keller Stanislawski, Brigitte" uniqKey="Keller Stanislawski B" first="Brigitte" last="Keller-Stanislawski">Brigitte Keller-Stanislawski</name>
<name sortKey="Mayer, Geert" sort="Mayer, Geert" uniqKey="Mayer G" first="Geert" last="Mayer">Geert Mayer</name>
<name sortKey="Pavel, Jutta" sort="Pavel, Jutta" uniqKey="Pavel J" first="Jutta" last="Pavel">Jutta Pavel</name>
</country>
</tree>
</affiliations>
</record>

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   |texte=   Retrospective multicenter matched case-control study on the risk factors for narcolepsy with special focus on vaccinations (including pandemic influenza vaccination) and infections in Germany.
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