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이경민Kyeongmin Lee
경희대학교
Clin. Microbiol. Infect., 9 May 2025 | https://doi.org/10.1016/j.cmi.2025.05.003
Effectiveness of the live zoster vaccine in patients with type 2 diabetes: A nationwide emulated target trial
Tae Hyeon Kim 1,2 &, Kyeongmin Lee 2,3 &, Sooji Lee 1,2, Jiyeon Oh 1,2, Jaeyu Park 2,4, Hyesu Jo 2,3, Yejun Son 2,4, Soeun Kim 2,4, Sang Youl Rhee 1,2,3,4,5, Lee Smith 6, Hanseul Cho 7, Junyang Jung 8, Seung Geun Yeo 9#, Hayeon Lee 2,10,11#, Dong Keon Yon 1,2,3,4,10,12#
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
2Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
4Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
5Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
6Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
8Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul, South Korea
9Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
10Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
11Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea
12Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
&These authors contributed equally to this work as first authors.
#These authors contributed equally to this work as corresponding authors.
Corresponding authors: Seung Geun Yeo, Hayeon Lee, Dong Keon Yon
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
2Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
4Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
5Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
6Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
8Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul, South Korea
9Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
10Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
11Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea
12Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
&These authors contributed equally to this work as first authors.
#These authors contributed equally to this work as corresponding authors.
Corresponding authors: Seung Geun Yeo, Hayeon Lee, Dong Keon Yon
Abstract
Objectives
Real-world studies on its effectiveness in patients with type 2 diabetes mellitus (T2DM) remain limited. This study aimed to evaluate the effectiveness of the live zoster vaccine in patients with T2DM more than 10 years.
Real-world studies on its effectiveness in patients with type 2 diabetes mellitus (T2DM) remain limited. This study aimed to evaluate the effectiveness of the live zoster vaccine in patients with T2DM more than 10 years.
Methods
In this target trial emulation study, we utilized a large-scale, nationwide cohort in South Korea, consisting of individuals aged 50 years and older with T2DM from January 1, 2012 to December 31, 2021 (n=934,945). This cohort was integrated using health insurance data from the Korea Health Insurance Review and Assessment Service, national health screening results from the Korean National Health Insurance Service, and live zoster vaccination data from the Korea Disease Control and Prevention Agency. Vaccine effectiveness in preventing HZ, postherpetic neuralgia, and hospital admissions for HZ based on ICD-10 codes was evaluated in patients with T2DM. In a propensity score-based overlap-weighted cohort, Cox proportional hazard models were used to evaluate the adjusted hazard ratios (aHRs) and 95% confidential intervals (CIs) for the effectiveness of the live zoster vaccine among patients with T2DM.
Results
After propensity score-based overlap-weighting, 253,660 patients with T2DM were included (mean age, 62.4 years [standard deviation, 2.3 years]; 138,338 males, 54.5%). Live zoster vaccination was associated with a reduced risk of HZ (aHR, 0.59 [95% CI, 0.57–0.61]), postherpetic neuralgia (aHR, 0.59 [95% CI, 0.57–0.61]), and hospital admissions for HZ (aHR, 0.41 [95% CI, 0.36–0.47]). Vaccine effectiveness was highest within the first-year post-vaccination, with a sustained protective effect lasting up to six years. Furthermore, the effectiveness was greater in the non-insulin treatment group compared with the insulin treatment group.
Conclusion
Our target trial highlighted that live zoster vaccination significantly reduced the risk of HZ, postherpetic neuralgia, and hospital admissions in patients with T2DM. However, its effectiveness was attenuated in those undergoing insulin treatment.
논문정보
- Research article
- 2025년 05월 (BRIC 등록일 2025-05-12)
- 국내(교신)+국외 연구진
- 의약학 > 의약학 기타
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