{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:34:11Z","timestamp":1792020851122,"version":"4.4.0"},"reference-count":26,"publisher":"S. Karger AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"abstract":"<jats:p>Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Prevention of exacerbations is fundamental to COPD management. Methods: The RETRIEVE study was a multicenter, 7-year retrospective study (NCT03858348) of patients with spirometry confirmation of COPD, who received LABA\/ICS for at least 1 year and either continued or escalated to open triple therapy, according to their physicians\u2019 judgment. In this post hoc analysis, we explored exacerbation rate and lung function pre- and post-pneumococcal vaccination in a real-world setting. Results: Among 466 COPD patients, 48.1% received LABA\/ICS for a mean 32 months, while 51.9% received LABA\/ICS for a mean 21 months and then escalated to open triple therapy. Patients treated solely with LABA\/ICS presented a significant reduction in COPD exacerbations (incidence rate ratio 0.66, 95% confidence interval [0.56, 0.78]) and related hospitalizations (0.43 [0.25, 0.72]) after pneumococcal vaccination compared to pre-vaccination. High-risk patients, who ultimately escalated to triple therapy, presented no reduction in exacerbations post-vaccination compared to pre-vaccination, and their airflow obstruction tended to deteriorate over time post-vaccination while they received LABA\/ICS. However, after escalation to open triple therapy, there was significant reduction in exacerbations (0.78 [0.66, 0.94]) and related hospitalizations (0.41 [0.26, 0.66]) post-vaccination compared to pre-vaccination. Pneumococcal vaccination rates increased from 2012 to 2018 in our study, exceeding 90% from 2015 onward. Preserved lung function potentially delayed vaccination. Conclusion: This post hoc analysis of the RETRIEVE real-world study highlights the importance of appropriate, personalized maintenance COPD treatment, along with pneumococcal vaccination, for the prevention of COPD exacerbations. <\/jats:p>","DOI":"10.1159\/000545232","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T12:02:18Z","timestamp":1744891338000},"page":"626-636","source":"Crossref","is-referenced-by-count":1,"title":["COPD Exacerbations and Airflow Obstruction Severity Pre- and Post-Pneumococcal Vaccination: A post hoc Analysis of the RETRIEVE Real-World Study"],"prefix":"10.1159","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5102-0480","authenticated-orcid":false,"given":"Stavros","family":"Tryfon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymia","family":"Papadopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polyanthi","family":"Papanastasiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Ginis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-3942","authenticated-orcid":false,"given":"Konstantinos","family":"Kostikas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.7326\/M19-3007"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0141-2022"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0151-2023"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2005.040527"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00002610"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713901"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1916046"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006826.pub2"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006829.pub2"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-020-01407-y"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200506-859OC"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0800353"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0034-2023"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14612"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001390.pub4"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-95129-w"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00476-2022"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2102840"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-20-814"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis212"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/nri2494"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2022.06.024"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30052-5"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30165-1"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/res\/article-pdf\/doi\/10.1159\/000545232\/4366658\/000545232.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T16:01:20Z","timestamp":1758902480000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000545232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,26]]},"published-print":{"date-parts":[[2025,9,17]]}},"URL":"https:\/\/doi.org\/10.1159\/000545232","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]}}}