P259 Optimizing subcutaneous dosing of immunoglobulin in obese primary immune deficiency patients treated in the home

Kristofek, Loretta; Kile, Samantha; Bolgar, William; Seidu, Luqman

doi:10.1016/j.anai.2017.08.175

Cited by 1 publication

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“…In particular, similar SCIG dose/ serum IgG level ratios were observed between obese and Additionally, in a cohort of 107 patients with common variable immunodeficiency, Khan and colleagues found no relationship between the annual dose of IgG and trough IgG levels regardless of infusion frequency or adjustment for weight or body mass index [21]. Conversely, a poster presented in 2017 by Checkley et al [22] suggested that increasing the SCIG dose might improve clinical outcomes in PID patients suffering from frequent infections. On the other hand, we should consider that immunoglobulin does not distribute to adipose tissue and is only present in the intravascular space and extracellular fluids.…”

Section: Discussionmentioning

confidence: 78%

Correlations Among Subcutaneous Immunoglobulin Dosage, Immunoglobulin G Serum Pre-infusional Levels and Body Mass Index in Primary Antibody Deficiency Patients: A Pooled Analysis from the SHIFT/IBIS Studies

et al. 2020

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Background and ObjectiveIn recent years, two Italian non-interventional studies evaluated subcutaneous immunoglobulin (SCIG) treatment in patients affected by primary antibody deficiency (PAD). The SHIFT study considered patients who were treated with intravenous immunoglobulin (IVIG) or SCIG 16% (Vivaglobin ® ) and then replaced this therapy with weekly treatments of SCIG 20% (Hizentra ® ). The IBIS study evaluated patients previously taking a weekly SCIG 20% regimen, who instead began therapy with biweekly SCIG 20% to assess the correlation between the dose of immunoglobulin G (IgG) administered and the body mass index (BMI) of patients, determine if there is a need for dosage adjustments on a BMI basis, and identify the predictors of serum IgG trough levels in our cohort. Methods In this study, we analyzed the pooled data of 109 PAD patients enrolled in the SHIFT and IBIS studies. Only prospective phases were considered. Results The total monthly SCIG dose showed comparable trends among weight categories, except for underweight patients. When we considered the monthly SCIG dosage per kilogram of body weight, a significant decreasing trend according to BMI was observed. Data on IgG trough levels were available for 88 patients, with a mean IgG serum level of 8.4 ± 1.6 g/L. A stepwise regression model revealed that the mean monthly dosage of SCIG 20% (p = 0.04248) and the mean monthly dosage of IgG per kilogram of body weight were the only two independent predictors associated with IgG trough levels. No association was found between BMI and IgG trough levels. Conclusions These findings support the concept that the cumulative monthly dose of SCIG and the dose of SCIG per kilogram of body weight affect IgG trough levels in PAD patients, irrespective of BMI.

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Section: Discussionmentioning

confidence: 78%