Subcutaneous immunoglobulin replacement therapy for primary antibody deficiency: advancements into the 21st century

Moore, Meredith; Quinn, James A.

doi:10.1016/s1081-1206(10)60197-4

Cited by 58 publications

(54 citation statements)

References 45 publications

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“…Treatment with human immunoglobulin can be achieved through various avenues to include intravenous in hospital preparations, intravenous administration in the clinic setting, home subcutaneous therapy, and subcutaneous pump therapy [1]. Dosing is typically 200 -600 mg/kg body weight given every 2 -4 weeks [9]. Survival certainly appears to be dose-related as one trial by the UK research council at a dose of 0.1 g/kg/month had a 10-year survival of 37% [1,10], and another trial showed at 0.4 g/kg/ month survival rate of 78% [1,11].…”

Section: Discussionmentioning

confidence: 99%

An Active Duty Patient With Common Variable Immune Deficiency With Early Diagnosis With the Help of the Electronic Record

2015

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Electronic medical records have become an integral part to the practice of both military and civilian medicine. One key benefit is the ability to observe the patient as a whole, as opposed to one presenting symptom at a time. We report a case of common variable immunodeficiency in an active duty male who presented with a variety of soft tissue and sinopulmonary tract infections. With the assistance of the electronic medical record, we could view the entirety of the patient's medical history with ease and were able to make the diagnosis. Because treatment with IVIG has been shown to reduce both morbidity and mortality, it is necessary for diagnosis to be made early in our active duty population.

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Section: Discussionmentioning

confidence: 99%

An Active Duty Patient With Common Variable Immune Deficiency With Early Diagnosis With the Help of the Electronic Record

2015

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“…A patient survey in 2008 by the Immune Deficiency Foundation reported that 68% of respondents noted fatigue and increased susceptibility to infections at the time of their trough nadir just prior to their next IVIg infusion. 20 Clinicians have also attempted to correlate infusion related side effects such as headache and back pain to high peak serum IgG levels. 21 In contrast, a lower systemic side effect profile has been consistently observed throughout many reports of subcutaneous replacement therapy, most likely related to the more stable physiologic IgG levels achieved.…”

Section: Pharmacokinetics Of Scigmentioning

confidence: 99%

“…Patients with anti-IgA antibodies, intolerant of low-IgA IVIg have successfully been transitioned to subcutaneous therapy. 20,29 Young children and pregnant women with PIDD have safely received subcutaneous infusions of immunoglobulin. 30,31 And while little data exists on the use of subcutaneous immunoglobulin therapy in patients with significant thrombocytopenia, anticoagulant use or bleeding disorders, there is a report of the safe use of subcutaneous therapy in a child with CVID and von Willebrand disease.…”

Section: Dovepressmentioning

confidence: 99%

Subcutaneous immunoglobulin replacement therapy in the treatment of patients with primary immunodeficiency disease

Ochs¹

2009

TCRM

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Antibody deficiency is the most frequently encountered primary immunodeficiency disease (PIDD) and patients who lack the ability to make functional immunoglobulin require life-long replacement therapy to prevent serious bacterial infections. Human serum immunoglobulin manufactured from pools of donated plasma can be administered intramuscularly, intravenously or subcutaneously. With the advent of well-tolerated preparations of intravenous immunoglobulin (IVIg) in the 1980s, the suboptimal painful intramuscular route of administration is no longer used. However, some patients continued to experience unacceptable adverse reactions to the intravenous preparations, and for others, vascular access remained problematic. Subcutaneously administered immunoglobulin (SCIg) provided an alternative delivery method to patients experiencing difficulties with IVIg. By 2006, immunoglobulin preparations designed exclusively for subcutaneous administration became available. They are therapeutically equivalent to intravenous preparations and offer patients the additional flexibility for the self-administration of their product at home. SCIg as replacement therapy for patients with primary antibody deficiencies is a safe and efficacious method to prevent serious bacterial infections, while maximizing patient satisfaction and improving quality of life.

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“…IgG may be given by the intramuscular, intravenous and subcutaneous routes. Intravenous immunoglobulin (IVIG) is an efficient therapy which can be administered at a dose of 0.3-0.8 g/kg every 2-4 weeks (5,6). However, it is a significant disadvantage that this therapy necessitates a healthcare center, nurse and vascular access and constitutes a risk in terms of systemic side effects (6).…”

Section: Introductionmentioning

confidence: 99%

Use of subcutaneous immunoglobulin in primary immune deficiencies

et al. 2016

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Aim: Immunoglobulin replacement therapy is required to reduce the frequency and severity of infections in patients with primary antibody deficiencies. Immunoglobulin G (IgG) can be administered intramuscularly, intravenously or subcutaneously. We aimed to evaluate the efficacy, dose adjustment and adverse events in subcutaneous immunoglobulin therapy by retrospectively presenting the records of 16 patients who received subcutaneous immunoglobulin therapy. Material and Methods: The demographic findings, clinical and laboratory findings, subcutaneous immunoglobulin dosage and dose frequency, infusion time, area and methods, adverse events and frequency of infections were obtained from patient files and recorded. Results: Sixteen patients (seven female, nine male) aged between 0-33 years who were diagnosed with primary immune deficiency and treated with subcutaneous immunoglobulin were enrolled. All patients had been receiving intravenous imunoglobulin (5-10%) at a dose of 0.33-1.25 gr/ kg/dose with two-four week intervals before subcutaneous immunoglobulin. Subcutaneous immunoglobulin (10%) was administered at a dose of 0.03-0.43 gr/kg/dose with one-two week intervals. No significant difference was found between serum through IgG levels before administration of intravenous imunoglobulin and steady state IgG levels during subcutaneous immunoglobulin therapy. When five patients whose serum through IgG levels were below 600 mg/dL were evaluated, however, a significant increase was found in steady state IgG levels with subcutaneous immunoglobulin therapy (p=0.043). In a ten-month follow-up period, seven infections were observed in four patients (three upper respiratory infectons, two lower respiratory tract infections and three acute gastroenteritis). No acute severe bacterial infection was observed. Local advers reaction was reported in only 10 of 180 infusions (6%). No serious adverse events were reported. All 16 patients were willing to continue IgG replacement therapy by subcutaneous administration. Conclusions: Ig replacement therapy by subcutaneous route is an efficient, safe and easy option which is eligible for individual administration. Home therapy is feasible for patients with primary immune deficiency, if informed consent is obtained and sufficient education is ensured. (Turk Pediatri Ars 2016; 51: 8-14)

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Subcutaneous immunoglobulin replacement therapy for primary antibody deficiency: advancements into the 21st century

Cited by 58 publications

References 45 publications

An Active Duty Patient With Common Variable Immune Deficiency With Early Diagnosis With the Help of the Electronic Record

An Active Duty Patient With Common Variable Immune Deficiency With Early Diagnosis With the Help of the Electronic Record

Subcutaneous immunoglobulin replacement therapy in the treatment of patients with primary immunodeficiency disease

Use of subcutaneous immunoglobulin in primary immune deficiencies

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