The Effect of Two Different Dosages of Intravenous Immunoglobulin on the Incidence of Recurrent Infections in Patients with Primary Hypogammaglobulinemia

Eijkhout, H.W.; Meer, J.W.M. van der; Kallenberg, Cees G. M.; Weening, R.S.; Dissel, Jaap T. van; Sanders, Lieke A.M.; Strengers, P. F. W.; Nienhuis, H. E.; Schellekens, P. T. A.

doi:10.7326/0003-4819-135-3-200108070-00008

Cited by 219 publications

(138 citation statements)

References 17 publications

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“…The prescribed doses, calculated with the number of grams of Ig ordered, the patient's weight, and the frequency of administration, were generally in accordance with the recommended dose of 400 to 600 mg/kg/month [8,[14][15][16][17]. The most common frequency of IV Ig dosing was every 4 weeks, consistent with the survey by Yong et al, which reported that 87 % of surveyed allergist/immunologists initially prescribed this frequency [18].…”

Section: Discussionsupporting

confidence: 69%

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

Huang

Cunningham‐Rundles

2012

Journal of Allergy and Clinical Immunology

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Purpose-Utilization reports on immunoglobulin (Ig) use for immunodeficiency in the United States (U.S.) have focused on prescribing practices in hospitals. There have been no large-scale reports on Ig use for immune deficiency in the home. We investigated the use of Ig in 3,187 subjects diagnosed with primary immunodeficiency.Methods-Cross-sectional data on 4,580 subjects in the U.S. receiving Ig in 2011 was obtained from a major home care provider. Demographics, route, dose, and frequency of Ig use by subjects with ICD-9 coded primary immunodeficiencies were analyzed.Results-Of 4,580 subjects, 3,187 had ICD-9 codes suggesting primary immunodeficiencies; 1,939 (60.8 %) were females and 1,248 (39.2 %) were males, with age ranging from 0 to 95 years. The predominant diagnoses were: common variable immunodeficiency (279.06; n =1,764; 55.3 %), hypogammaglobulinemia (279.00; n=635; 19.9 %), unspecified immunity deficiency (279.3; n=286; 9 %), other selective Ig deficiencies (279.03; n=171; 5.4 %), and agammaglobulinemia (279.04; n=127; 4 %). 54 % of subjects received Ig by the subcutaneous (SC) route, and 46 % by intravenous (IV) route, with more SC use by older subjects. The mean dose prescribed was 483 mg/kg/month, but less Ig was ordered for subjects on SCIg (409 mg/kg/month), as compared to subjects on IVIg (568 mg/kg/month). A highly significant inverse correlation between increasing age and dosage of Ig ordered was found (P=<.0001).Conclusion-Analysis of home care use of Ig in primary immune deficiency revealed that the SC route was prescribed more than the IV route, especially for older patients. By either method of administration, less immunoglobulin was prescribed for older subjects.

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Section: Discussionsupporting

confidence: 69%

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

Huang

Cunningham‐Rundles

2012

Journal of Allergy and Clinical Immunology

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“…Patients require immunoglobulin replacement therapy, which can be administered intravenously (IVIG) or subcutaneously (SCIG) [7][8][9][10][11][12][13][14]. Subcutaneous administration produces stable serum IgG levels and is associated with fewer systemic adverse events (AEs).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of a New 20% Immunoglobulin Preparation for Subcutaneous Administration, IgPro20, in Patients with Primary Immunodeficiency

Hagan¹,

Fasano²,

Spector³

et al. 2010

Journal of Allergy and Clinical Immunology

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“…bulin therapy (adults, 600 mg/kg of body weight every 4 weeks) significantly reduces the number and duration of infections as compared with the standard immunoglobulin dose (adults, 300 mg/kg of body weight every 4 weeks) (7). The amount of immunoglobulin supplementation should be increased for cases with recurrent bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

von Recklinghausen Disease in a Patient with X-linked Agammaglobulinemia.

et al. 2002

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A 33-year-old manwas referred to our hospital because of intractable cellulitis in his left lower leg. He was diagnosed with agammaglobulinemia at the age of 6 years and had been receiving y-globulin supplementation since then. Laboratory examination revealed a markedly reduced number of B cells, decreased protein amount of Bruton's tyrosine kinase (BTK) in monocytes, and a single base substitution of C994^T(missense mutation of in BTKgene, confirming the diagnosis of X-linked agammaglobulinemia (XLA). The patient also had characteristic features of von Recklinghausen disease, such as numerous subcutaneous nodules, cafe-au-lait spots, Lisch nodules in the iris and spinal scoliosis. Biopsy of a subcutaneous nodule confirmed a neurofibroma. Although the influence of XLAon the development of von Recklinghausen disease is unknownfor the moment, this is, to our knowledge, the first report of a patient with XLAwho also developed von Recklinghausen disease.

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The Effect of Two Different Dosages of Intravenous Immunoglobulin on the Incidence of Recurrent Infections in Patients with Primary Hypogammaglobulinemia

Abstract: In patients with hypogammaglobulinemia, doubling the standard dose of intravenous immunoglobulin significantly reduced the number and duration of infections.

Cited by 219 publications

References 17 publications

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

Efficacy and Safety of a New 20% Immunoglobulin Preparation for Subcutaneous Administration, IgPro20, in Patients with Primary Immunodeficiency

von Recklinghausen Disease in a Patient with X-linked Agammaglobulinemia.

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