The Nuts and Bolts of Immunoglobulin Treatment for Antibody Deficiency

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Presentation transcript:

The Nuts and Bolts of Immunoglobulin Treatment for Antibody Deficiency Richard L. Wasserman, MD, PhD The Journal of Allergy and Clinical Immunology: In Practice Volume 4, Issue 6, Pages 1076-1081.e3 (November 2016) DOI: 10.1016/j.jaip.2016.09.011 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure 1 Meta-analysis demonstrating a relationship between IgG trough level and pneumonia compiled from published studies of IGIV therapy in patients with PIDD. Each circle or square represents a single study and the size corresponds to the patient-years of the study. The squares represent the incidence of pneumonia before the start of immunoglobulin therapy. The multilevel model predictions are indicated by the red line and the 95% CI of the meta-regression by the dashed lines. IRR, Incidence rate ratio. Reprinted from Orange JS, Grossman WJ, Navickis RJ, Wilkes MM. Impact of trough IgG on pneumonia incidence in primary immunodeficiency: a meta-analysis of clinical studies. Clin Immunol 2010;137:21-30,13 with permission from Elsevier. The Journal of Allergy and Clinical Immunology: In Practice 2016 4, 1076-1081.e3DOI: (10.1016/j.jaip.2016.09.011) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure 2 Pharmacokinetic curves from one subject comparing a 4-week infusion of IGIV, a weekly infusion of IGSC 10% at 143% of the IV dose with the same data points extended across the 4-week period to facilitate comparison with the other curves, and a 4-week infusion of IGHy at 104% of the IV dose. These curves are typical of pharmacokinetics from other studies of IGIV and IGSC as well as other subjects in this study who received IGHy. Reprinted from Gupta S, Puck J, Engl W. Recombinant human hyaluronidase-facilitated subcutaneous infusion of human immunoglobulins for primary immunodeficiency. J Allergy Clin Immunol 2012;130:951-7,6 with permission from Elsevier. The Journal of Allergy and Clinical Immunology: In Practice 2016 4, 1076-1081.e3DOI: (10.1016/j.jaip.2016.09.011) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Figure E1 Characteristics of immunoglobulin products used to treat PIDDs licensed for use in the United States. The Journal of Allergy and Clinical Immunology: In Practice 2016 4, 1076-1081.e3DOI: (10.1016/j.jaip.2016.09.011) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions