Optimizing immunoglobulin treatment for patients with primary immunodeficiency disease to prevent pneumonia and infection incidence: review of the current data.

Abstract

BACKGROUND:

An increasing body of evidence suggests that the optimal dose for IgG replacement therapy is the dose that keeps the patient as free from infection as possible by either intravenous or subcutaneous delivery.

OBJECTIVE:

To review the current evidence on optimizing IgG therapy in patients with primary immunodeficiency disease (PIDD).

METHODS:

Surveys conducted among physicians who treat patients with PIDD indicate that most practitioners follow existing data and guidelines on the use and dosage of immunoglobulin therapy. On the basis of the current guidelines, most use intravenous immunoglobulin (IVIG) therapy at a starting dose of 400 mg/kg every 4 weeks to treat a number of primary PIDDs with humoral immune deficiencies. However, for the optimal treatment of PIDDs, therapy needs to be tailored.

RESULTS:

Among the issues is the assessment of IgG trough levels or steady-state levels with subcutaneous immunoglobulin (SCIG) therapy needed to reduce or prevent infection in patients with PIDD. Increasing evidence suggests that optimization of treatment can be based on identifying the dosage of IVIG or SCIG for each patient needed to reduce infection.

CONCLUSION:

More studies are needed to better clarify the optimal dose, IgG trough level, or IgG steady-state level necessary to reduce infection and optimize treatment for patients with PIDD treated with IVIG or SCIG.

• Authors: Mark Ballow
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 111 Issue 6 Suppl Pg. S2-5 (Dec 2013) ISSN: 1534-4436 [Electronic] United States
• PMID: 24267401 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Immunoglobulin G

Topics

• Bacterial Infections (prevention & control)
• Humans
• Immunoglobulin G (therapeutic use)
• Immunologic Deficiency Syndromes (therapy)
• Pneumonia (prevention & control)
• Virus Diseases (prevention & control)