Critical decisions in selecting an intravenous immunoglobulin product.

Use of intravenous immunoglobulin (IVIG) therapy has expanded enormously in the past two to three decades, targeting a large number of autoimmune and inflammatory disorders as well as primary immunodeficiency disease, human immunodeficiency virus, and Kawasaki disease. Increased use, particularly at higher doses and in older patients, has presented certain challenges related to safety and tolerability. All IVIGs are not the same. They differ in manufacturing processes, methods of virus elimination, and final composition. Carefully evaluating patient risk factors and matching them to potential IVIG product risks and benefits are becoming increasingly important in the selection of a particular IVIG.