Marcel Reiser1, Michael Borte2, Dörte Huscher3, Ulrich Baumann4, David Pittrow5, Claudia Sommer6, Martin Stangel7, Maria Fasshauer2, Ralf Gold8, Manfred Hensel9. 1. PIOH - Praxis internistischer Onkologie und Hämatologie, Köln, Germany. 2. Paediatric Rheumatology, Immunology and Infectiology, Hospital St. Georg, Leipzig, Germany. 3. Epidemiology unit, German Rheumatism Research Centre, A Leibniz institute, Berlin, Germany. 4. Paediatric Pulmonology, Allergy and Neonatology, Hanover Medical School, Hanover, Germany. 5. Medical Faculty, Institute for Clinical Pharmacology, Technical University Dresden, Dresden, Germany. 6. Department of Neurology, University Hospital Würzburg, Würzburg, Germany. 7. Department of Neurology, Hanover Medical School, Hanover, Germany. 8. Department for Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany. 9. Mannheimer Onkologie Praxis, Mannheim, Germany.
Abstract
OBJECTIVE: We aimed to describe the current management and outcomes of patients with secondary immunodeficiencies (SID) on intravenous (IV) or subcutaneous (SC) immunoglobulins (IG) as maintenance therapy to prevent infections. METHODS: Non-interventional, prospective study (average follow-up 20.5 months). RESULTS: Of the 307 SID patients (mean age 63.7±14.4 years, 52% males, in 31% IG newly initiated), 95.4% received IV IG (mean dosing interval 4.6 weeks, average dose 199 mg/kg per 4 weeks) and 4.6% were treated with SC IG (2.6 weeks, 343 mg/kg per 4 weeks). Median IG through level at first documentation was 5.8 g/L and did not differ between IV and SC treatment or between underlying malignancies. In 24.1% of patients, treatment was interrupted temporarily, over a mean of 11.6±6.3 months. In patients with newly initiated IG treatment the 82% overall infection rate prior to treatment dropped to 21% at 1 year. CONCLUSIONS: Under clinical practice conditions, IG replacement therapy in SID patients was feasible, diminished infection rates and improved quality of life. Average IG doses were relatively low. Tolerability of IV IG treatment was excellent.
OBJECTIVE: We aimed to describe the current management and outcomes of patients with secondary immunodeficiencies (SID) on intravenous (IV) or subcutaneous (SC) immunoglobulins (IG) as maintenance therapy to prevent infections. METHODS: Non-interventional, prospective study (average follow-up 20.5 months). RESULTS: Of the 307 SIDpatients (mean age 63.7±14.4 years, 52% males, in 31% IG newly initiated), 95.4% received IV IG (mean dosing interval 4.6 weeks, average dose 199 mg/kg per 4 weeks) and 4.6% were treated with SC IG (2.6 weeks, 343 mg/kg per 4 weeks). Median IG through level at first documentation was 5.8 g/L and did not differ between IV and SC treatment or between underlying malignancies. In 24.1% of patients, treatment was interrupted temporarily, over a mean of 11.6±6.3 months. In patients with newly initiated IG treatment the 82% overall infection rate prior to treatment dropped to 21% at 1 year. CONCLUSIONS: Under clinical practice conditions, IG replacement therapy in SIDpatients was feasible, diminished infection rates and improved quality of life. Average IG doses were relatively low. Tolerability of IV IG treatment was excellent.
Authors: Il-Kang Na; Matthew Buckland; Carlo Agostini; John David M Edgar; Vanda Friman; Mauricette Michallet; Silvia Sánchez-Ramón; Carmen Scheibenbogen; Isabella Quinti Journal: Eur J Haematol Date: 2019-03-24 Impact factor: 2.997