An L Nguyen1, Gregory Constantine2, Carleigh Kutac3,4, Maha N Syed3,4, Jordan S Orange5, Kathleen E Sullivan6. 1. Vitality Allergy, Houston, TX, USA. 2. National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA. 3. Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Section of Immunology, 1102 Bates St. FC 330, Houston, TX, 77030, USA. 4. The William T Shearer Center for Human Immunobiology at Texas Children's Hospital, Houston, TX, USA. 5. Department of Pediatrics, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA. 6. Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Abstract
PURPOSE: Prophylactic antibiotics (PA) and immunoglobulin replacement (IGRT) are commonly used in specific antibody deficiency (SAD); however, optimal treatment is not well-established. Our purpose is to compare treatment outcomes with IGRT and/or PA among SAD patients. METHODS: A retrospective chart review of SAD patients treated at two tertiary centers between January 2012 and May 2017 was performed. Clinical and laboratory data, and rates of infections prior to and after treatment with IGRT or PA were analyzed. Descriptive analyses, between-group comparisons of rates of infection after 1 year of treatment, and a stepwise logistic regression model were employed to explore factors contributing to treatment outcomes. RESULTS: We identified 65 SAD patients with mean age were 18 years (2-71 years). The baseline mean number of infections in the PA group and IGRT group was 4.71 (SD 3.15) and 7.73 (SD 6.65), respectively. Twenty-nine (44.6%) received IGRT, 7 (10.7%) received PA, 7 (10.7%) received both IGRT and PA, 15 (23.1%) failed PA and switched to IGRT, and 7 did not receive any specific treatment. After 1 year of treatment, the difference in the mean number of infections in PA vs. IGRT was not statistically significant [2.86 (2.73) vs. 4.44 (4.74), p = 0.27]. Reporting autoimmunity increased the odds for persistent infections (OR = 4.29; p = 0.047), while higher IgG levels decreased the odds for persistent infections (OR = 0.68, p = 0.018). CONCLUSIONS: PA and IGRT are equally effective as first line in preventing infections in SAD patients. However, patients who fail PA would benefit from IGRT.
PURPOSE: Prophylactic antibiotics (PA) and immunoglobulin replacement (IGRT) are commonly used in specific antibody deficiency (SAD); however, optimal treatment is not well-established. Our purpose is to compare treatment outcomes with IGRT and/or PA among SADpatients. METHODS: A retrospective chart review of SADpatients treated at two tertiary centers between January 2012 and May 2017 was performed. Clinical and laboratory data, and rates of infections prior to and after treatment with IGRT or PA were analyzed. Descriptive analyses, between-group comparisons of rates of infection after 1 year of treatment, and a stepwise logistic regression model were employed to explore factors contributing to treatment outcomes. RESULTS: We identified 65 SADpatients with mean age were 18 years (2-71 years). The baseline mean number of infections in the PA group and IGRT group was 4.71 (SD 3.15) and 7.73 (SD 6.65), respectively. Twenty-nine (44.6%) received IGRT, 7 (10.7%) received PA, 7 (10.7%) received both IGRT and PA, 15 (23.1%) failed PA and switched to IGRT, and 7 did not receive any specific treatment. After 1 year of treatment, the difference in the mean number of infections in PA vs. IGRT was not statistically significant [2.86 (2.73) vs. 4.44 (4.74), p = 0.27]. Reporting autoimmunity increased the odds for persistent infections (OR = 4.29; p = 0.047), while higher IgG levels decreased the odds for persistent infections (OR = 0.68, p = 0.018). CONCLUSIONS: PA and IGRT are equally effective as first line in preventing infections in SADpatients. However, patients who fail PA would benefit from IGRT.
Entities:
Keywords:
Specific antibody deficiency; immunoglobulin replacement therapy; prophylactic antibiotics
Authors: Joo Hee Kim; Jae Hyuk Jang; So Hee Lee; Eun Mi Yang; Seung Hun Jang; Ki Suck Jung; Hae Sim Park Journal: Allergy Asthma Immunol Res Date: 2021-03 Impact factor: 5.764
Authors: Bas M Smits; Ilona Kleine Budde; Esther de Vries; Ineke J M Ten Berge; Robbert G M Bredius; Marcel van Deuren; Jaap T van Dissel; Pauline M Ellerbroek; Michiel van der Flier; P Martin van Hagen; Chris Nieuwhof; Bram Rutgers; Lieke E A M Sanders; Anna Simon; Taco W Kuijpers; Joris M van Montfrans Journal: J Clin Immunol Date: 2020-11-18 Impact factor: 8.317