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Nakamura H, Hanafusa N, Kitamura K, Nakamura H, Sekihara H, Shimizu K, Anayama M, Makino Y, Tamura K, Nagasawa M. Biochemical evaluation of processed ascites in patients undergoing cell-free and concentrated ascites reinfusion therapy. Ther Apher Dial 2020; 24:516-523. [PMID: 32524759 DOI: 10.1111/1744-9987.13541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The biochemical composition of processed ascites is not well researched and may differ among institutions. This prospective study was conducted to evaluate the biochemical characteristics of processed ascites of 11 patients with liver cirrhosis and carcinoma who underwent cell-free and concentrated ascites reinfusion therapy. The ascites due to carcinoma were more acidic and had higher lactate dehydrogenase activity than those due to liver cirrhosis. The ascites due to liver cirrhosis contained a higher amount of immunoglobulin than those due to carcinoma. Immunoglobulin preparations were approximately 2.95% IgG in liver cirrhosis ascites and 2.25% IgG in carcinoma ascites. Moreover, the concern about IgA infusion in the patient with IgA deficiency made it important to identify the source of the ascites. The present study provided fundamental information regarding the safety of cell-free and concentrated ascites reinfusion therapy.
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Affiliation(s)
| | - Norio Hanafusa
- Department of Blood Purification, Kidney Center, Tokyo Women's Medical Hospital, Tokyo, Japan
| | - Kentaro Kitamura
- Department of Clinical engineering, Shinonoi General Hospital, Nagano, Japan
| | - Hiroaki Nakamura
- Department of Clinical engineering, Shinonoi General Hospital, Nagano, Japan
| | - Hiroyuki Sekihara
- Department of Clinical engineering, Shinonoi General Hospital, Nagano, Japan
| | - Kazuaki Shimizu
- Department of Clinical engineering, Shinonoi General Hospital, Nagano, Japan
| | - Mariko Anayama
- Department of Nephrology, Shinonoi General Hospital, Nagano, Japan
| | - Yasushi Makino
- Department of Nephrology, Shinonoi General Hospital, Nagano, Japan
| | - Katsuhiko Tamura
- Department of Nephrology, Shinonoi General Hospital, Nagano, Japan
| | - Masaki Nagasawa
- Department of Nephrology, Shinonoi General Hospital, Nagano, Japan
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Nikolov N, Reisinger J, Schwarz HP. 10% liquid human immunoglobulin (KIOVIG®) for immunomodulation in autoimmune disorders. Immunotherapy 2016; 8:923-40. [DOI: 10.2217/imt-2016-0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Intravenous immunoglobulins have been used to treat autoimmune disorders (ADs) for over 50 years. The etiologies of various ADs are not fully understood and although intravenous immunoglobulin treatment has proved its immunomodulatory properties, the roles of proposed mechanisms of action also remain a matter of speculation. A systemic search of the literature regarding KIOVIG® (Baxalta US, Inc., MA, USA) use in clinical trials on patients with ADs and a detailed review of retrieved articles revealed eight relevant publications. These articles reported KIOVIG use in multifocal motor neuropathy, chronic inflammatory demyelinating polyneuropathy, idiopathic thrombocytopenic purpura, Kawasaki disease, Guillain–Barré syndrome and other autoimmune and neurologic disorders and showed that KIOVIG is an effective, safe and well-tolerated treatment in the studied populations. Nevertheless, further studies on larger patient cohorts are needed.
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Affiliation(s)
- Nikolai Nikolov
- Baxalta GmbH, Medical Affairs, Thurgauerstrasse 130, Zurich, Switzerland
| | - Jürgen Reisinger
- Baxalta Innovations GmbH, Clinical Scientific Affairs, Industriestraße 67, 1220, Vienna, Austria
| | - Hans P Schwarz
- Baxalta Innovations GmbH, Immunology, Industriestraße 67, 1220, Vienna, Austria
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3
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Çulha S, Armutcu C, Uzun L, Şenel S, Denizli A. Synthesis of l-lysine imprinted cryogels for immunoglobulin G adsorption. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 52:315-24. [DOI: 10.1016/j.msec.2015.03.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 01/25/2015] [Accepted: 03/23/2015] [Indexed: 11/24/2022]
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Lozano-Blasco J, Martín-Mateos MA, Alsina L, Domínguez O, Giner MT, Piquer M, Alvaro M, Plaza AM. A 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in paediatric patients with primary immunodeficiencies and hypersensitivity to IVIG. Allergol Immunopathol (Madr) 2014; 42:136-41. [PMID: 23253680 DOI: 10.1016/j.aller.2012.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/09/2012] [Accepted: 10/26/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND The objective of this study was to evaluate safety and efficacy of Privigen®, a 10% intravenous immunoglobulin (IVIG), in a particular group of paediatric patients (highly sensitive to previous IVIG infusion) affected with Primary Immunodeficiencies (PID). MATERIAL AND METHODS Patients (n=8) from 3 to 17 years old diagnosed of PID who often suffered from adverse events related to the infusion to previous IVIG were switched to Privigen® in an open protocol. Data were prospectively collected regarding Privigen® administration: infusion, safety and efficacy. In parallel, data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10% IVIG product used. RESULTS 50% of the patients required premedication with previous IVIG. At the end of the study none required premedication with Privigen®. The infusion rate was lower than that recommended by the manufacturer. All patients had suffered through adverse events during previous IVIG infusion being severe in three patients and recurrent in the rest. With Privigen® only three patients suffered from an adverse event (all cases were milder than previous related). Trough levels of IgG remained stable. None suffer from any episode of bacterial infection. CONCLUSION The present work shows that Privigen® was safe in a group of hypersensitive paediatric patients who did not tolerate the administration of a previous 10% liquid IVIG by using a particular infusion protocol slower than recommended. The number of adverse effects was smaller than published, and all cases were mild. No premedication was needed. Privigen® was also effective in this small group.
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Affiliation(s)
- J Lozano-Blasco
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - M A Martín-Mateos
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
| | - L Alsina
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - O Domínguez
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - M T Giner
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - M Piquer
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - M Alvaro
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - A M Plaza
- Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
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5
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Rezaei N, Abolhassani H, Aghamohammadi A, Ochs HD. Indications and safety of intravenous and subcutaneous immunoglobulin therapy. Expert Rev Clin Immunol 2014; 7:301-16. [DOI: 10.1586/eci.10.104] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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6
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Hazenbos WLW, Kajihara KK, Vandlen R, Morisaki JH, Lehar SM, Kwakkenbos MJ, Beaumont T, Bakker AQ, Phung Q, Swem LR, Ramakrishnan S, Kim J, Xu M, Shah IM, Diep BA, Sai T, Sebrell A, Khalfin Y, Oh A, Koth C, Lin SJ, Lee BC, Strandh M, Koefoed K, Andersen PS, Spits H, Brown EJ, Tan MW, Mariathasan S. Novel staphylococcal glycosyltransferases SdgA and SdgB mediate immunogenicity and protection of virulence-associated cell wall proteins. PLoS Pathog 2013; 9:e1003653. [PMID: 24130480 PMCID: PMC3794999 DOI: 10.1371/journal.ppat.1003653] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 08/09/2013] [Indexed: 11/26/2022] Open
Abstract
Infection of host tissues by Staphylococcus aureus and S. epidermidis requires an unusual family of staphylococcal adhesive proteins that contain long stretches of serine-aspartate dipeptide-repeats (SDR). The prototype member of this family is clumping factor A (ClfA), a key virulence factor that mediates adhesion to host tissues by binding to extracellular matrix proteins such as fibrinogen. However, the biological siginificance of the SDR-domain and its implication for pathogenesis remain poorly understood. Here, we identified two novel bacterial glycosyltransferases, SdgA and SdgB, which modify all SDR-proteins in these two bacterial species. Genetic and biochemical data demonstrated that these two glycosyltransferases directly bind and covalently link N-acetylglucosamine (GlcNAc) moieties to the SDR-domain in a step-wise manner, with SdgB appending the sugar residues proximal to the target Ser-Asp repeats, followed by additional modification by SdgA. GlcNAc-modification of SDR-proteins by SdgB creates an immunodominant epitope for highly opsonic human antibodies, which represent up to 1% of total human IgG. Deletion of these glycosyltransferases renders SDR-proteins vulnerable to proteolysis by human neutrophil-derived cathepsin G. Thus, SdgA and SdgB glycosylate staphylococcal SDR-proteins, which protects them against host proteolytic activity, and yet generates major eptopes for the human anti-staphylococcal antibody response, which may represent an ongoing competition between host and pathogen. Staphylococcus aureus and S. epidermidis are major bacterial pathogens that can cause life-threatening human diseases. Following entry into the circulation, S.aureus can infect virtually any organ. However, it must first counter antibacterial mechanisms of the innate immune system, including those involving macrophages and neutrophils. Important for staphylococcal adhesion to and successful colonization of host tissues, is a family of bacterial surface proteins containing multiple repeats of serine-aspartate repeats (SDR) adjacent to an adhesive A-domain. The biological functions of the SDR-domain of these SDR proteins remain elusive. We found that the SDR-domain of all staphylococcal SDR proteins is heavily glycosylated. We identified two novel glycosylases, SdgA and SdgB, which are responsible for glycosylation in two steps, and found that this glycosylation protects the adhesive SDR proteins against proteolytic attack by human neutrophil cathepin G. Since pathogen binding to human tissues, including the extracellular matrix protein fibrinogen, depends on SDR proteins, this glycosylation may be important for successful colonization of the human host. We also show that the SdgB-mediated glycosylation creates an immunodominant epitope for highly opsonic antibodies in humans. These antibodies account for a significant proportion of the total anti-staphylococcal IgG response.
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Affiliation(s)
- Wouter L. W. Hazenbos
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Kimberly K. Kajihara
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Richard Vandlen
- Protein Chemistry, Genentech, Inc., San Francisco, California, United States of America
| | - J. Hiroshi Morisaki
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Sophie M. Lehar
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Mark J. Kwakkenbos
- AIMM Therapeutics and Department of Cell Biology and Histology, Academic Medical Center, Amsterdam, The Netherlands
| | - Tim Beaumont
- AIMM Therapeutics and Department of Cell Biology and Histology, Academic Medical Center, Amsterdam, The Netherlands
| | - Arjen Q. Bakker
- AIMM Therapeutics and Department of Cell Biology and Histology, Academic Medical Center, Amsterdam, The Netherlands
| | - Qui Phung
- Proteomics Lab, Genentech Inc., San Francisco, California, United States of America
| | - Lee R. Swem
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Satish Ramakrishnan
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Janice Kim
- Translational Immunology, Genentech, Inc., San Francisco, California, United States of America
| | - Min Xu
- Translational Immunology, Genentech, Inc., San Francisco, California, United States of America
| | - Ishita M. Shah
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Binh An Diep
- Division of Infectious Diseases, University of California, San Francisco, California, United States of America
| | - Tao Sai
- Antibody Engineering, Genentech, Inc., San Francisco, California, United States of America
| | - Andrew Sebrell
- Antibody Engineering, Genentech, Inc., San Francisco, California, United States of America
| | - Yana Khalfin
- Biochemical and Cellular Pharmacology, Genentech, Inc., San Francisco, California, United States of America
| | - Angela Oh
- Structural Biology, Genentech, Inc., San Francisco, California, United States of America
| | - Chris Koth
- Structural Biology, Genentech, Inc., San Francisco, California, United States of America
| | - S. Jack Lin
- Early Discovery Biochemistry, Genentech, Inc., San Francisco, California, United States of America
| | - Byoung-Chul Lee
- Protein Chemistry, Genentech, Inc., San Francisco, California, United States of America
| | | | | | | | - Hergen Spits
- AIMM Therapeutics and Department of Cell Biology and Histology, Academic Medical Center, Amsterdam, The Netherlands
| | - Eric J. Brown
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Man-Wah Tan
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
| | - Sanjeev Mariathasan
- Dept. of Infectious Diseases, Genentech, Inc., San Francisco, California, United States of America
- * E-mail:
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Preliminary evaluation of the safety and efficacy of standard intravenous immunoglobulins in pregnant women with primary cytomegalovirus infection. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1991-3. [PMID: 23100477 DOI: 10.1128/cvi.00509-12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hyperimmune globulins were reported to prevent and treat fetal cytomegalovirus (CMV) infection during pregnancy. Here, we report that infusions of standard human intravenous immunoglobulin significantly increase CMV IgG titers and avidity indexes in pregnant women, paving the way to their use for passive transfer of maternal CMV humoral immunity to fetuses. Preliminary data on perinatal outcomes of the first 67 newborns are encouraging.
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8
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Novaretti MCZ, Dinardo CL. Immunoglobulin: production, mechanisms of action and formulations. Rev Bras Hematol Hemoter 2012; 33:377-82. [PMID: 23049343 PMCID: PMC3415776 DOI: 10.5581/1516-8484.20110102] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 03/23/2011] [Indexed: 11/27/2022] Open
Abstract
Human immunoglobulin (Ig) began to be applied in the clinical practice with the treatment of primary immunodeficiencies. Quickly, applications of Ig increased, as its anti-inflammatory and immunomodulatory functions were elucidated. Currently, Ig is the most commonly used blood product. Ig is obtained by processing plasma; methods, in particular, techniques to reduce plasma viral loads have been evolving over the years and include: pasteurization, solvent/ detergent treatment, caprylic acid treatment and nanofiltration. These methods contribute to increased safety and quality of blood products. The mechanisms of action of Ig not only involve the blockade of Fc receptors of phagocytes, but also control complement pathways, idiotype-anti-idiotype dimer formation, blockage of superantigen binding to T cells, inhibition of dendritic cells and stimulation of regulatory T cells (Tregs). There are several formulations of Ig available, each one with its own peculiar characteristics. In Brazil, there is stringent legislation regulating the quality of Ig. Only Ig products that completely fulfill the quality control criteria are released for use. These standards involve different tests from visual inspection to determination of anti-complementary activity. This paper will further review the history and current status of Ig, including its production and mechanisms of action. The formulations available in Brazil and also the criteria of quality control currently applied will be presented.
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9
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Abstract
The 2 most commonly encountered primary immunodeficiency syndromes in adult practice are antibody deficiency disorders and hereditary angioedema.Immunologic therapy for these disorders has significantly improved patient management. Therapy with immunoglobulin leads to improvement in overall quality of life. With increasing survival rates and decreasing levels of life-threatening infections in patients with primary antibody deficiencies, disease complications are more commonly encountered. Treatment of these complications with monoclonal antibody therapy seems promising and is likely to increase in the future. More recently,several additional agents have become available, including novel drugs targeted at different elements of the disease process.
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MESH Headings
- Adrenergic beta-Antagonists/therapeutic use
- Anemia, Hemolytic, Autoimmune/therapy
- Angioedemas, Hereditary/therapy
- Bradykinin/analogs & derivatives
- Bradykinin/therapeutic use
- Complement C1 Inactivator Proteins/therapeutic use
- Complement C1 Inhibitor Protein/therapeutic use
- Cost-Benefit Analysis
- Delayed Diagnosis
- Disease Transmission, Infectious
- Filtration/methods
- Granuloma/therapy
- Home Infusion Therapy
- Humans
- Hypersensitivity, Delayed
- Hypersensitivity, Immediate
- Immunization, Passive
- Immunoglobulin G/blood
- Immunoglobulins/therapeutic use
- Immunologic Deficiency Syndromes/therapy
- Infections/epidemiology
- Kallikreins/antagonists & inhibitors
- Nanotechnology
- Peptides/therapeutic use
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Quality Control
- Quality of Life
- Recombinant Proteins/therapeutic use
- Self Administration
- Technology, Pharmaceutical
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Affiliation(s)
- Philip Wood
- Department of Clinical Immunology, St James's University Hospital, Beckett Wing, Leeds, Yorkshire LS9 7TF, UK.
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10
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Wood P. Human normal immunoglobulin in the treatment of primary immunodeficiency diseases. Ther Clin Risk Manag 2012; 8:157-67. [PMID: 22547934 PMCID: PMC3333462 DOI: 10.2147/tcrm.s22599] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The primary antibody deficiency syndromes are a rare group of disorders that can present at any age, and for which delay in diagnosis remains common. Replacement therapy with immunoglobulin in primary antibody deficiencies increases life expectancy and reduces the frequency and severity of infection. Higher doses of immunoglobulin are associated with reduced frequency of infection. Late diagnosis and delayed institution of immunoglobulin replacement therapy results in increased morbidity with a wide variety of organ-specific complications and increased mortality. Risks of immunoglobulin therapy are minimized by modern manufacturing processes, although patients can experience both immediate and delayed adverse reactions, and concerns remain over the transmission of prions in plasma. Immunoglobulin therapy leads to improvements in overall quality of life, and many of the improvements relate to reduced infection rates and fear of future infections, strongly suggesting that the immunoglobulin therapy itself is the major factor in this improvement. There are limited data on the economic benefits of immunoglobulin therapy, with the fluctuating costs of immunoglobulins making comparison between different studies difficult. However, estimates suggest that early intervention with immunoglobulin replacement compares favorably with prolonged therapy for other more common chronic diseases.
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Affiliation(s)
- Philip Wood
- St James University Hospital, Leeds, United Kingdom
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11
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Chérin P, Cabane J. Relevant criteria for selecting an intravenous immunoglobulin preparation for clinical use. BioDrugs 2010; 24:211-23. [PMID: 20623988 DOI: 10.2165/11537660-000000000-00000] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Over the past several decades, the use of intravenous human normal immunoglobulin (IVIg) products in a diverse range of immunodeficiency, inflammatory and infectious disorders has increased significantly. Newer manufacturing processes have increased the yield of intact IVIg molecules and have also improved the tolerability and safety of these products, including reducing the transmission risk of blood-borne diseases. While there are no appreciable differences between the numerous commercially available IVIg products in terms of efficacy, different manufacturing processes and the final composition of IVIg products have resulted in different safety and tolerability profiles. The tolerability profile of different IVIg products may be idiosyncratic for individual patients and may not be predictable, based on product characteristics. Consequently, patients receiving an IVIg product should be carefully monitored at initial exposure, and switching of products should be avoided. To achieve the best outcomes in patients requiring IVIg therapy, treatment should be tailored to the patient's needs. The risk/benefit profile of an IVIg in relation to patient risk factors and the underlying immune deficiency, or autoimmune or inflammatory disorder should be considered when deciding on the most appropriate therapy.
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Affiliation(s)
- Patrick Chérin
- Service de Médecine Interne I, Hôpital Pitié-Salpêtrière, Paris, France.
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Treatment of primary immunodeficiency with Kiovig: a literature review. Adv Ther 2010; 27:142-9. [PMID: 20422472 DOI: 10.1007/s12325-010-0016-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Primary immunodeficiency disorders are associated with increased patient susceptibility to recurrent infections. Since the 1950s, immunoglobulin products have been administered to treat infections in primary immunodeficiency, and patients often require lifelong therapy. The aim of this study is to carry out a literature review of a ready-to-use 10% liquid immunoglobulin preparation, Kiovig (Baxter, Brussels, Belgium), in the treatment of primary immunodeficiency. METHODS Studies were identified by searching PubMed, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, and EconLit up to January 2010. The clinical literature review focused on studies of the safety, tolerability, and effectiveness of Kiovig. Evidence about cost-effectiveness was derived from economic evaluations. In addition, budget impact analyses were identified that examined the financial impact of adopting Kiovig for the treatment of primary immunodeficiency. RESULTS The evidence indicates that Kiovig and other intravenous immunoglobulin products have similar safety and effectiveness. Given that Kiovig and other intravenous immunoglobulin products appear to have similar effectiveness, the pharmacoeconomic value of Kiovig depends on the costs of immunoglobulin treatment, including drug acquisition costs, and pharmacist and nursing time costs. A Belgian study indicated that the price of Kiovig is the main driver of its budget impact on the treatment of primary immunodeficiency. CONCLUSION The current evidence base on the treatment of primary immunodeficiency with Kiovig is limited. Head-to-head comparative studies are called for to investigate the safety, tolerability, effectiveness, and cost-effectiveness of Kiovig versus other immunoglobulin products in the treatment of primary immunodeficiency.
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:386-90. [DOI: 10.1097/aci.0b013e32832eb836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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