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Engelmaier A, Butterweck HA, Weber A. Stability assessment of anti-bacterial antibodies in immunoglobulin G-depleted serum with validated immunoassays. Immunotherapy 2023; 15:1459-1476. [PMID: 37753548 DOI: 10.2217/imt-2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Aim: To investigate the stability of the anti-pneumococcal (PCP) and anti-haemophilus type B (Hib) immunoglobulins (IgGs) in human IgG-depleted serum samples frozen at -20°C. Materials & methods: Modified commercially available immunoassays (ELISAs) were bioanalytically validated. These ELISAs were used to measure levels of the two anti-bacterial IgG in samples kept at -20°C for up to 15 months. Human IgG-depleted serum was spiked with GAMMAGARD Liquid to obtain those samples. Results: Both ELISAs passed the validation test. Anti-PCP IgG and anti-Hib IgG were shown to be stable for at least 15 months at -20°C. Conclusion: These data confirm the stability of anti-bacterial IgG in human IgG-depleted serum and support the common practice of testing frozen samples.
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Affiliation(s)
- Andrea Engelmaier
- Baxalta Innovations GmbH, part of Takeda, Pharmaceutical Science, Vienna A-1220, Austria
| | - Harald A Butterweck
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
| | - Alfred Weber
- Baxalta Innovations GmbH, part of Takeda, Plasma Derived Therapies R&D, Vienna A-1220, Austria
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Rosenbach K, Park M, Sanchirico M, Nwose O, Paris K. Real-World Evidence of Tolerability of 20% Subcutaneous Immunoglobulin Treatment. J Clin Immunol 2023; 43:912-920. [PMID: 36809598 PMCID: PMC10275800 DOI: 10.1007/s10875-023-01436-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/19/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE The safety and efficacy of subcutaneous immune globulin 20% (human) solution (Ig20Gly) were demonstrated in clinical trials. However, real-world evidence of the tolerability of self-administered Ig20Gly in elderly patients is lacking. We describe real-world patterns of Ig20Gly usage for 12 months in patients with primary immunodeficiency diseases (PIDD) in the USA. METHODS This retrospective chart review of longitudinal data from 2 centers included patients aged ≥ 2 years with PIDD. Ig20Gly administration parameters, tolerability, and usage patterns were assessed at initial and subsequent 6- and 12-month infusions. RESULTS Of 47 enrolled patients, 30 (63.8%) received immunoglobulin replacement therapy (IGRT) within 12 months before starting Ig20Gly, and 17 (36.2%) started IGRT de novo. Patients were predominantly White (89.1%), female (85.1%), and elderly (aged > 65 years, 68.1%; median age = 71.0 years). Most adults received at-home treatment during the study, and most self-administered at 6 months (90.0%) and 12 months (88.2%). Across all time points, infusions were administered at a mean rate of 60-90 mL/h/infusion, using a mean of 2 sites per infusion, on a weekly or biweekly frequency. No emergency department visits occurred, and hospital visits were rare (n = 1). Forty-six adverse drug reactions occurred in 36.4% of adults, mostly localized site reactions; none of these or any adverse events led to treatment discontinuation. CONCLUSION These findings demonstrate tolerability and successful self-administration of Ig20Gly in PIDD, including elderly patients and patients starting IGRT de novo.
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Affiliation(s)
| | - Michelle Park
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
| | | | | | - Kenneth Paris
- Department of Pediatrics, Louisiana State University Health Sciences Center, Children's Hospital, New Orleans, LA, USA
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Heropolitańska-Pliszka E, Pac M, Pietrucha B, Machura E, Pukas-Bochenek A, Chrobak E, Bień E, Malanowska M, Pituch-Noworolska A, Drygała S, Kamieniak M, Kasprzak J, Mach-Tomalska M. Subcutaneous immunoglobulin 20% (Ig20Gly) treatment regimens in pediatric patients with primary immunodeficiencies - real-world data from the IG TATRY study. Expert Rev Clin Immunol 2023; 19:1281-1291. [PMID: 37489744 DOI: 10.1080/1744666x.2023.2240514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/20/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Subcutaneous administration of immunoglobulins is associated with fewer systemic adverse events and easier infusion compared to intravenous administration. Ig20Gly is a 20% immunoglobulin formulation effective and safe in patients with primary immune deficiency diseases (PIDDs). Real-world data are scarce, therefore our study aimed to examine the real-life treatment regimen and clinical outcomes of Ig20Gly in Polish children with PIDDs. RESEARCHDESIGN We retrospectively analyzed the medical documentation of 75 pediatric patients aged 0-17 years (mean 9.9) who received Ig20Gly (Cuvitru®; Baxalta US, Inc.; part of Takeda, MA, U.S.A.). RESULTS The median exposure to treatment of the study population was 22.3 months. At the end of the study, 59 (78.7%) were still on Ig20Gly. The median monthly dose was 0.40 g/kg. The median treatment interval was 7.7 days. Most patients (96%) used one infusion site. The median infusion rate increased with patient age. The median IgG level in the study population, 8.0 g/L, was stable. There was one case of serious bacterial infection. CONCLUSION This is the largest, long-term real-world study to date on the treatment patterns of Ig20Gly in pediatric patients with PIDDs. The results of this study support the feasibility and tolerability of Ig20Gly usage in PIDD patients across the pediatric age spectrum. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov (NCT04636502).
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Affiliation(s)
| | - Małgorzata Pac
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - Barbara Pietrucha
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - Edyta Machura
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Anna Pukas-Bochenek
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Ewelina Chrobak
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Ewa Bień
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Malanowska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | | | - Szymon Drygała
- Takeda Pharma Sp. Z.O.o, Medical Affairs, Warsaw, Poland
| | | | - Jakub Kasprzak
- Takeda Pharma Sp. Z.O.o, Medical Affairs, Warsaw, Poland
| | - Monika Mach-Tomalska
- Department of Immunology, University Children's Hospital of Cracow, Cracow, Poland
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Borte M, Anderson-Smits C, Hermann C. Update on real-world use of facilitated subcutaneous immunoglobulin and immune globulin subcutaneous (human) 20% solution in patients with immunodeficiencies: poster extracts from the 19th Biennial Meeting of the European Society for Immunodeficiencies. Expert Rev Clin Immunol 2021; 17:7-8. [DOI: 10.1080/1744666x.2021.1913122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Michael Borte
- Hospital for Children and Adolescents, St. Georg Hospital; Academic Teaching Hospital of the University of Leipzig, Leipzig, Germany
| | - Colin Anderson-Smits
- Global Evidence and Outcomes, Shire Human Genetic Therapies, Inc., a Takeda Company, Cambridge, MA, USA
| | - Corinna Hermann
- Global Medical Affairs, Baxalta Innovations GmbH, a Takeda Company, Vienna, Austria
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Kobayashi RH, Mandujano JF, Rehman SM, Kobayashi AL, Geng B, Atkinson TP, Melamed I, Turpel-Kantor E, Clodi E, Gupta S. Treatment of children with primary immunodeficiencies with a subcutaneous immunoglobulin 16.5% (cutaquig ® [octanorm]). Immunotherapy 2021; 13:813-824. [PMID: 33955240 DOI: 10.2217/imt-2021-0064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Subcutaneous human immunoglobulin (16.5%; octanorm/cutaquig®) was efficacious and well tolerated in patients with primary immunodeficiencies in a Phase III study. A subanalysis of pediatric data is presented here. Materials & methods: Children (2-16 years) previously treated with intravenous human immunoglobulin received weekly subcutaneous human immunoglobulin infusions over 64 weeks. The main objective was to assess the efficacy of cutaquig in preventing serious bacterial infections. Results: 38 children received 2213 infusions of cutaquig. No serious bacterial infections developed during the study. The rate of other infections was 3.1 per person-year and the rate of adverse drug reactions was 0.083 per infusion. Higher immunoglobulin G trough levels were achieved with cutaquig compared with previous intravenous therapy. Conclusion: Once-weekly infusions of cutaquig were efficacious and well tolerated in children with primary immunodeficiencies.
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Affiliation(s)
- Roger H Kobayashi
- Department of Pediatrics, Division of Immunology and Allergy, UCLA School of Medicine, Los Angeles, CA 90095, USA
| | | | - Syed M Rehman
- Asthma & Allergy Center, Inc., Toledo, OH 43617, USA
| | | | - Bob Geng
- Divisions of Adult and Pediatric, Allergy and Immunology, University of California-San Diego, La Jolla, CA 92093, USA
| | - Thomas Prescott Atkinson
- Department of Pediatric Allergy, Asthma and Immunology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | - Eva Turpel-Kantor
- Octapharma Pharmazeutika Produktionsges, m.b.H., Vienna, 1100, Austria
| | - Elisabeth Clodi
- Octapharma Pharmazeutika Produktionsges, m.b.H., Vienna, 1100, Austria
| | - Sudhir Gupta
- Division of Basic and Clinical Immunology, University of California, Irvine, CA 92697, USA
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Woodley WD, Yue W, Morel DR, Lainesse A, Pettis RJ, Bolick NG. Clinical Evaluation of an Investigational 5 mL Wearable Injector in Healthy Human Subjects. Clin Transl Sci 2020; 14:859-869. [PMID: 33278331 PMCID: PMC8212760 DOI: 10.1111/cts.12946] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022] Open
Abstract
An investigational wearable injector (WI), the BD Libertas Wearable Injector (BD Libertas is a trademark of Becton, Dickinson and Company), was evaluated in an early feasibility clinical study for functional performance, tissue effects, subject tolerability, and acceptability of 5 mL, non‐Newtonian ~ 8 cP subcutaneous placebo injections in 52 healthy adult subjects of 2 age groups (18–64 years and ≥ 65 years). Randomized WI subcutaneous injections (n = 208, 4/subject) were delivered to the right and left abdomen and thigh of each subject, 50% (1 thigh and 1 abdomen) with a defined movement sequence during injection. Injector functional performance was documented. Deposition was qualified and quantified with ultrasound. Tissue effects and tolerability (pain) were monitored through 24 hours with corresponding acceptability questionnaires administered through 72 hours. WI (n = 205) automatically inserted the needle, delivered 5 mL ± 5% in 5.42 minutes (SD 0.74) and retracted. Depots were entirely (93.2%) or predominantly (5.4%) localized within the target subcutaneous tissue. Slight to moderate wheals (63.9%) and erythema (75.1%) were observed with ≥ 50% resolution within 30–60 minutes. Subject pain (100 mm Visual Analog Scale) peaked mid‐injection (mean 9.1 mm, SD 13.4) and rapidly resolved within 30 minutes (mean 0.4 mm, SD 2.6). Subjects’ peak pain (≥ 90.2%), injection site appearance (≥ 92.2%) and injector wear, size, and removal (≥ 92.1%) were acceptable (Likert responses) with 100% likely to use the injector if prescribed. Injection site preference was divided between none (46%), abdomen (25%), or thigh (26.9%). The investigational WI successfully delivered 5 mL viscous subcutaneous injections. Tissue effects and pain were transient, well‐tolerated and acceptable. Neither injection site, movement or subject age affected injector functional performance or subject pain and acceptability.
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Affiliation(s)
- Wendy D Woodley
- BD Technologies & Innovation, Research Triangle Park, North Carolina, USA
| | - Wen Yue
- BD, Franklin Lakes, New Jersey, USA
| | | | | | - Ronald J Pettis
- BD Technologies & Innovation, Research Triangle Park, North Carolina, USA
| | - Natasha G Bolick
- BD Technologies & Innovation, Research Triangle Park, North Carolina, USA
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