Association between serum IgG concentrations and the incidence of infections in patients with chronic lymphocytic leukemia and secondary immunodeficiency under treatment with Privigen

OBJECTIVE

To investigate the association between serum immunoglobulin G (IgG) concentrations and the incidence of infections in patients with chronic lymphocytic leukemia (CLL) and secondary immunodeficiency receiving treatment with Privigen.

MATERIALS AND METHODS

Data was analyzed from a non-interventional study conducted in 31 centers in Germany and 1 in Austria. Adult CLL patients with hypogammaglobulinemia and recurrent infections were allowed to enter the study upon signing informed consent, if a prior decision for treatment with Privigen had been made. All infections requiring an antimicrobial treatment were subject to analysis. Patients were stratified according to their mean post-baseline serum IgG trough levels in a group with lower IgG trough levels (≤ 5.0 g/L), and a group with higher IgG trough levels (> 5.0 g/L).

RESULTS

Overall, 89 patients and 840 treatment cycles were analyzed. Up to 11 treatment cycles (average duration 29 days) were documented in each patient. In the group with higher IgG trough levels (> 5.0 g/L, N = 72), significantly fewer infections were observed than in the group with lower IgG trough levels (≤ 5.0 g/L, N = 17), including fewer severe and serious infections. The Privigen dosage was a major determinant of the post-baseline serum IgG levels. Overall tolerability of Privigen was assessed as very good or good in 91% of patients.

CONCLUSION

This analysis confirms the association of serum IgG trough levels with the incidence of infections and highlights the importance of careful monitoring of IgG levels during treatment of secondary immunodeficiencies in CLL patients.

[Approach for identifying of treatment option for pediatric patients in Guillain-Barre syndrome considering results of pharmacoeconomic analysis]

AIM

A pharmacoeconomic analysis of direct costs on treatment with high dose intravenous immunoglobulins (IVIG) and plasmapheresis (PP) in children.

MATERIAL AND METHODS

Literature data on the pathogenesis of Guillain-Barre syndrome (GBS) were analyzed. The results of pharmacoeconomic analysis of direct costs on treatment of GBS using IVIG and PP are presented. Risks for complications during treatment with IVIG and PP are calculated.

RESULTS AND CONCLUSION

The pharmacoeconomic analysis demonstrates comparable costs of treatment with IVIG or PP in the Russian Federation. Nevertheless, a less number of complications, convenience in use and the good safety and tolerability profile make it more preferable to this group of patients. In a clinical case of a 7-year child described in the article, treatment with 10% IVIG - privigen in dose 2 g/kg during 5 days started in the 3^rd week of disease showed a marked positive effect.