Emerging Paradigm of Primary Immunodeficiency Disease: Individualizing Immunoglobulin Dose and Delivery to Enhance Outcomes

J Clin Immunol. 2017 Feb;37(2):190-196. doi: 10.1007/s10875-014-9990-x. Epub 2014 Jan 30.

Abstract

An emerging paradigm for the treatment of primary immunodeficiency disease (PIDD) with immunoglobulin (IgG) replacement therapy emphasizes the tailoring of treatments to each patient with the goal of preventing infections and minimizing side effects. Increasing evidence shows that the IgG dose needed to prevent infection varies with each patient, and both intravenous immunoglobulin (IGIV) and subcutaneous immunoglobulin (IGSC) have emerged as feasible modes of delivery. Although IGIV is currently the routine treatment, IGSC is increasingly being chosen as the preferred route of delivery due to greater flexibility and reduced side effects.

Keywords: IVIG; IgG trough level; Primary immunodeficiency; common variable immunodeficiency; immunoglobulin replacement therapy; subcutaneous immunoglobulin.

Publication types

  • Review

MeSH terms

  • Clinical Decision-Making
  • Disease Management
  • Humans
  • Immunoglobulin G / isolation & purification
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / adverse effects
  • Immunoglobulins, Intravenous / pharmacokinetics
  • Immunologic Deficiency Syndromes / complications
  • Immunologic Deficiency Syndromes / diagnosis
  • Immunologic Deficiency Syndromes / drug therapy*
  • Infection Control
  • Infections / etiology
  • Infusions, Subcutaneous
  • Precision Medicine
  • Treatment Outcome

Substances

  • Immunoglobulin G
  • Immunoglobulins, Intravenous