2013, Number 6
<< Back Next >>
Acta Pediatr Mex 2013; 34 (6)
Subcutaneus gammaglobulin in primary immunodeficiencies. Experience at the National Institute of Pediatrics and review of the literature
Bustamante OJC, Hernández BV, Gutiérrez HJA
Language: Spanish
References: 18
Page: 332-340
PDF size: 392.48 Kb.
ABSTRACT
Primary immunodeficiencies (PID) were first described over 50 years
ago. They are hereditary disorders, mostly monogenic diseases that
produce immune system dysfunction. The most frequent PID group
is primarily antibody deficiencies, where antibody production is impaired,
for which reason these patients require to use exogenous
immunoglobulin for a long time in order to maintain homeostasis.
Immunoglobulin products and routes of administration have changed
over the years. Subcutaneous immunoglobulin administration is
effective and offers some advantages over the intravenous route:
severe adverse reactions are less frequent, medical care costs can
be reduced and patients can administer it by themselves at home,
improving their quality of life. Subcutaneous route has been used
in twenty-one PID patients at our institution. In the near future, our
goal is to establish a self-administered home program that will allow
to reduce costs for patients as well as for health systems. We
report our experience using subcutaneous route for PID patients,
and a literature review on this topic.
REFERENCES
McKuster C, Warrington R. Primary Immunodeficiency. Allergy, Asthma & Clinical Immunology. 2011;7:11-19.
Al-Herz W, Bousfiha A, Casanova JL, Chapel H, Conley ME, Cunningham-Rundles C, et al. Primary immunodeficiency diseases: an update on the classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency. Front Immunol. 2011;2:54.
Melamed Isaac, Testori Alessandro, Spirer Zvi. Characteristics and their role in primary immunodeficiency disease. Int Rev Immunol. 2012;31:451-461.
Kobrynski L. Subcutaneous immunoglobulin therapy: a new option for patients with primary immunodeficiency diseases. Biologics: targets and therapy 2012;6:277-287.
Eibl M. History of immunoglobulin replacement. Immunol Allergy Clin N Am 2008;28:737-764.
Berger M, Jolles S, Orange JS, Sleasman J. Bioavailability of IgG administered by the subcutaneous route. J Clin Immunol. 2013;33:984-990.
Stiehm ER, Casillas AM, Finkelstein J, et al. Slow subcutaneous human intravenous immunoglobulin in the treatment of antibody immunodeficiency: Use of an old method with a new product. J Allergy Clin Immunol. 1998;101848-849. 340 Acta Pediátrica de México Volumen 34, Núm. 6, noviembre-diciembre, 2013 Bustamante-Ogando JC et al.
Wasserman RI, Irani AM, Tracy J,et al. Pharmacokinetics and safety of subcutaneous immune globulin (human), 10% caprylate/chromatography purified in patients with primary immunodeficiency disease. Clin and Exper Immunol. 2010;161:518-526.
Orange JS, Belohradsky BH, Berger M, et al. Evaluation of correlation between dose and clinical outcomes in subcutaneous immunoglobulin replacement therapy. Clin Exp Immunol 2012;169:172-181.
Orange JS, Grossman W, Navickis R, Wilkes M. Impact of trough IgG on pneumonia incidence in primary immunodeficiency: A meta-analysis of clinical studies. Clin Immunol. 2010;137:21-30.
Shapiro R. Subcutaneous immunoglobulin: rapid push vs infusion pump in pediatrics. Pediatr Allergy Immunol. 2013;24:49- 53.
Abolhassani H, Salehi M. Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: Systematic review and meta-analysis. J Clin Immunol. 2012;32:1180-1192.
Martin A, Lavoie L, Goetghebeur M, Schellenberg R. Economic benefits of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency. Transfusion Medicine. 2013;23:55-60.
Condino-Neto A, Costa-Carvalho BT, Grumach AS, et al. Guidelines for the use of human immunoglobulin therapy in patients with primary immunodeficiencies in Latin America. Allergol Immunopathol. 2013;467:1-16.
Shapiro R. Why I use subcutaneous immunoglobulin? J Clin Immunol 2013;2:95-98.
Simoens S. Pharmacoeconomics of immunoglobulins in primary immunodeficiency. Expert Rev Pharmacoeconomics Outcomes Res. 2009;9:375-386.
Gardulf A, Andersen V, Björkander J, et al. Subcutaneous immunoglobulin replacement in patients with primery antibody deficiencies: safety and costs. The Lancet. 1995;345:365-369.
Haddad E, Barnes D, Kafal A. Home therapy with subcutaneous immunoglobulins for patients with primary immunodeficiency diseases. Transfusion and Apheresis Science. 2012;46:315-321.