Comparison of high-dose and low-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency diseases.
To assess safety and efficacy of high-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency syndromes we treated a group of 19 patients with a monthly dose of 400 mg/kg of reduced and alkylated, maltose-containing immunoglobulin (Gamimune, Cutter Biological, Berkeley, California) and compared their responses with a group of 16 patients receiving 100 mg/kg per month intravenously. Side effects observed were mild to moderately severe and similar in both groups. In one adult patient receiving the high dose a severe enough reaction developed during the first infusion to exclude her from the study. Serum IgG levels of patients receiving high-dose immunoglobulin showed a stepwise increase in both trough and peak values until a new plateau was reached after four to six infusions. None of the patients receiving the low dose showed such a stepwise increase. On average, serum IgG levels rose by approximately 250 mg/dl for each 100 mg/kg immunoglobulin infused. The mean catabolic rate of the infused IgG was estimated to be 26 days in patients receiving high-dose immunoglobulin infusions. We demonstrated that 400 mg/kg immunoglobulin given intravenously every four weeks to patients with immunodeficiency results in a substantial increase in serum IgG during the postinfusion period, suggesting persistence of specific antibody throughout the interval between infusions.
D000328:Adult; D000361:Agammaglobulinemia / Q000276:immunology / Q000628:therapy*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006207:Half-Life; D006801:Humans; D007116:Immunization, Passive / Q000009:adverse effects; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism; D016756:Immunoglobulins, Intravenous; D007263:Infusions, Parenteral; D008297:Male; D013997:Time Factors
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous