Immunoglobulin dosage and switch from intravenous to subcutaneous immunoglobulin replacement therapy in patients with primary hypogammaglobulinemia: decreasing dosage does not alter serum IgG levels.
OBJECTIVE
The impact of reducing immunoglobulin dosage while switching from intravenous to subcutaneous replacement therapy was evaluated.


METHODS
Sixty-five patients with primary hypogammaglobulinemia on stable intravenous replacement therapy were included in a monocentric longitudinal trial. IgG trough levels were measured at baseline and during 1 year following the switch to the subcutaneous route.


RESULTS
Mean IgG trough level after 12 months of subcutaneous therapy was increased by 5.4 percent (8.37-8.82 g/l, p=0.3), while immunoglobulin dosage had been reduced by 28.3% (151-108 mg/kg/week, p<0.0001). For the patients with the lowest serum IgG level upon intravenous infusions, serum IgG level rose by 37 percent (5.33-7.33 g/l, p=0.003), while mean immunoglobulin dosage was reduced by 36 percent (170-109 mg/kg/week, p=0.04).


CONCLUSIONS
The present study shows that sustained serum IgG levels can be achieved after switching towards subcutaneous replacement despite using reduced immunoglobulin doses.
Thépot
Sylvain
S
Département d'Immunologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75010 Paris, France.
Malphettes
Marion
M
Gardeur
Anaëlle
A
Galicier
Lionel
L
Asli
Bouchra
B
Karlin
Lionel
L
Gérard
Laurence
L
Laumont
Richard
R
Doize
Marie-Laure
ML
Arnulf
Bertrand
B
Fieschi
Claire
C
Bengoufa
Djaouïda
D
Oksenhendler
Eric
E
D000361:Agammaglobulinemia / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D007136:Immunoglobulins / Q000008:administration & dosage* / Q000097:blood; D016756:Immunoglobulins, Intravenous; D055104:Infusions, Subcutaneous; D008137:Longitudinal Studies
D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous
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