title: Immunoglobulin dosage and switch from intravenous to subcutaneous immunoglobulin replacement therapy in patients with primary hypogammaglobulinemia: decreasing dosage does not alter serum IgG levels.
abstract: 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.
authors.affiliation: Département d'Immunologie, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75010 Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Thépot
authors.forename: Marion
authors.initials: M
authors.lastname: Malphettes
authors.forename: Anaëlle
authors.initials: A
authors.lastname: Gardeur
authors.forename: Lionel
authors.initials: L
authors.lastname: Galicier
authors.forename: Bouchra
authors.initials: B
authors.lastname: Asli
authors.forename: Lionel
authors.initials: L
authors.lastname: Karlin
authors.forename: Laurence
authors.initials: L
authors.lastname: Gérard
authors.forename: Richard
authors.initials: R
authors.lastname: Laumont
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Doize
authors.forename: Bertrand
authors.initials: B
authors.lastname: Arnulf
authors.forename: Claire
authors.initials: C
authors.lastname: Fieschi
authors.forename: Djaouïda
authors.initials: D
authors.lastname: Bengoufa
authors.forename: Eric
authors.initials: E
authors.lastname: Oksenhendler
mesh_terms: 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
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous
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