title: Higher doses of subcutaneous IgG reduce resource utilization in patients with primary immunodeficiency.
abstract: The recommended dose of IgG in primary immunodeficiency (PID) has been increasing since its first use. This study aimed to determine if higher subcutaneous IgG doses resulted in improved patient outcomes by comparing results from two parallel clinical studies with similar design. One patient cohort received subcutaneous IgG doses that were 1.5 times higher than their previous intravenous doses (mean 213 mg/kg/week), whereas the other cohort received doses identical to previous subcutaneous or intravenous doses (mean 120 mg/kg/week). While neither cohort had any serious infections, the cohort maintained on higher mean IgG dose had significantly lower rates of non-serious infections (2.76 vs. 5.18 episodes/year, P < 0.0001), hospitalization (0.20 vs. 3.48 days/year, P < 0.0001), antibiotic use (48.50 vs. 72.75 days/year, P < 0.001), and missed work/school activity (2.10 vs. 8.00 days/year, P < 0.001). The higher-dose cohort had lower health care utilization and improved indices of well being compared to the cohort treated with traditional IgG doses.
authors.affiliation: Department of Pediatrics, and Microbiology and Immunology, CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Elie
authors.initials: E
authors.lastname: Haddad
authors.forename: Melvin
authors.initials: M
authors.lastname: Berger
authors.forename: Edward C Y
authors.initials: EC
authors.lastname: Wang
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Jones
authors.forename: Martin
authors.initials: M
authors.lastname: Bexon
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Baggish
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000628:therapy*; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G