title: Prophylactic immunoglobulin therapy in secondary immune deficiency - an expert opinion.
abstract: BACKGROUND
  In primary immunodeficiency (PID), immunoglobulin replacement therapy (IgRT) for infection prevention is well-established and supported by a wealth of clinical data. On the contrary, very little evidence-based data is available on the challenges surrounding the use of IgRT in secondary immune deficiencies (SID), and most published guidelines are mere extrapolations from the experience in PID.
  
  
  METHODS
  In this article, four European experts provide their consolidated opinion on open questions surrounding the prophylactic use of IgRT in SID, based on their clinical experience. The main topics are IgRT initiation, route of administration, dose optimization, and therapy discontinuation. The authors hope this discussion will be of assistance to practicing physicians in their daily decision-making. Expert commentary: Although growing experience indicates that IgRT could play an important role in the management of SID, very little robust evidence is available to guide clinical practice. The authors stress the urgent need for new studies in the field and discuss points they find of importance to design them adequately.
authors.affiliation: a Clinical Immunology, Department of Medicine (DIMED) , Padua University , Padua , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Agostini
authors.affiliation: b Medical Department, Division of Hematology, Oncology and Tumor Immunology , Charité - Universitätsmedizin Berlin , Germany.
authors.forename: Igor-Wolfgang
authors.initials: IW
authors.lastname: Blau
authors.affiliation: c Department of Medicine , Karolinska Institute , Stockholm , Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Kimby
authors.affiliation: d Institute of Regional Health Science and Department of Hematology, Section of Internal Medicine, Vejle Hospital , University of Southern Denmark , Vejle , Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Plesner
mesh_terms: D000818:Animals; D002985:Clinical Protocols; D064420:Drug-Related Side Effects and Adverse Reactions / Q000188:drug therapy*; D005060:Europe; D019317:Evidence-Based Medicine; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007153:Immunologic Deficiency Syndromes / Q000209:etiology / Q000517:prevention & control*
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: IVIG; SCIG; Secondary immune deficiencies; expert opinion; fSCIG; immunoglobulin replacement; recommendations