title: Pharmacokinetics and Pharmacodynamics of Intravenous Immunoglobulin G Maintenance Therapy in Chronic Immune-mediated Neuropathies.
abstract: The regimen for IVIg maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics (PK) of IVIg have not yet been established. We aimed to determine the PK of IVIg maintenance treatment in patients with clinically stable, treatment-dependent, chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 g (range, 15-70 g) every 14 days (range, 7-28 days) resulting in high IgG peak levels (median, 25.9 g/L; range, 16.7-41.0 g/L) and trough levels (median, 16.1 g/L; range, 9.7-23.6 g/L). IgG PK parameters, including half-life (median, 23.1 days; range, 11-60 days), were constant during subsequent courses in the same patients, but varied considerably between patients. The IgG levels at 1 week after infusion correlated with grip strength. These results provide insight into the PK of IVIg maintenance treatment in patients with chronic immune-mediated neuropathies.
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.|Department of Neurology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: Wjr
authors.initials: W
authors.lastname: Fokkink
authors.affiliation: Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: Bcp
authors.initials: B
authors.lastname: Koch
authors.affiliation: Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: Crb
authors.initials: C
authors.lastname: Ramakers
authors.affiliation: Department of Neurology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: van Doorn
authors.affiliation: Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.|Department of Neurology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors.forename: B C
authors.initials: BC
authors.lastname: Jacobs
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006207:Half-Life; D018737:Hand Strength; D006801:Humans; D007154:Immune System Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors