Immunoglobulin Dosage and Switch from Intravenous to Subcutaneous Immunoglobulin Replacement Therapy in Patients with Primary Hypogammaglobulinemia: Decreasing Dosage Does Not Alter Serum IgG Levels
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- Thépot, S., Malphettes, M., Gardeur, A. et al. J Clin Immunol (2010) 30: 602. doi:10.1007/s10875-010-9417-2
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The impact of reducing immunoglobulin dosage while switching from intravenous to subcutaneous replacement therapy was evaluated.
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.
Mean IgG trough level after 12 months of subcutaneous therapy was increased by 5.4% (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% (5.33–7.33 g/l, p = 0.003), while mean immunoglobulin dosage was reduced by 36% (170–109 mg/kg/week, p = 0.04).
The present study shows that sustained serum IgG levels can be achieved after switching towards subcutaneous replacement despite using reduced immunoglobulin doses.