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Emerging Paradigm of Primary Immunodeficiency Disease: Individualizing Immunoglobulin Dose and Delivery to Enhance Outcomes

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Abstract

An emerging paradigm for the treatment of primary immunodeficiency disease (PIDD) with immunoglobulin (IgG) replacement therapy emphasizes the tailoring of treatments to each patient with the goal of preventing infections and minimizing side effects. Increasing evidence shows that the IgG dose needed to prevent infection varies with each patient, and both intravenous immunoglobulin (IGIV) and subcutaneous immunoglobulin (IGSC) have emerged as feasible modes of delivery. Although IGIV is currently the routine treatment, IGSC is increasingly being chosen as the preferred route of delivery due to greater flexibility and reduced side effects.

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Conflict of Interest

Dr Shapiro is an advisor and principal investigator for Baxter and CSL Behring, and a principal investigator for Viropharma and Kedrion. Dr Wasserman is a principal investigator for IgG studies for Baxter, Biotest, Korean Green Cross, Kedrion, and ADMA. He also is a consultant for ADMA, BPL, Biotest, and Baxter, and a speaker for Baxter and CSL Behring. Dr Bonagura has no conflict of interest. Dr Gupta has served as a consultant to Baxter and as a speaker. He has participated or is participating in clinical trials for Baxter, CSL Behring, Octapharma and BPL.

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Authors and Affiliations

  1. Midwest Immunology Clinic, 157300 37th Avenue, Suite 100, Plymouth, MN, 55446, USA

    Ralph S. Shapiro

  2. Medical City Children’s Hospital, Dallas, TX, USA

    Richard L. Wasserman

  3. Steven and Alexandra Cohen Children’s Medical Center of New York, New Hyde Park, NY, USA

    Vincent Bonagura

  4. University of California, Irvine, Irvine, CA, USA

    Sudhir Gupta

Authors
  1. Ralph S. Shapiro
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  2. Richard L. Wasserman
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  3. Vincent Bonagura
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  4. Sudhir Gupta
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Correspondence to Ralph S. Shapiro.

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Shapiro, R.S., Wasserman, R.L., Bonagura, V. et al. Emerging Paradigm of Primary Immunodeficiency Disease: Individualizing Immunoglobulin Dose and Delivery to Enhance Outcomes. J Clin Immunol 37, 190–196 (2017). https://doi.org/10.1007/s10875-014-9990-x

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  • DOI: https://doi.org/10.1007/s10875-014-9990-x

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