Journal of Clinical Immunology

, Volume 30, Issue 4, pp 602–606

Immunoglobulin Dosage and Switch from Intravenous to Subcutaneous Immunoglobulin Replacement Therapy in Patients with Primary Hypogammaglobulinemia: Decreasing Dosage Does Not Alter Serum IgG Levels

  • Sylvain Thépot
  • Marion Malphettes
  • Anaëlle Gardeur
  • Lionel Galicier
  • Bouchra Asli
  • Lionel Karlin
  • Laurence Gérard
  • Richard Laumont
  • Marie-Laure Doize
  • Bertrand Arnulf
  • Claire Fieschi
  • Djaouïda Bengoufa
  • Eric Oksenhendler
Article

Abstract

Objective

The impact of reducing immunoglobulin dosage while switching from intravenous to subcutaneous replacement therapy was evaluated.

Methods

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.

Results

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).

Conclusion

The present study shows that sustained serum IgG levels can be achieved after switching towards subcutaneous replacement despite using reduced immunoglobulin doses.

Keywords

Subcutaneous immunoglobulin replacement therapy primary immune deficiency 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sylvain Thépot
    • 1
  • Marion Malphettes
    • 1
  • Anaëlle Gardeur
    • 1
  • Lionel Galicier
    • 1
  • Bouchra Asli
    • 1
  • Lionel Karlin
    • 1
  • Laurence Gérard
    • 1
  • Richard Laumont
    • 1
  • Marie-Laure Doize
    • 1
  • Bertrand Arnulf
    • 1
  • Claire Fieschi
    • 1
  • Djaouïda Bengoufa
    • 2
  • Eric Oksenhendler
    • 1
  1. 1.Département d’ImmunologieHôpital Saint-Louis, Assistance Publique Hôpitaux de ParisParisFrance
  2. 2.Laboratoire d’Immunologie et d’HistocompatibilitéHôpital Saint-Louis, Assistance Publique Hôpitaux de ParisParisFrance

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