Immune globulin subcutaneous 20% is a new high-concentration (200 g/L) solution of highly purified human IgG (≥98%) indicated in the EU and the US for antibody replacement therapy in patients with primary immunodeficiency with antibody deficiency, and in the EU for replacement therapy in humoral immunodeficiency secondary to myeloma or chronic lymphocytic leukaemia.
Immune globulin subcutaneous 20% is formulated with L-proline, which imparts long-term stability at room temperature and a relatively low viscosity.
In two pivotal phase III trials in stably treated patients with primary immunodeficiency, immune globulin subcutaneous 20% at weekly subcutaneous dosages either equivalent to each patient’s previous intravenous or subcutaneous replacement therapy, or providing equivalent systemic exposure to previous intravenous therapy, produced mean serum IgG trough levels equal to or greater than pre-study levels. In each trial, there were no serious bacterial infections during treatment throughout the 28-week or 12-month efficacy periods. The rates of infectious episodes, days missed from work/school, days hospitalized or days with antibiotics were low.
Immune globulin subcutaneous 20% was generally well tolerated. A high proportion of patients experienced local infusion-site reactions, but infusion-related systemic adverse events were relatively infrequent. Most adverse events were of mild or moderate intensity and did not interfere with therapy.
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Acknowledgements and Disclosures
The manuscript was reviewed by: A. Fasth, Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden; R. Wasserman, DallasAllergyImmunology, Medical City Children’s Hospital, Dallas, TX, USA.
The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.
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McCormack, P.L. Immune Globulin Subcutaneous (Human) 20%. Drugs 72, 1087–1097 (2012). https://doi.org/10.2165/11209490-000000000-00000
- Immune Globulin
- Primary Immunodeficiency
- Common Variable Immunodeficiency
- Antibody Deficiency
- Primary Immunodeficiency Disorder