Cargando…
Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies
PURPOSE: The optimal immune globulin replacement dosages required over time to minimize infection risks in patients with Primary Antibody Deficiencies are not definitely established. As with many interventions, there may be specific subgroups of patients who are more likely to benefit from treatment...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165867/ https://www.ncbi.nlm.nih.gov/pubmed/25047154 http://dx.doi.org/10.1007/s10875-014-0081-9 |
_version_ | 1782335150607040512 |
---|---|
author | Milito, Cinzia Pulvirenti, Federica Pesce, Anna Maria Digiulio, Maria Anna Pandolfi, Franco Visentini, Marcella Quinti, Isabella |
author_facet | Milito, Cinzia Pulvirenti, Federica Pesce, Anna Maria Digiulio, Maria Anna Pandolfi, Franco Visentini, Marcella Quinti, Isabella |
author_sort | Milito, Cinzia |
collection | PubMed |
description | PURPOSE: The optimal immune globulin replacement dosages required over time to minimize infection risks in patients with Primary Antibody Deficiencies are not definitely established. As with many interventions, there may be specific subgroups of patients who are more likely to benefit from treatment with higher or lower dosages. The aim of the study was to verify the efficacy of a rationale for individualized immune globulin utilization and to elucidate the effects of care on patient outcome. METHODS: Single centre interventional study on 108 patients with Primary Antibody Deficiencies. The objective was to determine for each patient the best interval between immune globulins administration in order to: • Keep IgG trough levels >500 mg/dL, • Minimize of major infections (pneumonias and infections requiring hospitalization), • Minimize of adverse events (AE). RESULTS: Ninthly eight per cent of patients achieved the objective of the study. Patients who had low switched memory B cells and low IgA serum levels and/or are affected by bronchiectasis and/or enteropathy and/or continued to experience adverse events despite pre-medications, achieved the study objective by shortening the administration intervals to 2-weeks or to 1-week without the need to increase the monthly cumulative immunoglobulin dosage and its relative cost. The adverse events were reduced by administrating low Ig dosages in a single setting. Patients without risk factors achieved the study objective with immune globulin replacement administered with the widely used interval of 3 or 4 weeks. CONCLUSIONS: The exact timing and optimal immunoglobulin prophylaxis regimen might be tailored according to clinical and immunological markers. |
format | Online Article Text |
id | pubmed-4165867 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-41658672014-09-18 Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies Milito, Cinzia Pulvirenti, Federica Pesce, Anna Maria Digiulio, Maria Anna Pandolfi, Franco Visentini, Marcella Quinti, Isabella J Clin Immunol Original Research PURPOSE: The optimal immune globulin replacement dosages required over time to minimize infection risks in patients with Primary Antibody Deficiencies are not definitely established. As with many interventions, there may be specific subgroups of patients who are more likely to benefit from treatment with higher or lower dosages. The aim of the study was to verify the efficacy of a rationale for individualized immune globulin utilization and to elucidate the effects of care on patient outcome. METHODS: Single centre interventional study on 108 patients with Primary Antibody Deficiencies. The objective was to determine for each patient the best interval between immune globulins administration in order to: • Keep IgG trough levels >500 mg/dL, • Minimize of major infections (pneumonias and infections requiring hospitalization), • Minimize of adverse events (AE). RESULTS: Ninthly eight per cent of patients achieved the objective of the study. Patients who had low switched memory B cells and low IgA serum levels and/or are affected by bronchiectasis and/or enteropathy and/or continued to experience adverse events despite pre-medications, achieved the study objective by shortening the administration intervals to 2-weeks or to 1-week without the need to increase the monthly cumulative immunoglobulin dosage and its relative cost. The adverse events were reduced by administrating low Ig dosages in a single setting. Patients without risk factors achieved the study objective with immune globulin replacement administered with the widely used interval of 3 or 4 weeks. CONCLUSIONS: The exact timing and optimal immunoglobulin prophylaxis regimen might be tailored according to clinical and immunological markers. Springer US 2014-07-22 2014 /pmc/articles/PMC4165867/ /pubmed/25047154 http://dx.doi.org/10.1007/s10875-014-0081-9 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Research Milito, Cinzia Pulvirenti, Federica Pesce, Anna Maria Digiulio, Maria Anna Pandolfi, Franco Visentini, Marcella Quinti, Isabella Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title | Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title_full | Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title_fullStr | Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title_full_unstemmed | Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title_short | Adequate Patient’s Outcome Achieved with Short Immunoglobulin Replacement Intervals in Severe Antibody Deficiencies |
title_sort | adequate patient’s outcome achieved with short immunoglobulin replacement intervals in severe antibody deficiencies |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165867/ https://www.ncbi.nlm.nih.gov/pubmed/25047154 http://dx.doi.org/10.1007/s10875-014-0081-9 |
work_keys_str_mv | AT militocinzia adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT pulvirentifederica adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT pesceannamaria adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT digiuliomariaanna adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT pandolfifranco adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT visentinimarcella adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies AT quintiisabella adequatepatientsoutcomeachievedwithshortimmunoglobulinreplacementintervalsinsevereantibodydeficiencies |