Skip to main content
Top
Published in: Drugs 8/2012

01-05-2012 | Adis Drug Profile

Immune Globulin Subcutaneous (Human) 20%

In Primary Immunodeficiency Disorders

Author: Paul L. McCormack

Published in: Drugs | Issue 8/2012

Login to get access

Abstract

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.
Literature
2.
go back to reference Jolles S, Sleasman JW. Subcutaneous immunoglobulin replacement therapy with Hizentra®, the first 20% SCIG preparation: a practical approach. Adv Ther 2011; 28 (7): 521–33PubMedCrossRef Jolles S, Sleasman JW. Subcutaneous immunoglobulin replacement therapy with Hizentra®, the first 20% SCIG preparation: a practical approach. Adv Ther 2011; 28 (7): 521–33PubMedCrossRef
3.
go back to reference Jolles S, Bernatowska E, de Gracia J, et al. Efficacy and safety of Hizentra® in patients with primary immunodeficiency after a dose-equivalent switch from intravenous or subcutaneous replacement therapy. Clin Immunol 2011; 141 (1): 90–102PubMedCrossRef Jolles S, Bernatowska E, de Gracia J, et al. Efficacy and safety of Hizentra® in patients with primary immunodeficiency after a dose-equivalent switch from intravenous or subcutaneous replacement therapy. Clin Immunol 2011; 141 (1): 90–102PubMedCrossRef
4.
go back to reference Berger M. Choices in IgG replacement therapy for primary immune deficiency diseases: subcutaneous IgG vs. intravenous IgG and selecting an optimal dose. Curr Opin Allergy Clin Immunol 2011; 11 (6): 532–8CrossRef Berger M. Choices in IgG replacement therapy for primary immune deficiency diseases: subcutaneous IgG vs. intravenous IgG and selecting an optimal dose. Curr Opin Allergy Clin Immunol 2011; 11 (6): 532–8CrossRef
5.
go back to reference Gardulf A, Nicolay U. Replacement IgG therapy and self-therapy at home improve the health-related quality of life in patients with primary antibody deficiencies. Curr Opin Allergy Clin Immunol 2006 Dec; 6 (6): 434–42PubMedCrossRef Gardulf A, Nicolay U. Replacement IgG therapy and self-therapy at home improve the health-related quality of life in patients with primary antibody deficiencies. Curr Opin Allergy Clin Immunol 2006 Dec; 6 (6): 434–42PubMedCrossRef
6.
go back to reference Berger M. L-proline-stabilized human IgG: Privigen® 10% for intravenous use and Hizentra® 20% for subcutaneous use. Immunother 2011; 3 (2): 163–76CrossRef Berger M. L-proline-stabilized human IgG: Privigen® 10% for intravenous use and Hizentra® 20% for subcutaneous use. Immunother 2011; 3 (2): 163–76CrossRef
7.
go back to reference Maeder W, Lieby P, Sebald A, et al. Local tolerance and stability up to 24 months of a new 20% proline-stabilized polyclonal immunoglobulin for subcutaneous administration. Biologicals 2011; 39 (1): 43–9PubMedCrossRef Maeder W, Lieby P, Sebald A, et al. Local tolerance and stability up to 24 months of a new 20% proline-stabilized polyclonal immunoglobulin for subcutaneous administration. Biologicals 2011; 39 (1): 43–9PubMedCrossRef
10.
go back to reference Stucki M, Schäfer W, Hostettler T, et al. Pathogen safety of a new 20% liquid immunoglobulin product [abstract no. 331]. J Allergy Clin Immunol 2009; 123 (2 Suppl. 1): S89CrossRef Stucki M, Schäfer W, Hostettler T, et al. Pathogen safety of a new 20% liquid immunoglobulin product [abstract no. 331]. J Allergy Clin Immunol 2009; 123 (2 Suppl. 1): S89CrossRef
11.
go back to reference Stucki M, Boschetti N, Schäfer W, et al. Investigations of prion and virus safety of a new liquid IVIG product. Biologicals 2008 Jul; 36 (4): 239–47PubMedCrossRef Stucki M, Boschetti N, Schäfer W, et al. Investigations of prion and virus safety of a new liquid IVIG product. Biologicals 2008 Jul; 36 (4): 239–47PubMedCrossRef
12.
go back to reference Berger M. Incidence of infection is inversely related to steady-state (trough) serum IgG level in studies of subcutaneous IgG in PIDD. J Clin Immunol 2011; 31 (5): 924–6PubMedCrossRef Berger M. Incidence of infection is inversely related to steady-state (trough) serum IgG level in studies of subcutaneous IgG in PIDD. J Clin Immunol 2011; 31 (5): 924–6PubMedCrossRef
13.
go back to reference Orange JS, Grossman WJ, Navickis RJ, et al. Impact of trough IgG on pneumonia incidence in primary immunodeficiency: a meta-analysis of clinical studies. Clin Immunol 2010 Oct; 137 (1): 21–30PubMedCrossRef Orange JS, Grossman WJ, Navickis RJ, et al. Impact of trough IgG on pneumonia incidence in primary immunodeficiency: a meta-analysis of clinical studies. Clin Immunol 2010 Oct; 137 (1): 21–30PubMedCrossRef
14.
go back to reference Wasserman RL, Melamed I, Nelson RP, et al. Pharmaco-kinetics of subcutaneous IgPro 20 in patients with primary immunodeficiency. Clin Pharmacokinet 2011; 50 (6): 405–14PubMedCrossRef Wasserman RL, Melamed I, Nelson RP, et al. Pharmaco-kinetics of subcutaneous IgPro 20 in patients with primary immunodeficiency. Clin Pharmacokinet 2011; 50 (6): 405–14PubMedCrossRef
15.
go back to reference Berger M, Rojavin M, Kiessling P, et al. Pharmacokinetics of subcutaneous immunoglobulin and their use in dosing of replacement therapy in patients with primary immunodeficiencies. Clin Immunol 2011; 139 (2): 133–41PubMedCrossRef Berger M, Rojavin M, Kiessling P, et al. Pharmacokinetics of subcutaneous immunoglobulin and their use in dosing of replacement therapy in patients with primary immunodeficiencies. Clin Immunol 2011; 139 (2): 133–41PubMedCrossRef
16.
go back to reference Thépot S, Malphettes M, Gardeur A, et al. Immunoglobulin dosage and switch from intravenous to subcutaneous immunoglobulin replacement therapy in patients with primary hypogammaglobulinemia: decreasing dosage does not alter serum IgG levels. J Clin Immunol 2010; 30 (4): 602–6PubMedCrossRef Thépot S, Malphettes M, Gardeur A, et al. Immunoglobulin dosage and switch from intravenous to subcutaneous immunoglobulin replacement therapy in patients with primary hypogammaglobulinemia: decreasing dosage does not alter serum IgG levels. J Clin Immunol 2010; 30 (4): 602–6PubMedCrossRef
17.
go back to reference Hagan JB, Fasano MB, Spector S, et al. Efficacy and safety of a new 20% immunoglobulin preparation for subcutaneous administration, IgPro 20, in patients with primary immunodeficiency. J Clin Immunol 2010; 30 (5): 734–45PubMedCrossRef Hagan JB, Fasano MB, Spector S, et al. Efficacy and safety of a new 20% immunoglobulin preparation for subcutaneous administration, IgPro 20, in patients with primary immunodeficiency. J Clin Immunol 2010; 30 (5): 734–45PubMedCrossRef
18.
go back to reference Nelson RP, Melamed I, Stein MR, et al. Safety, tolerability, and efficacy of Hizentra over an extended period for the treatment of primary immunodeficiency disease [abstract no. 314]. J Allergy Clin Immunol 2012; 129 (2 Suppl.): AB83. Plus poster presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting; 2012 Mar 2–6; Orlando (FL) Nelson RP, Melamed I, Stein MR, et al. Safety, tolerability, and efficacy of Hizentra over an extended period for the treatment of primary immunodeficiency disease [abstract no. 314]. J Allergy Clin Immunol 2012; 129 (2 Suppl.): AB83. Plus poster presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting; 2012 Mar 2–6; Orlando (FL)
19.
go back to reference Jones CA, Rojavin M, Baggish JS. Patients with primary immunodeficiency receiving subcutaneous immune globulin Hizentra maintain health-related quality of life and treatment satisfaction in a multicentre extension study of efficacy, tolerability and safety. J Pharm Health Serv Res 2012 Mar; 3 (1): 41–7CrossRef Jones CA, Rojavin M, Baggish JS. Patients with primary immunodeficiency receiving subcutaneous immune globulin Hizentra maintain health-related quality of life and treatment satisfaction in a multicentre extension study of efficacy, tolerability and safety. J Pharm Health Serv Res 2012 Mar; 3 (1): 41–7CrossRef
20.
go back to reference Conley ME, Notarangelo LD, Etzioni A, representing PA-GID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Diagnostic criteria for primary immunodeficiencies. Clin Immunol 1999 Dec; 93 (3): 190–7PubMedCrossRef Conley ME, Notarangelo LD, Etzioni A, representing PA-GID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies). Diagnostic criteria for primary immunodeficiencies. Clin Immunol 1999 Dec; 93 (3): 190–7PubMedCrossRef
21.
go back to reference Borte M, Pac M, Serban M, et al. Efficacy and safety of Hizentra®, a new 20% immunoglobulin preparation for subcutaneous administration, in pediatric patients with primary immunodeficiency. J Clin Immunol 2011; 31 (5): 752–61PubMedCrossRef Borte M, Pac M, Serban M, et al. Efficacy and safety of Hizentra®, a new 20% immunoglobulin preparation for subcutaneous administration, in pediatric patients with primary immunodeficiency. J Clin Immunol 2011; 31 (5): 752–61PubMedCrossRef
22.
go back to reference Quevedo TG, Mannhardt-Laakmann W, Bernatowska E, et al. Health-related quality of life of patients with primary immunodeficiency switching from intravenous IgG to a new 20% subcutaneous IgG [abstract no. F39]. Clin Immunol 2010; 135 Suppl.: S87. Plus poster presented at the 10th Annual Meeting of the Federation of Clinical Immunology Societies; 2010 Jun 24–27; Boston (MA) Quevedo TG, Mannhardt-Laakmann W, Bernatowska E, et al. Health-related quality of life of patients with primary immunodeficiency switching from intravenous IgG to a new 20% subcutaneous IgG [abstract no. F39]. Clin Immunol 2010; 135 Suppl.: S87. Plus poster presented at the 10th Annual Meeting of the Federation of Clinical Immunology Societies; 2010 Jun 24–27; Boston (MA)
Metadata
Title
Immune Globulin Subcutaneous (Human) 20%
In Primary Immunodeficiency Disorders
Author
Paul L. McCormack
Publication date
01-05-2012
Publisher
Springer International Publishing
Published in
Drugs / Issue 8/2012
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/11209490-000000000-00000

Other articles of this Issue 8/2012

Drugs 8/2012 Go to the issue

Adis Drug Profile

Intravenous Ibuprofen

Adis Drug Evaluation

Azacitidine

Adis Drug Profile

Ulipristal Acetate