Skip to main content
Top
Published in: BioDrugs 2/2007

01-03-2007 | Therapy Review

Immunoglobulin Treatment for Primary Antibody Deficiencies

Advantages of the Subcutaneous Route

Author: Dr Ann Gardulf

Published in: BioDrugs | Issue 2/2007

Login to get access

Abstract

Adults and children with primary antibody deficiencies are prone to bacterial infections affecting the respiratory tract and gastrointestinal canal. To prevent or alleviate infections, replacement therapy with IgG is needed, usually on a lifelong basis. The IgG can be administered intramuscularly, intravenously, or subcutaneously. Subcutaneous IgG (SCIG) therapy, using small portable pumps for once-per-week self infusions, has shown many advantages compared with the two other routes of administration. This review highlights findings from international studies and demonstrates that: (i) SCIG therapy is safe, with very few adverse effects; (ii) the therapy can be used for patients with previous adverse effects to intravenous administration of IgG; (iii) the therapy leads to high serum IgG levels and good protection against infections; (iv) the therapy facilitates home therapy, as the infusion technique is easy for children, adults and elderly people to learn and there is no need for venous access; (v) SCIG home therapy leads to significantly improved life situations for the patients; (vi) the SCIG home therapy regimen in particular reduces the costs of treatment.
Literature
1.
go back to reference Chapel HM. Consensus Panel for the Diagnosis and Management of Primary Antibody Deficiencies. Consensus on diagnosis and management of primary antibody deficiencies. BMJ 1994; 308: 581–5PubMedCrossRef Chapel HM. Consensus Panel for the Diagnosis and Management of Primary Antibody Deficiencies. Consensus on diagnosis and management of primary antibody deficiencies. BMJ 1994; 308: 581–5PubMedCrossRef
2.
go back to reference Rosen FS, Eibl M, Roifman C, et al. Primary immunodeficiency diseases. Report of an IUIS Scientific Committee. Clin Exp Immunol 1999; 118Suppl. 1: 1–28 Rosen FS, Eibl M, Roifman C, et al. Primary immunodeficiency diseases. Report of an IUIS Scientific Committee. Clin Exp Immunol 1999; 118Suppl. 1: 1–28
3.
go back to reference Notarangelo L, Cassanova JL, Fischer A, et al. Primary immunodeficiency diseases: an update. J Allergy Clin Immunol 2004; 114: 667–87CrossRef Notarangelo L, Cassanova JL, Fischer A, et al. Primary immunodeficiency diseases: an update. J Allergy Clin Immunol 2004; 114: 667–87CrossRef
4.
5.
go back to reference Berger M, Cupps TR, Fauci AS. Immunoglobulin replacement therapy by slow subcutaneous infusions. Ann Intern Med 1980; 93: 55–6PubMed Berger M, Cupps TR, Fauci AS. Immunoglobulin replacement therapy by slow subcutaneous infusions. Ann Intern Med 1980; 93: 55–6PubMed
6.
go back to reference Gardulf A. Rapid subcutaneous immunoglobulin replacement therapy in patients with primary antibody deficiency: aspects of effectiveness, safety, home therapy, quality of life and costs. Stockholm: Karolinska Institute, 1994 Gardulf A. Rapid subcutaneous immunoglobulin replacement therapy in patients with primary antibody deficiency: aspects of effectiveness, safety, home therapy, quality of life and costs. Stockholm: Karolinska Institute, 1994
7.
go back to reference Gardulf A, Hammmarström L. Subcutaneous administration of immunoglobulins: what are the advantages? Clin Immunother 1996; 6: 108–16CrossRef Gardulf A, Hammmarström L. Subcutaneous administration of immunoglobulins: what are the advantages? Clin Immunother 1996; 6: 108–16CrossRef
8.
go back to reference Van der Meer JWM, van Furth R, Roord JJ. Subcutaneous administration of gammaglobulin. In: Nydegger UE, editor. Immunotherapy: a guide to immunoglobulin prophylxix and therapy. London: Academic Press, 1981: 133–42 Van der Meer JWM, van Furth R, Roord JJ. Subcutaneous administration of gammaglobulin. In: Nydegger UE, editor. Immunotherapy: a guide to immunoglobulin prophylxix and therapy. London: Academic Press, 1981: 133–42
9.
go back to reference Gardulf A, Hammarström L, Smith CIE. Home treatment of hypogammaglobu-linemia with subcutaneous gammaglobulin by rapid infusion. Lancet 1991; 338: 162–6PubMedCrossRef Gardulf A, Hammarström L, Smith CIE. Home treatment of hypogammaglobu-linemia with subcutaneous gammaglobulin by rapid infusion. Lancet 1991; 338: 162–6PubMedCrossRef
10.
go back to reference Hansen S, Gustafson R, Smith CIE, et al. Subcutaneous IgG infusions in patients with primary antibody deficiencies: decreased time of delivery with maintained safety. Clin Immunol 2002; 104: 237–41PubMedCrossRef Hansen S, Gustafson R, Smith CIE, et al. Subcutaneous IgG infusions in patients with primary antibody deficiencies: decreased time of delivery with maintained safety. Clin Immunol 2002; 104: 237–41PubMedCrossRef
11.
go back to reference Gardulf A, Björvell H, Gustafson R, et al. Safety of rapid subcutaneous gammaglobulin infusions in patients with primary antibody deficiency. Immunodeficiency 1993; 4: 81–4PubMed Gardulf A, Björvell H, Gustafson R, et al. Safety of rapid subcutaneous gammaglobulin infusions in patients with primary antibody deficiency. Immunodeficiency 1993; 4: 81–4PubMed
12.
go back to reference Thomas MJ, Brennan VM, Chapel HM. Rapid subcutaneous immunoglobulin infusions in children. Lancet 1993; 342: 1432–3PubMedCrossRef Thomas MJ, Brennan VM, Chapel HM. Rapid subcutaneous immunoglobulin infusions in children. Lancet 1993; 342: 1432–3PubMedCrossRef
13.
go back to reference Gardulf A, Andersen V, Björkander J, et al. Subcutaneous immunoglobulin replacement in patients with primary antibody deficiencies: safety and costs. Lancet 1995; 345: 365–9PubMedCrossRef Gardulf A, Andersen V, Björkander J, et al. Subcutaneous immunoglobulin replacement in patients with primary antibody deficiencies: safety and costs. Lancet 1995; 345: 365–9PubMedCrossRef
14.
go back to reference Abrahamsen TG, Sandersen H, Bustnes A. Home therapy with subcutaneous immunoglobulin infusions in children with congenital immunodeficiencies. Pediatrics 1996; 98: 1127–31PubMed Abrahamsen TG, Sandersen H, Bustnes A. Home therapy with subcutaneous immunoglobulin infusions in children with congenital immunodeficiencies. Pediatrics 1996; 98: 1127–31PubMed
15.
go back to reference Gustafson R, Gardulf A, Granert C, et al. Prophylactic therapy for selective IgA deficiency. Lancet 1997; 350: 865PubMedCrossRef Gustafson R, Gardulf A, Granert C, et al. Prophylactic therapy for selective IgA deficiency. Lancet 1997; 350: 865PubMedCrossRef
16.
go back to reference Gaspar J, Gerritsen B, Jones A. Immunoglobulin replacement therapy by rapid subcutaneous infusions. Arch Dis Child 1998; 79: 48–51PubMedCrossRef Gaspar J, Gerritsen B, Jones A. Immunoglobulin replacement therapy by rapid subcutaneous infusions. Arch Dis Child 1998; 79: 48–51PubMedCrossRef
17.
go back to reference Chapel HM, Spickett GP, Ericson D, et al. The comparison of the efficacy and safety of intravenous versus subcutaneous immunoglobulin replacement therapy. J Clin Immunol 2000; 20: 94–100PubMedCrossRef Chapel HM, Spickett GP, Ericson D, et al. The comparison of the efficacy and safety of intravenous versus subcutaneous immunoglobulin replacement therapy. J Clin Immunol 2000; 20: 94–100PubMedCrossRef
18.
go back to reference Andersen V, Franke K, Erkel J, et al. Subkutane IgG-infusion bei patients mit primärem immundefekt: eine retrospektive fallsammlung. Mitt Bayer Ges Immun-Tropenmed Impfwesen 2001: 14-7 Andersen V, Franke K, Erkel J, et al. Subkutane IgG-infusion bei patients mit primärem immundefekt: eine retrospektive fallsammlung. Mitt Bayer Ges Immun-Tropenmed Impfwesen 2001: 14-7
19.
go back to reference Radinsky S, Bonagura VR. Subcutaneous immunoglobulin infusion as an alternative to intravenous immunoglobulin. J Allergy Clin Immunol 2003; 112: 630–3PubMedCrossRef Radinsky S, Bonagura VR. Subcutaneous immunoglobulin infusion as an alternative to intravenous immunoglobulin. J Allergy Clin Immunol 2003; 112: 630–3PubMedCrossRef
20.
go back to reference Eijkhout HW, van der Broek PJ, van der Meer JWM. Substitution therapy in immunodeficient patients with anti-IgA antibodies or severe reactions to previous immunoglobulin therapy. Neth J Med 2003; 61: 213–7PubMed Eijkhout HW, van der Broek PJ, van der Meer JWM. Substitution therapy in immunodeficient patients with anti-IgA antibodies or severe reactions to previous immunoglobulin therapy. Neth J Med 2003; 61: 213–7PubMed
21.
go back to reference Berger M, Duff K, Poll J, et al. IgG replacement by the subcutaneous route using preparations licensed in the US for administration by other routes. In: Dalakas MS, Späth PJ, editors. Intravenous immunoglobulins in the third millennium. Proceedings of the 5th International Symposium on IVIG. New York: The Parthenon Publishing Group, 2004: 77–80 Berger M, Duff K, Poll J, et al. IgG replacement by the subcutaneous route using preparations licensed in the US for administration by other routes. In: Dalakas MS, Späth PJ, editors. Intravenous immunoglobulins in the third millennium. Proceedings of the 5th International Symposium on IVIG. New York: The Parthenon Publishing Group, 2004: 77–80
22.
go back to reference Gardulf A, Nicolay U, Asensio O, et al. Rapid subcutaneous IgG replacement therapy is effective and safe in children and adults with primary immunodeficiencies: a prospective, multi-national study. J Clin Immunol 2006; 26: 177–85PubMedCrossRef Gardulf A, Nicolay U, Asensio O, et al. Rapid subcutaneous IgG replacement therapy is effective and safe in children and adults with primary immunodeficiencies: a prospective, multi-national study. J Clin Immunol 2006; 26: 177–85PubMedCrossRef
23.
go back to reference Ochs HD, Gupta S, Kiessling P, et al. Safety and efficacy of self-administered subcutaneous immunoglobulin in patients with primary immunodeficiency diseases. J Clin Immunol 2006; 26: 265–73PubMedCrossRef Ochs HD, Gupta S, Kiessling P, et al. Safety and efficacy of self-administered subcutaneous immunoglobulin in patients with primary immunodeficiency diseases. J Clin Immunol 2006; 26: 265–73PubMedCrossRef
24.
go back to reference Gardulf A, Hansen S, Johansson K, et al. Rapid subcutaneous IgG replacement therapy in children and adults: 20 years of clinical experience. Immunologia 2006; 24: 50–3 Gardulf A, Hansen S, Johansson K, et al. Rapid subcutaneous IgG replacement therapy in children and adults: 20 years of clinical experience. Immunologia 2006; 24: 50–3
25.
go back to reference Ochs HD, Fischer SH, Wedgwood RJ, et al. Comparison of high-dose and low-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency diseases. Am J Med 1984; 76: 78–82PubMedCrossRef Ochs HD, Fischer SH, Wedgwood RJ, et al. Comparison of high-dose and low-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency diseases. Am J Med 1984; 76: 78–82PubMedCrossRef
26.
go back to reference Bonilla FA, Geha RS. Update on primary immunodeficiency diseases. J Allergy Clin Immunol 2006; 117 (2 Suppl. Mini-Primer): S435–41PubMedCrossRef Bonilla FA, Geha RS. Update on primary immunodeficiency diseases. J Allergy Clin Immunol 2006; 117 (2 Suppl. Mini-Primer): S435–41PubMedCrossRef
27.
go back to reference Gustafson R, Hammarström L, Leibl H, et al. Pharmacokinetics and safety of Gammabulin S/D [abstract and poster P02-29]. 9th Meeting of the European Society for Immunodeficiencies; 2000 Nov 5–9; Geneva Gustafson R, Hammarström L, Leibl H, et al. Pharmacokinetics and safety of Gammabulin S/D [abstract and poster P02-29]. 9th Meeting of the European Society for Immunodeficiencies; 2000 Nov 5–9; Geneva
28.
go back to reference Berger M. Subcutaneous immunoglobulin replacement in primary immunodeficiencies. Clin Immunol 2004; 112: 1–7PubMedCrossRef Berger M. Subcutaneous immunoglobulin replacement in primary immunodeficiencies. Clin Immunol 2004; 112: 1–7PubMedCrossRef
29.
go back to reference Dams ETM, van der Meer JWM. Subcutaneous immunoglobulin replacement therapy in patients with primary antibody deficiencies. Lancet 1995; 345: 864PubMedCrossRef Dams ETM, van der Meer JWM. Subcutaneous immunoglobulin replacement therapy in patients with primary antibody deficiencies. Lancet 1995; 345: 864PubMedCrossRef
30.
go back to reference Waniewski J, Gardulf A, Hammarström L. Bioavailability of gammaglobulin after subcutaneous infusions in patients with common variable immunodeficiency. J Clin Immunol 1994; 14: 90–7PubMedCrossRef Waniewski J, Gardulf A, Hammarström L. Bioavailability of gammaglobulin after subcutaneous infusions in patients with common variable immunodeficiency. J Clin Immunol 1994; 14: 90–7PubMedCrossRef
31.
go back to reference Ugazsio AG, Duse M, Re R, et al. Subcutaneous infusion of gammaglobulins in management of agammaglobulinemia. Lancet 1982; I: 226CrossRef Ugazsio AG, Duse M, Re R, et al. Subcutaneous infusion of gammaglobulins in management of agammaglobulinemia. Lancet 1982; I: 226CrossRef
32.
go back to reference Björkander J, Bengtsson U, Oxelius V-A, et al. Symptoms in patients with lowered levels of IgG subclasses, with or without IgA deficiency, and effects of immunoglobulin prophylaxis. Monogr Allergy 1986; 20: 157–63PubMed Björkander J, Bengtsson U, Oxelius V-A, et al. Symptoms in patients with lowered levels of IgG subclasses, with or without IgA deficiency, and effects of immunoglobulin prophylaxis. Monogr Allergy 1986; 20: 157–63PubMed
33.
go back to reference Thampakkul S, Ballow M. Replacement intravenous immune serum globulin therapy in patients with antibody immune deficiency. Immunol Allergy Clin North Am 2001; 21: 165–84CrossRef Thampakkul S, Ballow M. Replacement intravenous immune serum globulin therapy in patients with antibody immune deficiency. Immunol Allergy Clin North Am 2001; 21: 165–84CrossRef
34.
go back to reference Gustafson R, Hammarström L. Subcutaneous immunoglobulin replacement therapy. Ellipse 2002; 18: 45–8 Gustafson R, Hammarström L. Subcutaneous immunoglobulin replacement therapy. Ellipse 2002; 18: 45–8
35.
go back to reference Wells JV. Metabolism of immunoglobulins. In: Fudenberg HH, Stites DP, Cald-well JL, et al., editors. Basic and clinical immunology. 2nd ed. Los Altos (CA): Lange Medical Publishing, 1978: 237–45 Wells JV. Metabolism of immunoglobulins. In: Fudenberg HH, Stites DP, Cald-well JL, et al., editors. Basic and clinical immunology. 2nd ed. Los Altos (CA): Lange Medical Publishing, 1978: 237–45
36.
go back to reference Ochs HD, Smith CIE. X-linked agammaglobulinemia: a clinical and molecular analysis. Medicine 1996; 75: 287–99PubMedCrossRef Ochs HD, Smith CIE. X-linked agammaglobulinemia: a clinical and molecular analysis. Medicine 1996; 75: 287–99PubMedCrossRef
37.
go back to reference Gardulf A, Björvell H, Gustafson R, et al. The life situation of patients with primary antibody deficiency untreated or treated with subcutaneous gammaglobulin infusions. Clin Exp Immunol 1993; 92: 200–4PubMedCrossRef Gardulf A, Björvell H, Gustafson R, et al. The life situation of patients with primary antibody deficiency untreated or treated with subcutaneous gammaglobulin infusions. Clin Exp Immunol 1993; 92: 200–4PubMedCrossRef
38.
go back to reference Gardulf A, Nicolay U, Asensio O, et al. Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home. J Allergy Clin Immunol 2004; 114: 936–42PubMedCrossRef Gardulf A, Nicolay U, Asensio O, et al. Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home. J Allergy Clin Immunol 2004; 114: 936–42PubMedCrossRef
39.
go back to reference Nicolay U, Kiessling P, Berger M, et al. Health-related quality of life and treatment satisfaction in North American patients with primary immunodeficiency diseases receiving subcutaneous IgG self-infusions at home. J Clin Immunol 2006; 26: 65–72PubMedCrossRef Nicolay U, Kiessling P, Berger M, et al. Health-related quality of life and treatment satisfaction in North American patients with primary immunodeficiency diseases receiving subcutaneous IgG self-infusions at home. J Clin Immunol 2006; 26: 65–72PubMedCrossRef
41.
go back to reference Spertus JA, Jones P, McDonell M, et al. Health predicts long-term outcome in outpatients with coronary disease. Circulation 2002; 106: 43–9PubMedCrossRef Spertus JA, Jones P, McDonell M, et al. Health predicts long-term outcome in outpatients with coronary disease. Circulation 2002; 106: 43–9PubMedCrossRef
42.
go back to reference Bailis DS, Segall A, Chipperfield JG. Two views of self-rated health status. Soc Sci Med 2003; 56: 203–17PubMedCrossRef Bailis DS, Segall A, Chipperfield JG. Two views of self-rated health status. Soc Sci Med 2003; 56: 203–17PubMedCrossRef
43.
go back to reference Manderbacka K, Kåreholt I, Martikainen P, et al. The effect of point of reference on the association between self-rated health and mortality. Soc Sci Med 2003; 56: 1447–52PubMedCrossRef Manderbacka K, Kåreholt I, Martikainen P, et al. The effect of point of reference on the association between self-rated health and mortality. Soc Sci Med 2003; 56: 1447–52PubMedCrossRef
44.
go back to reference Gardulf A, Andersson E, Lindqvist M, et al. Rapid subcutaneous IgG replacement therapy at home for pregnant immunodeficient women. J Clin Immunol 2001; 21: 150–4PubMedCrossRef Gardulf A, Andersson E, Lindqvist M, et al. Rapid subcutaneous IgG replacement therapy at home for pregnant immunodeficient women. J Clin Immunol 2001; 21: 150–4PubMedCrossRef
45.
go back to reference Hansen S, Gardulf A, Andersson E, et al. Women with primary antibody deficiencies requiring IgG replacement therapy: their perception of prenatal care during pregnancy. J Obstet Gynecol Neonatal Nurs 2004; 33: 604–9PubMedCrossRef Hansen S, Gardulf A, Andersson E, et al. Women with primary antibody deficiencies requiring IgG replacement therapy: their perception of prenatal care during pregnancy. J Obstet Gynecol Neonatal Nurs 2004; 33: 604–9PubMedCrossRef
46.
go back to reference Gardulf A, Björvell H, Andersen V, et al. Lifelong treatment with gammaglobulin to patients with primary antibody deficiencies: the patients’ experiences of subcutaneous self-infusions and home therapy. J Adv Nurs 1995; 21: 917–27PubMedCrossRef Gardulf A, Björvell H, Andersen V, et al. Lifelong treatment with gammaglobulin to patients with primary antibody deficiencies: the patients’ experiences of subcutaneous self-infusions and home therapy. J Adv Nurs 1995; 21: 917–27PubMedCrossRef
47.
go back to reference Kittner JM, Grimbacher B, Wulff W, et al. Patients’ attitude to subcutaneous immunoglobulin substitution as home therapy. J Clin Immunol 2006; 26: 400–5PubMedCrossRef Kittner JM, Grimbacher B, Wulff W, et al. Patients’ attitude to subcutaneous immunoglobulin substitution as home therapy. J Clin Immunol 2006; 26: 400–5PubMedCrossRef
48.
go back to reference Gardulf A, Gustafson R. Substitutionsbehandling med gammaglobulin vid antikroppsbrist. In: Jönsson G, editor. Boken om immunbrist. Primära och sekundära orsaker till nedsatt immunitet. Uddevalla (Sweden): DMF, 2003: 20 Gardulf A, Gustafson R. Substitutionsbehandling med gammaglobulin vid antikroppsbrist. In: Jönsson G, editor. Boken om immunbrist. Primära och sekundära orsaker till nedsatt immunitet. Uddevalla (Sweden): DMF, 2003: 20
49.
go back to reference Berger M. A history of immune globulin therapy, from the Harvard crash program to monoclonal antibodies. Curr Allergy Asthma Report 2002; 2: 368–78CrossRef Berger M. A history of immune globulin therapy, from the Harvard crash program to monoclonal antibodies. Curr Allergy Asthma Report 2002; 2: 368–78CrossRef
50.
go back to reference Cunningham-Rundles C, Zhou Z, Mankarious S, et al. Long-term use of IgA depleted intravenous immunoglobulin in immunodeficient subjects with anti-IgA antibodies. J Clin Immunol 1993; 13: 272–8PubMedCrossRef Cunningham-Rundles C, Zhou Z, Mankarious S, et al. Long-term use of IgA depleted intravenous immunoglobulin in immunodeficient subjects with anti-IgA antibodies. J Clin Immunol 1993; 13: 272–8PubMedCrossRef
51.
go back to reference Sundin U, Nava S, Hammarström L. Induction of unresponsiveness against IgA in IgA-deficient patients on subcutaneous immunoglobulin infusion therapy. Clin Exp Immunol 1998; 112: 341–6PubMedCrossRef Sundin U, Nava S, Hammarström L. Induction of unresponsiveness against IgA in IgA-deficient patients on subcutaneous immunoglobulin infusion therapy. Clin Exp Immunol 1998; 112: 341–6PubMedCrossRef
52.
go back to reference Nicolay U. Health-related quality of life, treatment satisfaction and clinical aspects of patients with primary antibody deficiencies receiving subcutaneous IgG self-infusions at home. Stockholm: Karolinska Institute, 2006 Nicolay U. Health-related quality of life, treatment satisfaction and clinical aspects of patients with primary antibody deficiencies receiving subcutaneous IgG self-infusions at home. Stockholm: Karolinska Institute, 2006
53.
go back to reference Borte M, Oertelt C, Högy B. Behandlung von Patienten mit primären Antikörpermangelsyndromen in Deutschland. Klin Pädiatr 2005; 217: 276–80PubMedCrossRef Borte M, Oertelt C, Högy B. Behandlung von Patienten mit primären Antikörpermangelsyndromen in Deutschland. Klin Pädiatr 2005; 217: 276–80PubMedCrossRef
54.
go back to reference Daly PB, Evans JH, Kobayashi RH, et al. Home-based immunoglobulin infusion therapy: quality of life and patient health perceptions. Ann Allergy 1991; 67: 504–10PubMed Daly PB, Evans JH, Kobayashi RH, et al. Home-based immunoglobulin infusion therapy: quality of life and patient health perceptions. Ann Allergy 1991; 67: 504–10PubMed
55.
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; 6: 1–9CrossRef 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; 6: 1–9CrossRef
56.
go back to reference Høybraten Sigstad HM, Stray-Pedersen A, Frøland SS. Coping, quality of life, and hope in adults with primary antibody deficiencies. Health Qual Life Outcomes 2005; 3: 31CrossRef Høybraten Sigstad HM, Stray-Pedersen A, Frøland SS. Coping, quality of life, and hope in adults with primary antibody deficiencies. Health Qual Life Outcomes 2005; 3: 31CrossRef
57.
go back to reference Lorig K. Patient education. A practical approach. 3rd ed. Thousand Oaks (CA): Sage Publications, Inc., 2001 Lorig K. Patient education. A practical approach. 3rd ed. Thousand Oaks (CA): Sage Publications, Inc., 2001
58.
go back to reference Rankin SH, Stallings KD. Patient education. Principles and practice. 4th ed. Philadelphia (PA): Lippincott, 2001 Rankin SH, Stallings KD. Patient education. Principles and practice. 4th ed. Philadelphia (PA): Lippincott, 2001
59.
go back to reference Högy B, Keinecke H-O, Borte M. Pharmacoeconomic evaluation of immunoglobulin treatment in patients with antibody deficiencies from the perspective of the German statutory health insurance. Eur J Health Econom 2005; 50: 24–9CrossRef Högy B, Keinecke H-O, Borte M. Pharmacoeconomic evaluation of immunoglobulin treatment in patients with antibody deficiencies from the perspective of the German statutory health insurance. Eur J Health Econom 2005; 50: 24–9CrossRef
60.
go back to reference Gardulf A, Möller G, Jonsson E. A comparison of the patient-borne costs of therapy with gammaglobulin given at the hospital or at home. Int J Technol Assess Health Care 1995; 11: 345–53PubMedCrossRef Gardulf A, Möller G, Jonsson E. A comparison of the patient-borne costs of therapy with gammaglobulin given at the hospital or at home. Int J Technol Assess Health Care 1995; 11: 345–53PubMedCrossRef
61.
go back to reference Olinder-Nielsen A-M, Granert C, Forsberg P, et al. Immunoglobulin prophylaxis in 350 adults with IgG subclass deficiency and recurrent respiratory tract infections: a long term follow-up. Scand J Inf Dis 2007; 39: 44–50CrossRef Olinder-Nielsen A-M, Granert C, Forsberg P, et al. Immunoglobulin prophylaxis in 350 adults with IgG subclass deficiency and recurrent respiratory tract infections: a long term follow-up. Scand J Inf Dis 2007; 39: 44–50CrossRef
62.
go back to reference Hammarström L, Samuelsson J, Grimfors G. Subcutaneous gammaglobulin for patients with secondary hypogammaglobulinaemia. Lancet 1995; 345: 382–3PubMed Hammarström L, Samuelsson J, Grimfors G. Subcutaneous gammaglobulin for patients with secondary hypogammaglobulinaemia. Lancet 1995; 345: 382–3PubMed
63.
go back to reference Yu Z, Lennon VA. Mechanisms of intravenous immune globulin therapy in antibody-mediated autoimmune diseases. New Engl J Med 1999; 340: 227–8PubMedCrossRef Yu Z, Lennon VA. Mechanisms of intravenous immune globulin therapy in antibody-mediated autoimmune diseases. New Engl J Med 1999; 340: 227–8PubMedCrossRef
64.
go back to reference Elkayam O, Paran D, Milo R, et al. Acute myocardial infarction associated with high dose intravenous immunoglobulin infusion for autoimmune disorders: a study of four cases. Ann Rheum Dis 2000; 59: 77–80PubMedCrossRef Elkayam O, Paran D, Milo R, et al. Acute myocardial infarction associated with high dose intravenous immunoglobulin infusion for autoimmune disorders: a study of four cases. Ann Rheum Dis 2000; 59: 77–80PubMedCrossRef
65.
go back to reference Alliot C, Rapin JP, Besson M, et al. Pulmonary embolism after intravenous immunoglobulin. J R Soc Med 2001; 94: 187–8PubMed Alliot C, Rapin JP, Besson M, et al. Pulmonary embolism after intravenous immunoglobulin. J R Soc Med 2001; 94: 187–8PubMed
Metadata
Title
Immunoglobulin Treatment for Primary Antibody Deficiencies
Advantages of the Subcutaneous Route
Author
Dr Ann Gardulf
Publication date
01-03-2007
Publisher
Springer International Publishing
Published in
BioDrugs / Issue 2/2007
Print ISSN: 1173-8804
Electronic ISSN: 1179-190X
DOI
https://doi.org/10.2165/00063030-200721020-00005

Other articles of this Issue 2/2007

BioDrugs 2/2007 Go to the issue

Adis Drug Profile

Adalimumab