Journal article
Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies
The World Allergy Organization journal, v 12(10), 100068
01 Oct 2019
PMID: 31641401
Abstract
Background: Monthly intravenous immunoglobulin (IVIG) and weekly subcutaneous immunoglobulin (SCIG) have been regarded as therapeutically equivalent treatments for primary immunodeficiency diseases (PIDD). Immunoglobulin G (IgG) trough level is used as a monitoring measure for infection prevention. Objective: A systematic review and meta-analysis were performed to elucidate the relationship between IgG dosing, trough IgG levels with overall infection incidence in patients with PIDD receiving IVIG and SCIG therapy. Methods: Medline, EMBASE, Cochrane, Central, and Scopus were searched for studies published from Jan 2010–June 2018, fulfilling the inclusion criteria. DerSimonian and Laird random-effects method were used to pool the difference of IgG trough levels. Random-effect meta-regression was used to evaluate infection incidence per 100 mg/dl IgG trough increase though IVIG and SCIG. Results: Out of 24 observational studies included, 11 compared IgG trough levels among SCIG and IVIG (mean difference: 73.4 mg/dl, 95% CI: 31.67–119.19 mg/dl, I2 = 45%, p = 0.05), favoring weekly SCIG. For every 100 mg/dl increase in the trough, a linear trend of decreased incidence rates of infection was identified in SCIG patients (p = 0.03), but no similar trend was identified in trough levels vs. infection rates for patients receiving IVIG (p = 0.67). Conclusion: In our study, weekly SCIG attained a higher trough level in comparison to monthly IVIG. Higher SCIG troughs were associated with lower infection rates, while IVIG troughs demonstrated no relationship.
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Details
- Title
- Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies
- Creators
- Pragya Shrestha - Mayo Clinic in FloridaParas Karmacharya - Mayo Clinic in ArizonaZhen Wang - Mayo Clinic in FloridaAnthony Donato - Reading HospitalAvni Y. Joshi - Mayo Clinic in Arizona
- Publication Details
- The World Allergy Organization journal, v 12(10), 100068
- Publisher
- Elsevier
- Grant note
- UL1 TR002377 / National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000002) National Center for Advancing Translational Sciences (http://data.elsevier.com/vocabulary/SciValFunders/100006108) T32 GM08685 / National Institutes of Health (100000002) UL1 TR002377 / National Center for Advancing Translational Sciences (100006108) Foundation for the National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000009)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Web of Science ID
- WOS:000497743800005
- Scopus ID
- 2-s2.0-85072949498
- Other Identifier
- 991022161832104721