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IVIG infusions

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https://www.readbyqxmd.com/read/28520084/renal-and-hematologic-side-effects-of-long-term-ivig-therapy-in-patients-with-neurologic-disorders
#1
Aidan A Levine, Todd D Levine, Kathie Clarke, David Saperstein
INTRODUCTION: For patients receiving intravenous immunoglobulin (IVIG), renal and hemolytic side effects are well recognized. However, there is very little data on the effects of chronic IVIG therapy. METHODS: We retrospectively analyzed laboratory data on 166 patients who received IVIG for 12 months with dosing from 0.441 gm/kg/month to 2.58 gm/kg/month, measuring changes in hematocrit and glomerular filtration rates (GFR) at 6 and 12 months. RESULTS: Of the 2,232 infusions, there were no incidents of clinical hemolysis...
May 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28508388/positive-clinical-outcome-in-a-patient-with-recalcitrant-bullous-pemphigoid-treated-with-rituximab-and-intravenous-immunoglobulin
#2
T Nguyen, A R Ahmed
A 41-year-old white man was treated for bullous pemphigoid (BP) for 4 years, using high-dose prednisone as well as ciclosporin and mycophenolate mofetil. Sustained clinical improvement was not observed. He suffered several serious side effects. Consequently, he was treated with a combination of rituximab (RTX) and intravenous immunoglobulin (IVIg). He received 12 infusions of RTX in 6 months and monthly IVIg until the end of the therapy. Within 5 weeks of this therapy, appearance of new lesions ceased. Within 8 weeks, all previous lesions resolved and previous medications were discontinued...
May 15, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28469537/rituximab-for-treatment-of-refractory-anti-nmda-receptor-encephalitis-in-a-pediatric-patient
#3
Sarah Hallowell, Esli Tebedge, Margaret Oates, Elizabeth Hand
Anti-N-methyl d-aspartate receptor (anti-NMDAR) encephalitis is a devastating disease that is increasingly being identified in both children and adults with psychosis, language disturbances, behavioral changes, and motor deficits. Currently no consensus guidelines exist for the optimal management of patients with this disease, although intravenous immune globulin (IVIG) therapy is often considered first-line pharmacotherapy. We present a case of an otherwise healthy 4 year-old-child who presented with seizures, loss of age-appropriate language skills, and behavioral changes, in whom anti-NMDAR was subsequently diagnosed...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28452863/efficacy-and-factors-associated-with-treatment-response-of-intravenous-immunoglobulin-in-inpatients-with-refractory-inflammatory-bowel-diseases
#4
Nicholas Horton, Gursimran Kochhar, Kajal Patel, Rocio Lopez, Bo Shen
BACKGROUND: The administration of intravenous immunoglobulin (IVIG) has demonstrated promise in the treatment of medically refractory inflammatory bowel diseases (IBD). We aimed to identify factors associated with IVIG failures in the treatment of refractory IBD. METHODS: Our historical cohort included patients with refractory IBD admitted to our inpatient service with an exacerbation and treated with at least 1 dose of IVIG (0.4 g/kg). Detailed clinical variables were recorded for subjects...
April 27, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28422989/the-lack-of-btk-does-not-impair-monocytes-and-polymorphonuclear-cells-functions-in-x-linked-agammaglobulinemia-under-treatment-with-intravenous-immunoglobulin-replacement
#5
Filomena Monica Cavaliere, Alessandro Prezzo, Caterina Bilotta, Metello Iacobini, Isabella Quinti
The lack of BTK in X-linked agammaglobulinemia (XLA) patients does not affect monocytes and polymorphonuclear cells (PMN) phenotype and functions. In this study, we show that XLA patients had an increased frequency of the intermediate monocytes subset and that BTK-deficient monocytes and PMN had a normal expression of receptors involved in the activation and cellular responses. We demonstrate that BTK is not required for migration, phagocytosis and the production of reactive oxygen species (ROS) following engagement of FC gamma receptors (FcγR)...
2017: PloS One
https://www.readbyqxmd.com/read/28421246/immunoglobulin-g-for-patients-with-necrotising-soft-tissue-infection-instinct-a-randomised-blinded-placebo-controlled-trial
#6
Martin B Madsen, Peter B Hjortrup, Marco B Hansen, Theis Lange, Anna Norrby-Teglund, Ole Hyldegaard, Anders Perner
PURPOSE: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI). METHODS: We randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation; patients who had died were given the lowest possible score (zero)...
April 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28394917/a%C3%AE-levels-in-the-jugular-vein-and-high-molecular-weight-a%C3%AE-oligomer-levels-in-csf-can-be-used-as-biomarkers-to-indicate-the-anti-amyloid-effect-of-ivig-for-alzheimer-s-disease
#7
Takashi Kasai, Masaki Kondo, Ryotaro Ishii, Akihiro Tanaka, Suzuka Ataka, Hiroyuki Shimada, Takami Tomiyama, Hiroshi Mori, Mark Taylor, David Allsop, Masanori Nakagawa, Toshiki Mizuno, Takahiko Tokuda
Intravenous immunoglobulin (IVIg) has been a candidate as a potential anti-amyloid immunotherapy for Alzheimer disease (AD) because it contains anti-amyloid β (Aβ) antibodies. Although several studies with IVIg in AD have been published, changing levels of Aβ efflux from the brain, or disaggregation of Aβ species induced by immunotherapy, have not been properly investigated. Here, we carried out an open label study of therapy with IVIg in five patients with AD. We collected plasma from a peripheral vein (peripheral-plasma) and from the internal jugular vein (jugular-plasma) to estimate directly the efflux of soluble Aβ from the brain...
2017: PloS One
https://www.readbyqxmd.com/read/28381506/a-phase-3-trial-of-iv-immunoglobulin-for-alzheimer-disease
#8
Norman R Relkin, Ronald G Thomas, Robert A Rissman, James B Brewer, Michael S Rafii, Christopher H van Dyck, Clifford R Jack, Mary Sano, David S Knopman, Rema Raman, Paul Szabo, David M Gelmont, Sandor Fritsch, Paul S Aisen
OBJECTIVE: We tested biweekly infusions of IV immunoglobulin (IVIg) as a possible treatment for mild to moderate Alzheimer disease (AD) dementia. METHODS: In a phase 3, double-blind, placebo-controlled trial, we randomly assigned 390 participants with mild to moderate AD to receive placebo (low-dose albumin) or IVIg (Gammagard Liquid; Baxalta, Bannockburn, IL) administered IV at doses of 0.2 or 0.4 g/kg every 2 weeks for 18 months. The primary cognitive outcome was change from baseline to 18 months on the 11-item cognitive subscale of the Alzheimer's Disease Assessment Scale; the primary functional outcome was 18-month change on the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory...
May 2, 2017: Neurology
https://www.readbyqxmd.com/read/28378901/pharmacokinetics-and-pharmacodynamics-of-intravenous-immunoglobulin-g-maintenance-therapy-in-chronic-immune-mediated-neuropathies
#9
Wjr Fokkink, Bcp Koch, Crb Ramakers, P A van Doorn, T van Gelder, B C Jacobs
The regimen for intravenous immunoglobulin (IVIg) maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics of IVIg have not been established. We aimed to determine the pharmacokinetics of IVIg maintenance treatment in patients with clinically stable, treatment-dependent chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 (15 - 70) grams every 14 (7 - 28) days resulting in high IgG peak levels (median 25...
April 5, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28370513/high-dose-intravenous-immunoglobulin-therapy-for-scleromyxedema-a-prospective-open-label-clinical-trial-using-an-objective-score-of-clinical-evaluation-system
#10
A Guarneri, M Cioni, F Rongioletti
BACKGROUND: Scleromyxedema is a primary fibro-mucinosis whose therapy is still challenging. OBJECTIVE: To evaluate the safety and efficacy of high-dose intravenous immunoglobulin (IVIg) for the management of scleromyxedema prospectically using an objective score. METHODS: In a prospective open-label study, IVIg was administered to 8 patients with scleromyxedema in a dose of 2 gr/Kg per month. The patients were followed up to a minimum of 6 months and their disease activity and response to treatment were assessed using the Physician's Global Assessment of disease severity (PGA) and a modified objective skin scoring system for patients with scleroderma (modified Rodnan score system for scleromyxedema or mRSSS)...
March 29, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28362052/plasmapheresis-intravenous-immunoglobulins-and-autologous-serum-eyedrops-in-the-acute-eye-complications-of-toxic-epidermal-necrolysis
#11
Antonio Pinna, Eleonora Nuvoli, Francesco Blasetti, Maria Alma Posadinu, Francesco Boscia
PURPOSE: Toxic epidermal necrolysis (TEN) is a rare, life-threatening, drug-induced, mucocutaneous disease, which can severely affect the ocular surface. The purpose of this study was to investigate the efficacy of plasmapheresis, human IV immunoglobulins (IVIg), and autologous serum (AS) eyedrops in the treatment of the severe acute ocular complications of TEN. METHODS: A retrospective chart review of all patients admitted to the Burn Unit, Azienda Ospedaliero-Universitaria-Sassari, Sassari, Italy, from 2009 to 2015, identified 9 patients (2 men, 7 women; mean age 63...
March 21, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28345437/clinical-profile-dosing-and-quality-of-life-outcomes-in-primary-immune-deficiency-patients-treated-at-home-with-immunoglobulin-g-data-from-the-ideal-patient-registry
#12
Sean Kearns, Loretta Kristofek, William Bolgar, Luqman Seidu, Samantha Kile
BACKGROUND: Patients with primary immune deficiency (PID) often require immunoglobulin G (IgG, commonly referred to as Ig) replacement therapy to prevent infections and associated comorbidities. Ig therapy can be given either through intravenous or subcutaneous routes, and both can be done in the home setting. There is limited information available on the real-world diagnosis, management, and outcomes of this patient population, given the variable disease presentation and treatment options...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28316003/evaluation-of-the-safety-tolerability-and-pharmacokinetics-of-gammaplex-%C3%A2-10-versus-gammaplex-%C3%A2-5-in-subjects-with-primary-immunodeficiency
#13
RANDOMIZED CONTROLLED TRIAL
Richard L Wasserman, Isaac R Melamed, Mark R Stein, Stephen Jolles, Miranda Norton, James N Moy
PURPOSE: This phase 3, multicenter, open-label, randomized, two-period, crossover bioequivalence trial evaluated the safety, tolerability, and pharmacokinetics of intravenous immunoglobulins (IVIGs) Gammaplex 5% and Gammaplex 10% in 33 adults and 15 children with primary immunodeficiency diseases (PIDs). METHODS: Eligible adults received five Gammaplex 5% infusions followed by five Gammaplex 10% infusions, or vice versa, stratified by a 21- or 28-day dosing regimen...
April 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28240400/low-dose-prednisone-and-immunoglobulin-g-treatment-for-woman-at-risk-for-neonatal-alloimmune-thrombocytopenia-and-t-helper-1-immunity
#14
Annie Skariah, Nayoung Sung, Maria D Salazar Garcia, Li Wu, Anjali Tikoo, Alice Gilman-Sachs, Joanne Kwak-Kim
PROBLEM: Fetal and neonatal alloimmune thrombocytopenia is an alloimmune disorder resulting from platelet opsonization by maternal antibodies that destroy fetal platelets. As there is no antenatal screening or immunization to prevent sensitization, selection of high-risk population or the prevention of antenatal sensitization is significantly limited. METHOD OF STUDY: (i) A case report of ante- and postnatal management of a woman with paternal homozygosity for human platelet antigen-1(HPA) incompatibility...
February 27, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28224702/early-platelet-and-leukocyte-decline-in-patients-with-neuroinflammatory-disorders-after-intravenous-immunoglobulins
#15
A Totzeck, M Stettner, T Hagenacker
BACKGROUND AND PURPOSE: Intravenous immunoglobulins (IVIGs) are a common therapy in patients with neuroinflammatory disorders, especially chronic inflammatory demyelinating polyradiculoneuropathy or Guillain-Barré syndrome. Hematological toxicities upon IVIG infusion are a known side effect and still an important subject of investigation. METHODS: Laboratory results and data for clinical efficacy and tolerability of 62 patients with neuroinflammatory disorders treated with IVIG (0...
February 22, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28213939/protective-antibodies-against-clostridium-difficile-are-present-in-intravenous-immunoglobulin-and-are-retained-in-humans-following-its-administration
#16
O H Negm, B MacKenzie, M R Hamed, O A J Ahmad, C C Shone, D P Humphreys, K Ravi Acharya, C E Loscher, I Marszalowska, M Lynch, M H Wilcox, T M Monaghan
The prevalence of serum antibodies against Clostridium difficile (CD) toxins A and B in healthy populations have prompted interest in evaluating the therapeutic activity of intravenous immunoglobulin (IVIg) in individuals experiencing severe or recurrent C. difficile infection (CDI). Despite some promising case reports, a definitive clinical role for IVIg in CDI remains unclear. Contradictory results may be attributed to a lack of consensus regarding optimal dose, timing of administration and patient selection as well as variability in specific antibody content between commercial preparations...
June 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28203488/efficacy-and-safety-of-clairyg-%C3%A2-a-ready-to-use-intravenous-immunoglobulin-in-adult-patients-with-primary-immune-thrombocytopenia
#17
Borhane Slama, Olivier Fain, Hervé Maisonneuve, Eric Jourdan, Jean-François Viallard, Rabye Ouaja, Ousmane Alfa-Cissé, Bertrand Godeau
PURPOSE: The present study was designed to assess the efficacy and safety of IGNG that is a new liquid, saccharose and maltose-free highly purified ready-to-use 5% intravenous immunoglobulin (IVIg), in primary immune thrombocytopenic patients with severe thrombocytopenia. METHODS: Nineteen adults with a platelet count ≤ 25 × 10(9)/L received a single dose of IGNG (1 g/kg) on Day 1, with a second identical dose on Day 3 if needed. Patients were followed for 30 days...
2017: American Journal of Blood Research
https://www.readbyqxmd.com/read/28199785/assessment-of-tocilizumab-anti-interleukin-6-receptor-monoclonal-as-a-potential-treatment-for-chronic-antibody-mediated-rejection-and-transplant-glomerulopathy-in-hla-sensitized-renal-allograft-recipients
#18
J Choi, O Aubert, A Vo, A Loupy, M Haas, D Puliyanda, I Kim, S Louie, A Kang, A Peng, J Kahwaji, N Reinsmoen, M Toyoda, S C Jordan
Extending the functional integrity of renal allografts is the primary goal of transplant medicine. The development of donor-specific antibodies (DSAs) posttransplantation leads to chronic active antibody-mediated rejection (cAMR) and transplant glomerulopathy (TG), resulting in the majority of graft losses that occur in the United States. This reduces the quality and length of life for patients and increases cost. There are no approved treatments for cAMR. Evidence suggests the proinflammatory cytokine interleukin 6 (IL-6) may play an important role in DSA generation and cAMR...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28144763/high-dose-ig-vena-is-well-tolerated-and-efficacious-in-patients-with-multifocal-motor-neuropathy
#19
Eduardo Nobile-Orazio, Dario Cocito, Chiara Briani, Rosaria Plasmati, Angelo Schenone, Francesca Gallia, Ivan Marjanovic, Anna Lotti Suffredini
Multifocal motor neuropathy (MMN) is a rare, chronic, motor neuropathy that progressively impairs physical functioning and quality of life. Randomised controlled trials have shown that high-dose intravenous immunoglobulin (IVIg) is superior to placebo in improving muscle strength and disability, but many patients require periodic infusions to maintain long-term improvement. This observational, multicentre, retrospective study investigated the efficacy and tolerability of human normal immunoglobulin (Ig VENA) at high intravenous infusion rates in 20 MMN patients (14 male, 6 female)...
January 31, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28130210/antenatal-management-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-systematic-review
#20
Dian Winkelhorst, Michael F Murphy, Andreas Greinacher, Nadine Shehata, Taman Bakchoul, Edwin Massey, Jillian Baker, Lani Lieberman, Susano Tanael, Heather Hume, Donald M Arnold, Shoma Baidya, Gerald Bertrand, James Bussel, Mette Kjaer, Cécile Kaplan, Jens Kjeldsen-Kragh, Dick Oepkes, Greg Ryan
Several strategies can be used to manage fetal or neonatal alloimmune thrombocytopenia (FNAIT) in subsequent pregnancies. Serial fetal blood sampling (FBS) and intrauterine platelet transfusions (IUPT), as well as weekly maternal IV immunoglobulin infusion (IVIG), with or without additional corticosteroid therapy, are common options, but optimal management has not been determined. The aim of this systematic review was to assess antenatal treatment strategies for FNAIT. Four randomized controlled trials and 22 nonrandomized studies were included...
March 16, 2017: Blood
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