Skip to main content
Erschienen in:

01.03.2010

Efficacy, Pharmacokinetics, Safety, and Tolerability of Flebogamma® 10% DIF, a High-Purity Human Intravenous Immunoglobulin, in Primary Immunodeficiency

verfasst von: Melvin Berger, Paul J. Pinciaro, Arthur Althaus, Mark Ballow, Akhilesh Chouksey, James Moy, Hans Ochs, Mark Stein

Erschienen in: Journal of Clinical Immunology | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Flebogamma® 10% DIF represents an evolution of intravenous immune globulin from the previous 5% product to be administered at higher rates and with smaller infusion volumes. Pathogen safety is enhanced by the combination of multiple methods with different mechanisms of action.

Objective

The objective of this study as to evaluate the efficacy, pharmacokinetics, and safety of Flebogamma® 10% DIF for immunoglobulin replacement therapy in primary immunodeficiency diseases (PIDD).

Methods

Flebogamma® 10% DIF was administered to 46 subjects with well-defined PIDD at a dose of 300–600 mg/kg every 21–28 days for 12 months.

Results

Serious bacterial infection rate was 0.025/subject/year. Half-life in serum of the administered IgG was approximately 35 days. No serious treatment-related adverse event (AE) occurred in any patient. Most of the potentially treatment-related AEs occurred during the infusion, accounting for 20% of the 601 infusions administered.

Conclusions

Flebogamma® 10% DIF is efficacious and safe, has adequate pharmacokinetic properties, and is well-tolerated for the treatment of PIDD.
Literatur
1.
Zurück zum Zitat Berger M. A history of immune globulin therapy, from the Harvard crash program to monoclonal antibodies. Curr Allergy Asthma Rep. 2002;2:368–78.CrossRefPubMed Berger M. A history of immune globulin therapy, from the Harvard crash program to monoclonal antibodies. Curr Allergy Asthma Rep. 2002;2:368–78.CrossRefPubMed
2.
Zurück zum Zitat Eibl MM. History of immunoglobulin replacement. Immunol Allergy Clin North Am. 2008;28:737–64.CrossRefPubMed Eibl MM. History of immunoglobulin replacement. Immunol Allergy Clin North Am. 2008;28:737–64.CrossRefPubMed
3.
Zurück zum Zitat Outbreak of hepatitis C associated with intravenous immunoglobulin administration—United States, October 1993–June 1994 (1994) MMWR Morb Mortal Wkly Rep 43:505–509 Outbreak of hepatitis C associated with intravenous immunoglobulin administration—United States, October 1993–June 1994 (1994) MMWR Morb Mortal Wkly Rep 43:505–509
4.
Zurück zum Zitat Kempf C, Stucki M, Boschetti N. Pathogen inactivation and removal procedures used in the production of intravenous immunoglobulin. Biologicals. 2007;35:35–42.CrossRefPubMed Kempf C, Stucki M, Boschetti N. Pathogen inactivation and removal procedures used in the production of intravenous immunoglobulin. Biologicals. 2007;35:35–42.CrossRefPubMed
5.
Zurück zum Zitat Horowitz B, Wiebe ME, Lippin A, Stryker MH. Inactivation of viruses in labile blood derivatives. 1. Disruption of lipid-enveloped viruses by tri-(n-butyl) phosphate detergent combinations. Transfusion. 1985;25:516–22.CrossRefPubMed Horowitz B, Wiebe ME, Lippin A, Stryker MH. Inactivation of viruses in labile blood derivatives. 1. Disruption of lipid-enveloped viruses by tri-(n-butyl) phosphate detergent combinations. Transfusion. 1985;25:516–22.CrossRefPubMed
6.
Zurück zum Zitat Korneyeva M, Hotta J, Lebing W, Rosenthal RS, Franks L, Petteway SR Jr. Enveloped virus inactivation by caprylate—a robust alternative to solvent detergent treatment in plasma derived intermediates. Biologicals. 2002;30:153–62.CrossRefPubMed Korneyeva M, Hotta J, Lebing W, Rosenthal RS, Franks L, Petteway SR Jr. Enveloped virus inactivation by caprylate—a robust alternative to solvent detergent treatment in plasma derived intermediates. Biologicals. 2002;30:153–62.CrossRefPubMed
7.
Zurück zum Zitat Louie RE, Galloway CJ, Dumas ML, et al. Inactivation of hepatitis C virus in low pH Intravenous immunoglobulin. Biologicals. 1994;22:13–9.CrossRefPubMed Louie RE, Galloway CJ, Dumas ML, et al. Inactivation of hepatitis C virus in low pH Intravenous immunoglobulin. Biologicals. 1994;22:13–9.CrossRefPubMed
8.
Zurück zum Zitat Burnouf T, Radosevich M. Nanofiltration of plasma-derived biopharmaceutical products. Haemophilia. 2003;9:24–37.CrossRefPubMed Burnouf T, Radosevich M. Nanofiltration of plasma-derived biopharmaceutical products. Haemophilia. 2003;9:24–37.CrossRefPubMed
9.
Zurück zum Zitat O'Grady J, Losikoff A, Poiley J, Fickett D, Oliver C. Virus removal studies using nanofiltration membranes. Dev Biol Stand. 1996;88:319–26.PubMed O'Grady J, Losikoff A, Poiley J, Fickett D, Oliver C. Virus removal studies using nanofiltration membranes. Dev Biol Stand. 1996;88:319–26.PubMed
10.
Zurück zum Zitat Soluk L, Price H, Sinclair C, Atalla-Mikhail D, Genereux M. Pathogen safety of intravenous Rh immunoglobulin liquid and other immune globulin products: enhanced nanofiltration and manufacturing process overview. Am J Ther. 2008;15:435–43.CrossRefPubMed Soluk L, Price H, Sinclair C, Atalla-Mikhail D, Genereux M. Pathogen safety of intravenous Rh immunoglobulin liquid and other immune globulin products: enhanced nanofiltration and manufacturing process overview. Am J Ther. 2008;15:435–43.CrossRefPubMed
11.
Zurück zum Zitat Kumar A, Teuber SS, Gershwin ME. Current perspectives on primary immunodeficiency diseases. Clin Dev Immunol. 2006;13:223–59.CrossRefPubMed Kumar A, Teuber SS, Gershwin ME. Current perspectives on primary immunodeficiency diseases. Clin Dev Immunol. 2006;13:223–59.CrossRefPubMed
12.
Zurück zum Zitat Berger M. Principles of and advances in immunoglobulin replacement therapy for primary immunodeficiency. Immunol Allergy Clin North Am. 2008;28:413–37.CrossRefPubMed Berger M. Principles of and advances in immunoglobulin replacement therapy for primary immunodeficiency. Immunol Allergy Clin North Am. 2008;28:413–37.CrossRefPubMed
13.
Zurück zum Zitat Hooper J. intravenous immunoglobulins: evolution of commercial IGIV preparations. Immunol Allergy Clin North Am. 2008;28:765–78.CrossRefPubMed Hooper J. intravenous immunoglobulins: evolution of commercial IGIV preparations. Immunol Allergy Clin North Am. 2008;28:765–78.CrossRefPubMed
14.
Zurück zum Zitat Jorquera JI. Flebogamma 5% DIF development: rationale for a new option in intravenous immunoglobulin therapy. Clin Exp Immunol. 2009;157(Suppl 1):17–21.CrossRefPubMed Jorquera JI. Flebogamma 5% DIF development: rationale for a new option in intravenous immunoglobulin therapy. Clin Exp Immunol. 2009;157(Suppl 1):17–21.CrossRefPubMed
15.
Zurück zum Zitat Vlug A, Nieuwenhuys EJ, van Eijk RV, Geertzen HG, van Houte AJ. Nephelometric measurements of human IgG subclasses and their reference ranges. Ann Biol Clin (Paris). 1994;52:561–7. Vlug A, Nieuwenhuys EJ, van Eijk RV, Geertzen HG, van Houte AJ. Nephelometric measurements of human IgG subclasses and their reference ranges. Ann Biol Clin (Paris). 1994;52:561–7.
17.
Zurück zum Zitat Code of Federal Regulations, Title 21, Volume7. CFR21 Part 640. April 1, 2008 Code of Federal Regulations, Title 21, Volume7. CFR21 Part 640. April 1, 2008
18.
Zurück zum Zitat Berger M, Flebogamma® 5% DIF® Investigators. A multicenter, prospective, open label, historically controlled clinical trial to evaluate efficacy and safety in primary immunodeficiency disease patients of Flebogamma 5% DIF®, the next generation of Flebogamma. J Clin Immunol. 2007;27:628–33.CrossRefPubMed Berger M, Flebogamma® 5% DIF® Investigators. A multicenter, prospective, open label, historically controlled clinical trial to evaluate efficacy and safety in primary immunodeficiency disease patients of Flebogamma 5% DIF®, the next generation of Flebogamma. J Clin Immunol. 2007;27:628–33.CrossRefPubMed
19.
Zurück zum Zitat Belda FJ, Otegui M, Caballero S, Domingo N, Díez JM, Gajardo R, et al. Viral safety studies of FlebogammaDIF®. Clin Exp Immunol. 2008;154:209.CrossRef Belda FJ, Otegui M, Caballero S, Domingo N, Díez JM, Gajardo R, et al. Viral safety studies of FlebogammaDIF®. Clin Exp Immunol. 2008;154:209.CrossRef
20.
21.
Zurück zum Zitat Berger M, Pinciaro PJ, Flebogamma 5% Investigators. Safety, efficacy and pharmacokinetics of Flebogamma 5% for replacement therapy in primary immune deficiency. J Clin Immunol. 2004;24:389–96.CrossRefPubMed Berger M, Pinciaro PJ, Flebogamma 5% Investigators. Safety, efficacy and pharmacokinetics of Flebogamma 5% for replacement therapy in primary immune deficiency. J Clin Immunol. 2004;24:389–96.CrossRefPubMed
22.
Zurück zum Zitat Heatherington AC, Vinci P, Golde H. A pharmacokinetic/pharmacodynamic comparison of SAAM II and PC/WinNonlin modeling software. J Pharm Sci. 1998;87:1255–63.CrossRefPubMed Heatherington AC, Vinci P, Golde H. A pharmacokinetic/pharmacodynamic comparison of SAAM II and PC/WinNonlin modeling software. J Pharm Sci. 1998;87:1255–63.CrossRefPubMed
25.
Zurück zum Zitat Bonagura VR, Marchlewski R, Cox A, Rosenthal DW. Biologic IgG level in primary immunodeficiency disease: the IgG level that protects against recurrent infection. J Allergy Clin Immunol. 2008;122:210–2.CrossRefPubMed Bonagura VR, Marchlewski R, Cox A, Rosenthal DW. Biologic IgG level in primary immunodeficiency disease: the IgG level that protects against recurrent infection. J Allergy Clin Immunol. 2008;122:210–2.CrossRefPubMed
26.
Zurück zum Zitat Daw Z, Padmore R, Neurath D, Cober N, Tokessy M, Desjardins D, et al. Hemolytic transfusion reactions after administration of intravenous immune (gamma) globulin: a case series analysis. Transfusion. 2008;48:1598–601.CrossRefPubMed Daw Z, Padmore R, Neurath D, Cober N, Tokessy M, Desjardins D, et al. Hemolytic transfusion reactions after administration of intravenous immune (gamma) globulin: a case series analysis. Transfusion. 2008;48:1598–601.CrossRefPubMed
27.
Zurück zum Zitat Stein MR, Nelson RP, Church JA, Wasserman RL, Borte M, Vermylen C, et al. Safety and efficacy of PrIGIVen®, a novel 10% liquid immunoglobulin preparation for intravenous use, in patients with primary immunodeficiencies. J Clin Immunol. 2009;29:137–44.CrossRefPubMed Stein MR, Nelson RP, Church JA, Wasserman RL, Borte M, Vermylen C, et al. Safety and efficacy of PrIGIVen®, a novel 10% liquid immunoglobulin preparation for intravenous use, in patients with primary immunodeficiencies. J Clin Immunol. 2009;29:137–44.CrossRefPubMed
28.
Zurück zum Zitat Pierce LR, Jain N. Risks associated with the use of intravenous immunoglobulin. Transfus Med Rev. 2003;17:241–51.CrossRefPubMed Pierce LR, Jain N. Risks associated with the use of intravenous immunoglobulin. Transfus Med Rev. 2003;17:241–51.CrossRefPubMed
Metadaten
Titel
Efficacy, Pharmacokinetics, Safety, and Tolerability of Flebogamma® 10% DIF, a High-Purity Human Intravenous Immunoglobulin, in Primary Immunodeficiency
verfasst von
Melvin Berger
Paul J. Pinciaro
Arthur Althaus
Mark Ballow
Akhilesh Chouksey
James Moy
Hans Ochs
Mark Stein
Publikationsdatum
01.03.2010
Verlag
Springer US
Erschienen in
Journal of Clinical Immunology / Ausgabe 2/2010
Print ISSN: 0271-9142
Elektronische ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-009-9348-y

Weitere Artikel der Ausgabe 2/2010

Journal of Clinical Immunology 2/2010 Zur Ausgabe

Kompaktes Leitlinien-Wissen Innere Medizin

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Innere Medizin

Weniger Frühgeburten im Corona-Lockdown

Die Rate an Geburten vor der 32. Schwangerschaftswoche war in Hessen im zweiten Corona-Lockdown um fast ein Drittel geringer als in der Zeit vor der Pandemie. Vor allem Frauen mit Risikoschwangerschaften erlitten weniger Frühgeburten.

Neues einmal wöchentliches Basisinsulin bei Langzeitblutzuckerkontrolle nicht unterlegen

Eine neue, nur einmal pro Woche zu applizierende Insulinformulierung scheint bei Diabetes Typ 1 (T1D) und Typ 2 (T2D) einem täglichen Basisinsulin nicht unterlegen zu sein. Bei T1D kam es aber zu mehr schweren Hypoglykämien.

High-Intensity-NIV könnte Intubation bei COPD-Exazerbation reduzieren

Die nicht invasive Beatmung (NIV) im High-Intensity-Modus könnte die Notwendigkeit einer endotrachealen Intubation bei anhaltender Hyperkapnie während einer akuten COPD-Exazerbation verringern, wie eine Studie aus China nahelegt.

Schützen GLP-1-Agonisten vor Zirrhose?

Diabeteskranke, welche die Kriterien einer MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) erfüllen, könnten im Hinblick auf das Zirrhoserisiko von einer Behandlung mit einem GLP-1-Rezeptor-Agonisten profitieren.

EKG Essentials: EKG befunden mit System

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.