Çocuklarda Subkutan İmmünglobülin Kullanımı

İnsan plazma kaynaklı immünglobülinler başta primer immün yetersizlik hastalıkları olmak üzere pek çok hastalı- ğın tedavi seçenekleri arasında yer almaktadır. İmmünglobülin preparatları; intravenöz IV , subkutan SC ya da intramüsküler IM yolla verilebilir. Son yıllar- da subkutan immünglobülin SIG uygulaması, hasta konfo- runun daha yüksek, maliyetinin ve yan etki insidansının daha düşük olması nedeniyle tercih edilmektedir. Bu yazıda çocuk hastalarda SIG kullanımı ile ilgili güncel bilgiler özetlenmiştir

Anahtar Kelimeler:

Subkutan immünglobülin, çocuk, tedavi

Subcutaneous Immunoglobulin Use in Children

Human plasma derived immunoglobulin products have been considered among treatment options for many of the disor- ders, particularly primary immune deficiencies. Immunoglobulins can be administered either intravenous IV , subcutaneous SC or intramuscular IM route. In recent years, SCIG use has been preferred increasingly because of higher patient comfort, with decreased systemic side effects and costs. Up-to-date information regarding SCIG use in pediatric patients is being summarized in this review

Keywords:

Subcutaneous immunoglobulin, children, treatment,

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Bruton oc. Agammaglobulinemia. Pediatrics 1952;9:722-8.
Jolles S. Subcutaneous and intramuscular immune globulin therapy. www.uptodate.com.
Janeway CA, Apt l, Gitlin D. Agammaglobulinemia. Trans Assoc Am Physicians 1953;66:200-2.
Gitlin D, Janeway CA. Agammaglobulinemia: conge- nital, acquired and transient forms. Prog Hematol 1956;1:318-56.
Hill lE, Mollison Pl. MRC working party on hypo- gammaglobulinemia, collection of cases and design of trial, Chap. II, Hypogammaglobulinemia in the UK. Her Majesty’s Stationery Office: London, 1971: pp. 4-8.
Berger M. Subcutaneous administration of IgG. Immunol Allergy Clin North Am 2008;28:779.
https://doi.org/10.1016/j.iac.2008.07.002
Stiehm ER. Adverse effects of human immunoglobu- lin therapy. Transfus Med Rev 2013;27:171.
https://doi.org/10.1016/j.tmrv.2013.05.004
Berger M. Subcutaneous IgG in neurologic diseases. Immunotherapy 2014;6:71-83.
https://doi.org/10.2217/imt.13.146
Bourque PR, Pringle CE, Cameron W, Cowan J, Chardon JW. Subcutaneous immunoglobulin therapy in the chronic management of myasthenia gravis: A retrospective cohort study. PLoS One 2016;11: e0159993.
https://doi.org/10.1371/journal.pone.0159993
Misbah SA, Baumann A, Fazio R, Dacci P, Schmidt DS, Burton J, Sturzenegger M. A smooth transition protocol for patients with multifocal motor neuropathy going from intravenous to subcutaneous immunoglo- bulin therapy: an open-label proof-of-concept study. J Peripher Nerv Syst 2011;16:92-7.
https://doi.org/10.1111/j.1529-8027.2011.00330.x
US Food and Drug Administration (FDA) approval: http://www.fda.gov/biologicsbloodvaccines/bloodblo- odproducts/approvedproducts/licensedproductsblas/ fractionatedplasmaproducts/ucm414117.htm (Accessed on September 19, 2014).
Hagan JB, Fasano MB, Spector S, et al. Efficacy and safety of a new 20% immunoglobulin preparation for subcutaneous administration, IgPro20, in patients with primary immunodeficiency. J Clin Immunol 2010; 30:734.
https://doi.org/10.1007/s10875-010-9423-4
Ochs HD, Gupta S, Kiessling P, et al. Safety and efficacy of self-administered subcutaneous immunog- lobulin in patients with primary immunodeficiency diseases. J Clin Immunol 2006;26:265.
https://doi.org/10.1007/s10875-006-9021-7
Gardulf A. Immunoglobulin treatment for primary antibody deficiencies: advantages of the subcutaneous route. Bio Drugs 2007;21:105.
https://doi.org/10.2165/00063030-200721020-00005
Orange JS, Hossny EM, Weiler CR, et al. Use of intravenous immunoglobulin in human disease: a revi- ew of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol 2006;117:S525.
https://doi.org/10.1016/j.jaci.2006.01.015
Bonilla FA. Pharmacokinetics of immunoglobulin administered via intravenous or subcutaneous routes. Immunol Allergy Clin North Am 2008;28:803.
https://doi.org/10.1016/j.iac.2008.06.006
Berger M, Rojavin M, Kiessling P, Zenker O. Pharmacokinetics of subcutaneous immunoglobulin and their use in dosing of replacement therapy in pati- ents with primary immunodeficiencies. Clin Immunol 2011;139:133.
https://doi.org/10.1016/j.clim.2011.01.006
Waniewski J, Gardulf A, Hammarström l. Bioavailability of gamma-globulin after subcutaneous infusions in patients with common variable immunode- ficiency. J Clin Immunol 1994;14:90.
https://doi.org/10.1007/BF01541341
Berger M, Rojavin M, Kiessling P, Zenker O. Pharmacokinetics of subcutaneous immunoglobulin and their use in dosing of replacement therapy in pati- ents with primary immunodeficiencies. Clin Immunol 2011;139:133.
https://doi.org/10.1016/j.clim.2011.01.006
Huang F, Feuille E, Cunningham-Rundles C. Home care use of intravenous and subcutaneous immunoglo- bulin for primary immunodeficiency in the United States. J Clin Immunol 2013;33:49.
https://doi.org/10.1007/s10875-012-9776-y
Kobrynski l. Subcutaneous immunoglobulin therapy: a new option for patients with primary immunodefici- ency diseases. Biologics 2012;6:277-87.
https://doi.org/10.2147/BTT.S25188
Jolles S, Orange JS, Gardulf A, et al. Current treat- ment options with immunoglobulin G for the individu- alization of care in patients with primary immunodefi- ciency disease. Clin Exp Immunol 2015;179:146.
https://doi.org/10.1111/cei.12485
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.
https://doi.org/10.1016/j.jaci.2008.04.044
Gardulf A, nicolay U, Asensio O, et al. Rapid subcu- taneous 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.
https://doi.org/10.1007/s10875-006-9002-x
Markvardsen lH, Christiansen I, Andersen H, Jakobsen J. Headache and nausea after treatment with high-dose subcutaneous versus intravenous immuno- globulin. Basic Clin Pharmacol Toxicol 2015;117:409- 12.
https://doi.org/10.1111/bcpt.12428
Epstein JS, Zoon KC. Dear doctor letter - important drug warning: immune globulin intravenous (human). FDA Med Watch. US Food and Drug Administration; 1998.
Pierce lR, Jain n. Risks associated with the use of intravenous immunoglobulin. Transfusion Med Rev 2003;17:241-51.
https://doi.org/10.1016/S0887-7963(03)00038-5
Fasth A, nystrom J. Safety and efficacy of subcutane- ous human immunoglobulin in children with primary immunodeficiency. Acta Paediatrica 2007;96:1474-8.
https://doi.org/10.1111/j.1651-2227.2007.00485.x
Sundin U, nava S, Hammarstrom l. Induction of unresponsiveness against IgA in IgA- deficient patients on subcutaneous immunoglobulin infusion therapy. Clin Exp Immunol 1998;112:341-6.
https://doi.org/10.1046/j.1365-2249.1998.00571.x
Karakoç Aydıner E, Kıykım A, Barıs S, Özen A, Barlan I. Use of subcutaneous immunoglobulin in primary immune deficiencies. Turk Pediatri Ars 2016;51:8-14.
https://doi.org/10.5152/TurkPediatriArs.2016.3058
Abolhassani H, Sadaghiani MS, Aghamohammadi A, Ochs HD, Rezaei n. Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody defi- ciencies: systematic review and meta-analysis. J Clin Immunol 2012;32:1180-92.
https://doi.org/10.1007/s10875-012-9720-1
Bonilla FA, Duff C. Subcutaneous Immunoglobulin Replacement. Immune Deficiency Foundation: Clinical Focus 2015;16:1-16.