Primary Immune Deficiency (PID)
Posters
The HILO Study: High Volumes and Flow Rates of Subcutaneous IgPro20 Pump-assisted Infusions in Patients With Primary Immunodeficiency
Please see full prescribing information for Hizentra®, Immune Globulin Subcutaneous (Human), 20% Liquid
Safety Profile of High IgPro20 Infusion Parameters in Patients With Primary Immunodeficiency (PID): Results From the Forced Upward Titration HILO Study
Please see full prescribing information for Hizentra®, Immune Globulin Subcutaneous (Human), 20% Liquid
Feasibility of Subcutaneous IgPro20 Administration Via Manual Push at High Flow Ratesin Patients With Primary Immunodeficiency: Findings of the HILO Study
Please see full prescribing information for Hizentra®, Immune Globulin Subcutaneous (Human), 20% Liquid
Immunoglobulin Replacement Therapy in Patients with Immunodeficiencies - Impact of Administration Method on Patient-Reported Outcomes
High treatment satisfaction with Hizentra, a 20% subcutaneous immunoglobulin (SCIG): Real-world survey data
Real-world experience of a cohort of previously untreated PI patients on SCIG
Isoagglutinin Reduction in IVIg by Specific Immunoaffinity Chromatography Reduces Spontaneous Reporting Rates of Hemolytic Reactions
Key Publications
Efficacy and Safety of a new 20% Immunoglobulin preparation for subcutaneous administration, IgPro20, in patients with Primary Immunodeficiency
Hagan, JB et alJ Clin Immunol
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Efficacy and safety of Hizentra in patients with Primary Immunodeficiency after a dose-equivalent switch from IV or SC replacement therapy
Jolles, S et alClinical Immunology, 2011
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Efficacy and safety of IgPro20, a subcutaneous immunoglobulin, in Japanese patients with Primary Immunodeficiency Diseases
Kanegane, H et alJ Clin Immunol, 2013
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Long-Term efficacy, safety and tolerability of Hizentra for treatment of Primary Immunodeficiency Disease
Jolles, S et alClinical Immunology, 2013
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PID
Safety and Efficacy of Privigen, a Novel 10% Liquid Immunoglobulin Preparation for Intravenous Use, in patients with Primary Immunodeficiencies
Stein, MR et alJ Clin Immunol 2009
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ITP
Efficacy and safety of Privigen®, a novel liquid intravenous immunoglobulin formulation in adolescent and adult patients with chronic immune thrombocytopenic purapura
Robak, T et alHematology 2009
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References:
1. Bonilla FA, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol. 2005;94:S1-S63. 2. Immune Deficiency Foundation www.immunedeficiencyfoundation.org/about. Accessed March 13, 2021. 3. Boyle JM, et al. Population Prevalence of Diagnosed Primary Immunodeficiency Diseases in the United States. J Clin Immunol. 2007;27:497-502. 4. Modell V. The impact of physician education and public awareness on early diagnosis of primary immunodeficiencies.. Immunol Res. 2007;38:43–47. 5. Immune Deficiency Foundation. Primary Immunodeficiency Diseases in America: 2007. The third national survey of patients. Published May 1, 2009 6. Cunningham-Rundles C, et al. J Allergy Clin Immunol. 2004;113(4):747-55. 7. Bousfiha A, et al. J Clin Immunol. 2020;40:66-81. 8. McCusker C et al. Primary Immunodeficiency. Allergy, Asthma Clin Immunol. 2011;7(Suppl 1):S11. 9. Kobrynski L. Subcutaneous immunoglobulin therapy: a new option for patients with primary immunodeficiency diseases.. Biologics. 2012;6:277–287. 10. Agarwal S et al. Ann Allergy Asthma Immunol. 2019;123(5):454-460. 11. Shapiro RS. Am J Hematol. 2011;86:49–55. 12. Warning Signs of Primary Immunodeficiency for Adults. Info4PI.org presented by the Jeffrey Modell Foundation. http://www.worldpiweek.org/sites/default/files/article_docs/10 Warning Signs of PI in adults.pdf. Accessed March 16 2021 13. Perez EE, et al. J Allergy Clin Immunol. 2017;139(3s):S1-S46. 14 .Bonilla FA, et al. J Allergy Clin Immunol. 2015;136(5):1186-205.e1-78.
Important Safety Information for Hizentra
WARNING: Thrombosis may occur with immune globulin products, including Hizentra. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity, and cardiovascular risk factors.
For patients at risk of thrombosis, administer Hizentra at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.
Hizentra is contraindicated in patients with a history of anaphylactic or severe systemic reaction to human immune globulin (Ig) or components of Hizentra (eg, polysorbate 80), as well as in patients with immunoglobulin A deficiency with antibodies against IgA and a history of hypersensitivity. Because Hizentra contains L-proline as stabilizer, use in patients with hyperprolinemia is contraindicated.
IgA-deficient patients with anti-IgA antibodies are at greater risk of severe hypersensitivity and anaphylactic reactions. Thrombosis may occur following treatment with Ig products, including Hizentra.
Monitor patients for aseptic meningitis syndrome (AMS), which may occur following treatment with Ig products, including Hizentra. In patients at risk of acute renal failure, monitor renal function, including blood urea nitrogen, serum creatinine and urine output. In addition, monitor patients for clinical signs of hemolysis or pulmonary adverse reactions (eg, transfusion-related acute lung injury [TRALI]).
Hizentra is derived from human blood. The risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent and its variant (vCJD), cannot be completely eliminated.
The most common adverse reactions (observed in ≥5% of study subjects) were local infusion-site reactions, as well as headache, diarrhea, fatigue, back pain, nausea, extremity pain, cough, upper respiratory tract infection, rash, pruritus, vomiting, upper abdominal pain, migraine, arthralgia, pain, fall, and nasopharyngitis.
The passive transfer of antibodies can interfere with response to live virus vaccines and lead to misinterpretation of serologic test results.
Indications for Hizentra
Hizentra®, Immune Globulin Subcutaneous (Human), 20% Liquid, is indicated for:
- Treatment of primary immunodeficiency (PI) in adults and pediatric patients 2 years and older.
- Maintenance therapy in adults with chronic inflammatory demyelinating polyneuropathy (CIDP) to prevent relapse of neuromuscular disability and impairment.
- Limitation of Use: Maintenance therapy in CIDP has been systematically studied for 6 months and for a further 12 months in a follow-up study. Continued maintenance beyond these periods should be individualized based on patient response and need for continued therapy.
For subcutaneous infusion only.
Please see full prescribing information for Hizentra including boxed warning.
To report SUSPECTED ADVERSE REACTIONS, contact the CSL Behring Pharmacovigilance Department at 1-866-915-6958 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Important Safety Information for Privigen
WARNING: THROMBOSIS, RENAL DYSFUNCTION AND ACUTE RENAL FAILURE
- Thrombosis may occur with immune globulin products, including Privigen. Risk factors may include advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity, and cardiovascular risk factors.
- Renal dysfunction, acute renal failure, osmotic nephrosis, and death may occur with immune globulin intravenous (IGIV) products in predisposed patients. Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products that contain sucrose. Privigen does not contain sucrose.
- For patients at risk of thrombosis, renal dysfunction or renal failure, administer Privigen at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.
See full prescribing information for complete boxed warning.
Privigen is contraindicated in patients with history of anaphylactic or severe systemic reaction to human immune globulin, in patients with hyperprolinemia, and in IgA-deficient patients with antibodies to IgA and a history of hypersensitivity.
In patients at risk of developing acute renal failure, monitor urine output and renal function, including blood urea nitrogen and serum creatinine.
Hyperproteinemia, increased serum viscosity, or hyponatremia can occur with Privigen. Infrequently, aseptic meningitis syndrome (AMS) may occur—especially with high doses or rapid infusion.
Hemolysis, either intravascular or due to enhanced red blood cell sequestration, may occur. Risk factors include non-O blood group and high doses. Closely monitor patients for hemolysis and hemolytic anemia.
During and shortly following Privigen infusion, elevations of systolic and diastolic blood pressure (including cases of hypertensive urgency) have been observed. These elevations resolved or significantly improved within hours with oral anti-hypertensive therapy or observation alone. Check patients for a history of hypertension and monitor blood pressure during this period.
Consider relative risks and benefits before prescribing high-dose regimen for chronic ITP and CIDP in patients at increased risk of thrombosis, hemolysis, acute kidney injury or volume overload. Monitor patients for pulmonary adverse reactions (transfusion-related acute lung injury [TRALI]).
Privigen is derived from human plasma. The risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent and its variant (vCJD), cannot be completely eliminated.
In clinical studies of patients with PI, the most common adverse reactions to Privigen, observed in >5% of subjects, were headache, fatigue, nausea, chills, vomiting, back pain, pain, elevated body temperature, abdominal pain, diarrhea, cough, stomach discomfort, chest pain, joint swelling/effusion, influenza-like illness, pharyngolaryngeal pain, urticaria, and dizziness. Serious adverse reactions were hypersensitivity, chills, fatigue, dizziness, and increased body temperature.
In clinical studies of patients being treated for chronic ITP, the most common adverse reactions, seen in >5% of subjects, were laboratory findings consistent with hemolysis, headache, elevated body temperature, anemia, nausea, and vomiting. A serious adverse reaction was aseptic meningitis syndrome.
In clinical studies of patients being treated for CIDP, the most common adverse reactions, observed in >5% of subjects, were headache, asthenia, hypertension, nausea, pain in extremity, hemolysis, influenza-like illness, leukopenia, and rash. Serious adverse reactions were hemolysis, exacerbation of CIDP, acute rash, increased diastolic blood pressure, hypersensitivity, pulmonary embolism, respiratory failure, and migraine.
Treatment with Privigen might interfere with a patient's response to live virus vaccines and could lead to misinterpretation of serologic testing. In patients over 65, do not exceed recommended dose and infuse at the minimum rate practicable.
Indications for Privigen
Privigen is indicated for the treatment of:
- Primary humoral immunodeficiency (PI)
- Chronic immune thrombocytopenic purpura (ITP) in patients age 15 years and older
- Chronic inflammatory demyelinating polyneuropathy (CIDP) in adults
- Limitation of use: maintenance therapy in CIDP has not been studied for periods longer than 6 months. Individualize duration of treatment beyond 6 months based on patient response.
Please see full prescribing information for Privigen.
To report SUSPECTED ADVERSE REACTIONS, contact the CSL Behring Pharmacovigilance Department at 1-866-915-6958 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
