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儿童原发性免疫缺陷病患者皮下与静脉免疫球蛋白替代治疗的对比研究:阿根廷多中心研究。

Comparative study of subcutaneous versus intravenous IgG replacement therapy in pediatric patients with primary immunodeficiency diseases: a multicenter study in Argentina.

机构信息

Inmunología, Hospital de Niños "Dr. Ricardo Gutiérrez", Pedro Goyena, 3944, Olivos, Provincia de Buenos Aires, 1636, Argentina,

出版信息

J Clin Immunol. 2013 Oct;33(7):1216-22. doi: 10.1007/s10875-013-9916-z. Epub 2013 Jul 12.

Abstract

PURPOSE

Several studies have shown that subcutaneous immunoglobulin (SCIG) infusions demonstrate similar efficacy to intravenous Ig (IVIG) in preventing infections in patients with primary immunodeficiency diseases (PID), and are safe and well tolerated in this population. This open, prospective/retrospective, multicenter study was designed to compare the effectiveness, safety and tolerability of a 16 % liquid human IgG preparation (Beriglobina P), administered SC, with previous IVIG treatment in PID pediatric patients in Argentina.

METHODS

Fifteen subjects were enrolled in the study, and a total of 13 subjects (aged 6-18 years) completed the 36-week SCIG treatment period. All children had previously received IVIG treatment. The dose of SCIG equaled the previous IVIG dose and subjects received an average weekly dose of 139 mg/kg (range 105-181) during the SCIG period.

RESULTS

Significantly higher serum IgG trough levels were recorded on SCIG treatment at 16, 24, and 36 weeks, when compared with previous IgG trough levels on steady-state IVIG treatment. The annualized infection rate was 1.4 infections/subject/year during the IVIG administration period compared with 0.4 infections/subject/year during the SCIG period. All subjects who completed the study chose to continue administering SCIG at home after the study had ended.

CONCLUSIONS

These data confirm that self-administered SCIG therapy is a well-tolerated and effective alternative to IVIG therapy for children with PID.

摘要

目的

多项研究表明,皮下免疫球蛋白(SCIG)输注在预防原发性免疫缺陷病(PID)患者感染方面与静脉注射免疫球蛋白(IVIG)疗效相当,并且在该人群中安全且耐受良好。本开放、前瞻性/回顾性、多中心研究旨在比较在阿根廷的 PID 儿科患者中,SC 给予 16%液体人 IgG 制剂(Beriglobina P)与之前 IVIG 治疗的有效性、安全性和耐受性。

方法

本研究纳入了 15 名受试者,共有 13 名受试者(6-18 岁)完成了 36 周的 SCIG 治疗期。所有儿童之前均接受过 IVIG 治疗。SCIG 的剂量与之前的 IVIG 剂量相等,在 SCIG 期间,受试者接受平均每周 139mg/kg(范围 105-181)的剂量。

结果

与 IVIG 稳态治疗时的 IgG 谷值相比,在第 16、24 和 36 周时,SCIG 治疗时记录到显著更高的血清 IgG 谷值。在 IVIG 给药期间,年感染率为 1.4 例/受试者/年,而在 SCIG 期间为 0.4 例/受试者/年。所有完成研究的受试者在研究结束后均选择在家中继续给予 SCIG。

结论

这些数据证实,对于 PID 儿童,自我管理的 SCIG 治疗是一种耐受良好且有效的 IVIG 治疗替代方案。

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