Ballow Mark, Pinciaro Paul J, Craig Timothy, Kleiner Gary, Moy James, Ochs Hans D, Sleasman John, Smits William
The Children's Hospital of Buffalo, Buffalo, NY, USA.
Division of Allergy and Immunology, Department of Pediatrics, University of South Florida, 601 4th Street South, Saint Petersburg, FL, 3370, USA.
J Clin Immunol. 2016 Aug;36(6):583-9. doi: 10.1007/s10875-016-0303-4. Epub 2016 Jun 8.
The previous studies with Flebogamma(®) 5 % DIF intravenous immunoglobulin (IVIG) contained insufficient numbers of pediatric subjects to fully warrant a pediatric indication by the FDA. The objective of this study was to evaluate the efficacy, safety, and pharmacokinetics of Flebogamma® 5 % DIF for replacement therapy in children (age 2-16) with primary immunodeficiency diseases (PIDD).
IVIG was administered at eight clinical sites to 24 subjects with well-defined PIDD at a dose of 300-800 mg/kg every 21-28 days for 12 months. The pharmacokinetics endpoint in this study was the dose-adjusted increment of the serum IgG trough levels.
The calculated serious bacterial infection rate was 0.05/subject/year. The incidence of adverse events considered potentially related to IVIG during or within 72 h after completing an infusion was within the FDA guidance threshold of <40 % at each time point. Dose-adjusted incremental IgG levels remained approximately equal to or slightly greater than pre-study IgG levels (between 800 and 1000 mg/dL throughout) when the subjects were treated with IVIG therapy other than Flebogamma(®) DIF 5 % indicating no evidence of a different pharmacokinetic profile in this pediatric population if compared to those profiles in previous Flebogamma studies in predominately adult populations.
Flebogamma(®) 5 % DIF is efficacious and safe, has adequate pharmacokinetic properties, is well-tolerated, and maintains the profile of Flebogamma(®) 5 % for the treatment of children with primary humoral immunodeficiency diseases.
先前使用Flebogamma(®) 5% DIF静脉注射免疫球蛋白(IVIG)的研究纳入的儿科受试者数量不足,无法完全获得美国食品药品监督管理局(FDA)的儿科适应症批准。本研究的目的是评估Flebogamma® 5% DIF用于替代治疗2至16岁原发性免疫缺陷病(PIDD)儿童的疗效、安全性和药代动力学。
在8个临床地点,对24名确诊为PIDD的受试者给予IVIG,剂量为300 - 800 mg/kg,每21 - 28天给药一次,持续12个月。本研究的药代动力学终点是血清IgG谷浓度的剂量调整增量。
计算得出的严重细菌感染率为0.05/受试者/年。在输注期间或输注完成后72小时内,被认为可能与IVIG相关的不良事件发生率在每个时间点均处于FDA指导阈值<40% 以内。当受试者接受除Flebogamma(®) DIF 5%以外的IVIG治疗时,剂量调整后的IgG增量水平在整个过程中(始终在800至1000 mg/dL之间)仍大致等于或略高于研究前的IgG水平,这表明与先前主要针对成人的Flebogamma研究中的药代动力学特征相比,该儿科人群中没有不同药代动力学特征的证据。
Flebogamma(®) 5% DIF有效且安全,具有足够的药代动力学特性,耐受性良好,并保持了Flebogamma(®) 5%治疗原发性体液免疫缺陷病儿童的特征。