Wasserman Richard L, Melamed Isaac, Kobrynski Lisa, Puck Jennifer, Gupta Sudhir, Doralt Jennifer, Sharkhawy Marlies, Engl Werner, Leibl Heinz, Gelmont David, Yel Leman
Allergy Partners of North Texas Research, Dallas, TX, USA.
IMMUNOe Health Centers, Centennial, CO, USA.
Immunotherapy. 2016 Oct;8(10):1175-86. doi: 10.2217/imt-2016-0066. Epub 2016 Jul 28.
To assess the long-term efficacy, safety and tolerability of recombinant human hyaluronidase-facilitated subcutaneous infusion of immunoglobulin (Ig) (fSCIG; HYQVIA(®); IGHy) in children aged <18 years.
PATIENTS & METHODS: Patients with primary immunodeficiency diseases were included in the studies. IGHy was administered every 3 or 4 weeks.
Validated acute serious bacterial infections were reported at 0.08/patient-year (four pneumonia episodes in three patients). No serious adverse drug reaction (ADR) was reported, and rates of local and systemic ADRs were low (0.09/infusion and 0.1/infusion). Infection rates were low (3.02/patient-year) with sustained Ig trough levels (median: 1009 mg/dl). Of 674 IGHy infusions, 97.2% required no change of administration due to ADR, in most (82.5%) with one infusion site. No patient developed neutralizing anti-rHuPH20 antibodies. Postpivotal study, 100% of patients aged <14 years or their caregivers and 85.7% of patients aged 14 to <18 years expressed preference for IGHy compared with Ig administered intravenously or Ig administered subcutaneously.
These studies, with the longest (maximum: 3.3 years) duration of any reported Ig replacement trials in children with primary immunodeficiency diseases, showed low infection, local and systemic reaction rates along with well-tolerated infusions given in a single site.
评估重组人透明质酸酶促进皮下输注免疫球蛋白(Ig)(fSCIG;HYQVIA(®);IGHy)在18岁以下儿童中的长期疗效、安全性和耐受性。
原发性免疫缺陷病患者纳入研究。IGHy每3或4周给药一次。
报告的经证实的急性严重细菌感染发生率为0.08/患者年(3例患者发生4次肺炎发作)。未报告严重药物不良反应(ADR),局部和全身ADR发生率较低(分别为0.09/输注和0.1/输注)。感染率较低(3.02/患者年),Ig谷浓度持续稳定(中位数:1009mg/dl)。在674次IGHy输注中,97.2%未因ADR而改变给药方式,大多数(82.5%)为单一输注部位。无患者产生抗重组人PH20中和抗体。关键试验后,100%的14岁以下患者或其护理人员以及85.7%的年龄在14至18岁之间患者表示,相较于静脉注射Ig或皮下注射Ig,他们更倾向于使用IGHy。
这些研究是原发性免疫缺陷病儿童Ig替代试验中报道的持续时间最长(最长达3.3年)的研究,显示感染、局部和全身反应率较低,且单部位输注耐受性良好。