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静脉注射用人免疫球蛋白 10%(潘赞珠®)治疗原发性免疫缺陷病的疗效和安全性:一项两阶段、多中心、前瞻性、开放标签研究。

Efficacy and Safety of Human Intravenous Immunoglobulin 10% (Panzyga®) in Patients with Primary Immunodeficiency Diseases: a Two-Stage, Multicenter, Prospective, Open-Label Study.

机构信息

Klinik für Kinder- und Jugendmedizin, Klinikum St. Georg gGmbH, Leipzig, Germany.

Immunodeficiency Centre Leipzig (IDCL), Hospital St. Georg gGmbH Leipzig, Delitzscher Strasse 141, 04129, Leipzig, Germany.

出版信息

J Clin Immunol. 2017 Aug;37(6):603-612. doi: 10.1007/s10875-017-0424-4. Epub 2017 Jul 29.

Abstract

PURPOSE

To assess the efficacy and safety of panzyga® (intravenous immunoglobulin 10%) in preventing serious bacterial infections (SBIs) in patients with primary immunodeficiency diseases (PIDs), a prospective, open-label, multicenter, phase 3 study and an open-label extension study were undertaken.

METHODS

Initially, the study drug (infusion rate ≤0.08 mL/kg/min) was administered at intervals of 3 or 4 weeks for 12 months, followed by 3 months of panzyga® at infusion rates increasing from 0.08 to 0.14 mL/kg/min. The primary endpoint in the main study was the rate of SBIs per patient-year on treatment. Secondary outcomes included non-serious infections, work/school absence, episodes of fever, quality of life, and adverse events (AEs).

RESULTS

The main study enrolled 51 patients (35% female, mean age 26.8 years), with 21 participating in the extension study. The rate of SBIs per patient-year was 0.08 in the total population; there were four SBIs in the 4-weekly treatment group (2/30 patients) and none in the 3-weekly group (n = 21). Compared with 4-weekly treatment, 3-weekly treatment was associated with a higher rate of upper respiratory tract infections (RTIs), ear infections, and work/school absences, but a lower rate of lower RTIs and fever. Treatment was generally well tolerated; no AE led to treatment withdrawal or death.

CONCLUSIONS

Overall, the use of panzyga® in patients with antibody-deficient PID was associated with a low rate of AEs and was effective in preventing SBIs, exceeding US FDA and European Medicines Agency recommendations for efficacy.

摘要

目的

评估泛泽佳®(静脉注射用人免疫球蛋白 10%)预防原发性免疫缺陷病(PID)患者严重细菌感染(SBI)的疗效和安全性,开展了一项前瞻性、开放标签、多中心、3 期研究和开放标签扩展研究。

方法

最初,研究药物(输注率≤0.08 mL/kg/min)以 3 或 4 周的间隔给药 12 个月,然后以 0.08 至 0.14 mL/kg/min 的递增输注率给予泛泽佳®3 个月。主要研究的主要终点是治疗期间每位患者每年 SBI 的发生率。次要结局包括非严重感染、缺勤/缺课、发热发作、生活质量和不良事件(AE)。

结果

主要研究纳入 51 例患者(35%为女性,平均年龄 26.8 岁),其中 21 例参加了扩展研究。总人群中每位患者每年 SBI 的发生率为 0.08;4 周治疗组有 4 例 SBI(30 例患者中的 2 例),3 周治疗组无 SBI(21 例患者)。与 4 周治疗相比,3 周治疗组上呼吸道感染(RTI)、耳部感染和缺勤/缺课的发生率较高,但下呼吸道感染和发热的发生率较低。治疗总体耐受性良好;无 AE 导致治疗中止或死亡。

结论

总体而言,泛泽佳®在抗体缺陷 PID 患者中的使用与低 AE 发生率相关,并能有效预防 SBI,超过了美国 FDA 和欧洲药品管理局对疗效的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eed/5554470/06ba3578429a/10875_2017_424_Fig1_HTML.jpg

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