Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.
Clin Immunol. 2020 Jun;215:108419. doi: 10.1016/j.clim.2020.108419. Epub 2020 Apr 11.
We conducted a retrospective multicenter cohort study of patients receiving Immunoglobulin replacement therapy (IgRT) for secondary immune deficiency (SID) during 2012.
Data were retrospectively collected from the first dose of Ig administered in 2012 to 1 year afterward in terms of the indication for IgRT, as well as efficacy and safety.
In total, 16 hospitals participated in the study, and 368 patients were included. Indications for IgRT were non-Hodgkin lymphoma (82 [22.3%] patients), multiple myeloma (76 [20.7%]), chronic lymphocytic leukemia (64 [17.4%]) and other (79 [21.5%]). Only 89 (24.2%) patients received IgRT according to 2011 European Medical Agency (EMA) recommendations; 196 (53.3%) received prophylactic antibiotics and 262 (76.2%) had an IgG level < 4 g/L before IgRT initiation.
In this study, whatever the criteria, only 24.2% of patients with SID who received IgRT met EMA recommendations, which suggests a misuse of IgRT in SID.
我们进行了一项回顾性多中心队列研究，纳入了 2012 年接受免疫球蛋白替代治疗（IgRT）的继发性免疫缺陷（SID）患者。
从 2012 年首次给予 Ig 治疗开始，收集了 1 年后的相关数据，包括 IgRT 的适应证、疗效和安全性。
共有 16 家医院参与了该研究，共纳入 368 例患者。IgRT 的适应证为非霍奇金淋巴瘤（82 [22.3%] 例）、多发性骨髓瘤（76 [20.7%]）、慢性淋巴细胞白血病（64 [17.4%]）和其他（79 [21.5%]）。仅有 89 例（24.2%）患者根据 2011 年欧洲药品管理局（EMA）的建议接受 IgRT；196 例（53.3%）接受预防性抗生素治疗，262 例（76.2%）在开始 IgRT 前 IgG 水平<4 g/L。
本研究中，无论采用何种标准，仅有 24.2%接受 IgRT 的 SID 患者符合 EMA 建议，提示 IgRT 在 SID 中的使用存在滥用。
