Overview of subcutaneous immunoglobulin 16.5% in primary and secondary immunodeficiency diseases

Authors: Kobayashi, RH; Litzman, J; Rizvi, S; Kreuwel, H; Hoeller, S; Gupta, S

Affiliations: Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90032 USA; Masaryk Univ, St Annes Univ Brno, Fac Med, Dept Clin Immunol & Allergol, Brno, Czech Republic; Octapharma AG, Paramus, NJ USA; Octapharma Pharm ProduduktionsgesmbH, Vienna, Austria; Univ Calif Irvine, Div Basic & Clin Immunol, Irvine, CA USA.

Publication: Immunotherapy ; 2021

Abstract: Primary immunodeficiency diseases, and select secondary immunodeficiency diseases, weaken the immune system, allowing infections and other health problems to occur more easily. Some patients require treatments to boost their immune system, such as immunoglobulin (IG) therapy, which can be either injected via a needle into a vein (intravenously) or inserted underneath the skin (subcutaneously; SCIG). The first instance of IG treatment for primary immunodeficiency disease was a 16.5% SCIG product given in 1952. While most SCIG products are now a 10 or 20% concentration, this review will focus on SCIG 16.5% products with a historical overview of development, including the early pioneers who initiated and refined IG therapy, as well as key characteristics, manufacturing and clinical studies. In determining an appropriate IG regimen, one must consider specific patient needs, characteristics and preferences. There are advantages to SCIG, such as stable serum immunoglobulin G levels, high tolerability and the flexibility of self-administered home treatment. Most primary immunodeficiency diseases, and select secondary immunodeficiency diseases, are treated with immunoglobulin (IG) therapy, administered intravenously or subcutaneously (SCIG). The first instance of IG replacement for primary immunodeficiency disease was a 16.5% formulation administered subcutaneously in 1952. While most SCIG products are now a 10 or 20% concentration, this review will focus on SCIG 16.5% products with a historical overview of development, including the early pioneers who initiated and refined IG replacement therapy, as well as key characteristics, manufacturing and clinical studies. In determining an appropriate IG regimen, one must consider specific patient needs, characteristics and preferences. There are advantages to SCIG, such as stable serum immunoglobulin G levels, high tolerability and the flexibility of self-administered home treatment.