Immunoglobulin replacement therapy: a twenty-year review and current update

Area of Science:

• Immunology
• Pharmacology
• Therapeutics

Background:

• Immunoglobulin replacement therapy has expanded to numerous disease entities over the past decade.
• The diversity of immunoglobulin products has increased in terms of their characteristics and composition.
• A comprehensive understanding of these product variations is crucial for effective clinical application.

Purpose of the Study:

• To conduct a 20-year literature review of commercially available immunoglobulin products.
• To comparatively analyze individual product properties, including purification, stabilizers, composition, and viral inactivation.
• To inform clinical decision-making regarding immunoglobulin product selection.

Main Methods:

• A comprehensive literature review spanning two decades.
• Searches conducted using PubMed and Ovid databases.
• Selection of randomized clinical and therapeutic trials for analysis.

Main Results:

• Significant variations exist among immunoglobulin products regarding purification, stabilizers, composition, and viral inactivation.
• These differing characteristics correlate with variable clinical safety and efficacy.
• Subcutaneous immunoglobulin therapy may offer comparable efficacy to intravenous immunoglobulin (IVIG) with fewer adverse events in certain patient groups.

Conclusions:

• Few comprehensive synopses exist detailing differences between IVIG products, despite widespread use.
• This review highlights key differences in immunoglobulin product development and application.
• Informed clinical decisions, considering patient risk factors and comorbidities, are essential for maximizing therapeutic efficacy and minimizing adverse events.