Immunoglobulin G Trough Levels and Infection Risk in Adults with Inborn Errors of Immunity Receiving Immunoglobulin...

Area of Science:

• Immunology
• Clinical Medicine
• Pharmacology

Background:

• Inborn errors of immunity (IEI) diagnosis is rising globally, particularly in developing nations.
• Immunoglobulin replacement therapy (IGRT) is essential for managing IEI.
• Monitoring IGRT is vital for improving patient outcomes.

Purpose of the Study:

• To investigate the association between serum IgG trough levels and infection rates in adults with IEI undergoing IGRT.
• To identify factors influencing infection risk in this patient population.

Main Methods:

• Retrospective analysis of 31 adult patients with primary immunodeficiency (29 CVID, 2 XLA) receiving IGRT for ≥6 months.
• Measurement of serum IgG trough levels and systematic recording of antibiotic-requiring infections.
• Statistical analysis, including Mann-Whitney U, t-test, and multivariate regression.

Main Results:

• The average follow-up was 13 months, with a mean IgG trough level of 815.8 mg/dL and an average IGRT dose of 498.8 mg/kg/month.
• 74.2% of patients experienced at least one infection requiring antibiotics.
• Lower mean IgG trough levels (<850 mg/dL) were significantly linked to higher rates of antibiotic-requiring infections (p=0.032).
• Multivariate analysis confirmed lower IgG trough levels as an independent predictor of increased infection rates (p=0.033).

Conclusions:

• IGRT is effective in decreasing antibiotic-requiring infections in primary immunodeficiency patients.
• Regular IgG trough level monitoring and individualized IGRT dose adjustments are recommended for optimizing treatment.
• Further prospective research is warranted to validate these findings.