TABLE 8.

Eight Guiding Principles for the Use of IVIg Products in PIDD

Indication: Immunoglobulin therapy is indicated as replacement therapy for patients with primary immunodeficiency diseases characterized by absent or deficient antibody production. Diagnoses: IVIg is indicated and recommended for a large number of primary immunodeficiency diagnoses. Frequency of immunoglobulin treatment: IVIg is indicated as continuous replacement therapy for primary immunodeficiency. Dosage: IVIg is indicated for patients with primary immunodeficiency at a starting dosage of 400–600 mg/kg every 3–4 weeks (100–200 mg/kg/wk for SCIg). IgG trough levels: IgG trough levels can be useful in some diagnoses to guide care but are NOT useful in many patients and should not be a consideration in attaining access to immunoglobulin therapy. Site of care: The decision to infuse IVIg in a hospital, hospital outpatient, community office, or home-based setting must be based on clinical characteristics. Route: The route of immunoglobulin administration must be based on patient characteristics. Product: IVIg products are not interchangeable.

IVIg = intravenous immunoglobulin; SCIg = subcutaneous immunoglobulin.

Source: Orange 2011b. Reproduced with permission.