TAILIEUCHUNG - Báo cáo y học: "Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens. | Review Article Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use Reasons and Regimens Akhilesh Chouksey MD Kimberly Duff RN BSN Nancy Wasserbauer DO Melvin Berger MD PhD Abstract For patients who require replacement therapy for primary immunodeficiency subcutaneous infusions of immunoglobulin G IgG may be preferable to intravenous infusions for several reasons. However at present there is no preparation marketed for use by this route in North America. In this article we describe the reasons patients have selected this route of therapy and the range of treatment regimens used. Approximately 20 of our patients have chosen the subcutaneous route mainly because of adverse effects from intravenous IV infusions or difficulties with venous access. Unit dose regimens using whole bottles of currently available 16 intramuscular preparations or sucrose-containing lyophilized preparations intended for IV use but reconstituted to 15 IgG for subcutaneous administration were individually tailored to each patient. In most cases self-infusions or home infusions were administered once or twice a week most commonly requiring two subcutaneous sites and 2 to 3 hours per infusion. On average patients took mL of IgG per kilogram of body weight per site per hour. There were no systemic adverse effects. In patients for whom comparative data were available trough serum IgG levels were higher with subcutaneous therapy than with IV therapy. Because immunoglobulin G IgG is distributed equally between the intravascular and extravascular compartments 1 it seems logical to expect that IgG injected into tissue spaces will equilibrate into the vascular compartment and be redistributed throughout the body just as well as would IgG Correspondence to Dr. Melvin Berger AllergyImmunology Division Department of Pediatrics Case Western Reserve University School of Medicine Rainbow Babies and Childrens .

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