Treatment FAQ

a. what form of treatment is ivig therapy?

by Quinten Klocko Published 3 years ago Updated 2 years ago
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What is an IVIG infusion? IVIG is a therapy used to treat antibody deficiencies related to a variety of inflammatory and immune-mediated diseases. It's made from antibodies called immunoglobulins, which your immune system typically makes to help fight off infections.May 5, 2022

What are the side effects of IVIG therapy?

The long-term side effects of IVIG infusion include:

  • Thrombotic events: Increased risk of clot formation may occur depending on preexisting conditions and a fast infusion rate. ...
  • Neurological disorders: Neurological side effects include meningitis, seizures, and nerve damage.
  • Renal impairment: May be due to the failure of the kidneys to clear out IVIG proteins.

What conditions does IVIG treat?

The symptoms of this include:

  • a chill or a fever
  • headache
  • stomach pain
  • feeling sick or vomiting
  • joint pain
  • low back pain
  • tiredness.

Are there side effects related to IVIG therapy?

There may be side effects associated with IVIG therapy, which is used to treat CVID. Flu like symptoms such as chills, fever, headaches, and muscle aches may be present. If a reaction is anticipated, it can be treated with acetaminophen, antihistamines or hydrocortisone. Side effects may be diminished by slowing the injection.

What is IVIG therapy used to treat?

  • Prevent infection by binding to pathogens
  • Help in removal of dying cells and altered cells such as tumors
  • Induce growth of myelin, which is a sheath around nerves that enables normal transmission of nerve signals
  • Inhibit growth of autoreactive B cells, which attack native tissue

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What type of therapy is IVIG?

Intravenous immune globulin ("IVIG") is a product made up of antibodies that can be given intravenously (through a vein). Antibodies are proteins that your body makes to help you fight infections.

Is IVIG considered chemotherapy?

In conclusion, IVIg is a potential anticancer treatment for several reasons: (a) the bidirectional relationship between cancer and autoimmunity; (b) the apparent association between cancer regression and IVIg administration; (c) a variety of anticancer effects of IVIg observed; and (d) IVIg is considered to be a safe ...

Is IVIG a monoclonal antibody treatment?

Immunoglobulin-based therapies, such as monoclonal antibodies and intravenous immunoglobulin (IVIg), have emerged as a major force in providing safe and effective long-term therapy for patients who do not respond to conventional anti-inflammatory drugs (Box 1 and Figure 1).

What is IVIG used to treat?

IVIG is used to treat various autoimmune, infectious, and idiopathic diseases. IVIG is an approved treatment for multifocal motor neuropathy, chronic lymphocytic lymphoma, chronic inflammatory demyelinating polyneuropathy, Kawasaki disease and ITP.

Is IVIg immunosuppressive therapy?

Does IVIG cause immunosuppression? Although the data classifying IVIG therapies as immunosuppressing agents is not conclusive, studies do show IVIG treatments have been found to help reduce symptoms of autoimmune diseases that exhibit excessive inflammation of the body.

Is chemotherapy and infusion therapy the same?

Infusion therapy takes place when medication is administered through a needle or catheter. This is most commonly used when a patient's disease is severe and oral medication is not an effective treatment option. Chemotherapy is a common infusion therapy used to treat cancers.

Is IVIg a biologic?

IVIG/SCIG is an established and trusted biologic for the treatment of various autoimmune diseases. Its manufacture is highly technical, dependent on supply of human plasma and subject to some natural variability due to the nature of the starting material; high doses (1–2 g/kg body weight) are required.

Is immunoglobulin A monoclonal antibody?

Monoclonal antibodies (mAb or moAb) are identical immunoglobulins, generated from a single B-cell clone. These antibodies recognize unique epitopes, or binding sites, on a single antigen.

Is monoclonal antibody the same as immunoglobulin?

When activated by an antigen, a circulating B cell multiplies to form a clone of plasma cells, each secreting identical immunoglobulin molecules. It is such immunoglobulins—derived from the descendants of a single B cell—that are called monoclonal antibodies.

What diseases are treated with infusion therapy?

Some examples of illnesses that may need to be treated with Infusion Therapy are among others:Serious Infections.Cancer.Dehydration.Gastrointestinal diseases / disorders.Congestive heart failure.Crohn's disease.Hemophilia.Immune deficiencies.More items...•

How does IVIg work in autoimmune disease?

Context Intravenous immunoglobulin (IVIG) enhances immune homeostasis by modulating expression and function of Fc receptors, interfering with activation of complement and production of cytokines, providing anti-idiotypic antibodies, and affecting the activation and effector functions of T and B cells.

How do you administer IVIg infusion?

Administer directly via the bottle provided by blood bank. Do not remove IVIg from the bottle and attempt to administer via a syringe driver. IVIg does not contain any antimicrobial preservative, therefore each bottle of IVIg must be administered within 6 hours from spiking the bottle.

What is IVIG used for?

IVIg is used to reduce the effects of some inflammatory conditions that involve the immune system , also known as autoimmune diseases. It’s also used to increase levels of immunoglobulins if these are low, or have been lowered by treatment with other drugs, such as rituximab. It can be used in the treatment of several different conditions, including:

How is IVIG given?

IVIg is given through a drip into a vein, this is known as intravenous infusion. It is sometimes given as an injection into a muscle if you’re only taking it to increase your immunoglobulin levels following other treatments.

How long does it take for IVIG to work?

IVIg should start to work within a few weeks, but this will vary depending on which condition you have and how you respond to the treatment. If IVIg works for you, the effects should last for a few months.

Why do you have to use the same IVIG every time?

You’ll usually be given the same brand of IVIg, such as Flebogamma or Octagam, every time you have it to reduce the likelihood of a reaction.

What is the purpose of immunoglobulins?

Immunoglobulins are the antibodies produced naturally by the body’s immune system, which help fight infection and disease. Intravenous immunoglobulin, or IVIg, is a treatment that combines immunoglobulins donated by different people and is given by a drip to treat various conditions.

What are the side effects of IVIG?

The symptoms of this include: a chill or a fever. headache. stomach pain. feeling sick or vomiting. joint pain. low back pain.

What are the symptoms of IVIG?

If you experience any of the following symptoms, you should seek urgent medical attention: chest tightness. breathing difficulties. a rash.

What is IVIg?

Intravenous immune globulin (IVIg) is a mixture of antibodies that is used to treat a variety of immune system disorders. It is made by gathering blood from thousands of donors to create a concentrated collection of antibodies.

Uses of IVIg

IVIG is given into a vein (intravenously), usually in a doctor’s office or hospital. It may also be given at home under specific arrangements and medical guidance.

IVIg Side Effects

This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects.

IVIg Drug Interactions

Drug interactions can be dangerous and, in rare cases, even life-threatening. Let your doctor know about all drugs and supplements you are using or considering to reduce the risk of drug interactions.

IVIg Dosage

IVIg dosage is personalized for each person and disease. The dose, infusion rate, dosage schedule, and duration of treatment can all vary depending on the condition. Researchers are still trying to find the optimal dose for each disease.

What is IVIG in medicine?

Intravenous immunoglobulin (IVIG) is a concentrate of the pooled immunoglobulins derived from 1000 to 100000 healthy donors depending upon the manufacturer . Immunoglobulins play a pivotal role in humoral adaptive immunity; ergo, IVIG reflects a collective exposure of the donor population to their environment and can be expected to contain an antibody repertoire of multiple specificities against a broad spectrum of infectious agents (bacterial, viral, and others), self-antigens and anti-idiotype antibodies.

What is IVIG in healthcare?

Intravenous immunoglobulin (IVIG) is a pooled antibody, and a biological agent used to manage various immunodeficiency states and a plethora of other conditions, ...

What is IVIG in plasma?

The composition of IVIG products closely corresponds to that of immunoglobulins in the normal human plasma, especially IgG (along with its subclasses), IgA, traces of other Igs, cytokines, and soluble receptors. IVIG products are prepared using the Cohn-Oncley procedure, the first step of which is cold ethanol precipitation used to enrich the IgG from the plasma of donors. Any two IVIG product varies with respect to the presence of excipients such as substances used to stabilize proteins and prevent aggregation of IgG (sugars such as glucose, maltose, D-sorbitol or more recently amino acids such as glycine or proline), sodium levels, pH levels, osmolality and other immunoglobulins (for example, IgA can vary from 0.06 mg to 40 mg in different preparations). [6]

Why is IgG important?

IgG levels in blood serve as an essential yardstick to guide IVIG therapy. It is also used to assess the effectiveness of the treatment and helps to modify the IVIG course and frequency. Measuring IgG levels at different times to evaluate the peak plasma levels and trough levels can assess response to therapy.

How does IVIG work?

In humoral immunodeficiencies, IVIG primarily acts by substituting for the lack of IgG and confers passive immunity by neutralizing bacterial toxins and viruses through the Fab portion. They also help activate the complement cascade at low doses by specific interaction with pathogens , a function that reverses in high doses to complement inactivation by non-specific interactions. [23] Polyvalent IVIG products with a higher number of donors would contain a much larger spectrum of specificities and would be more efficient in immune replacement therapies. [24] The effects of replacement dose IVIG in PIs are observable well beyond the half-life of IgG administered, suggesting the induction of active immunity. [25] This is exemplified by the activation of cellular immunity; for example, IVIG modulates T cell immunity in PIs and increases CD4 counts in CVID, induces B cell immunoglobulin production in CVID patients, and induces dendritic cell (DC) maturation. [26] [27] [28]

How is IVIG administered?

The most common means of administration is as a single intramuscular dose after the suspected exposure to a particular pathogen, and the earlier it is administered after exposure, the better the outcome. In addition to the intramuscular route, some of these immune sera are given as IVIG therapy. They may also be administered in a multi-dose regimen; for example, 750 mg/kg of respiratory syncytial virus (RSV) IVIG is given every month to infants in RSV season. The dosage can also increase in cases of immunocompromised and immunosuppressed patients. [18]

How much IVIG should I take?

High-dose immunomodulatory and anti-inflammatory therapy: For immunomodulation, higher doses of IVIG are necessary, ranging from 1000 to 3000 mg/kg of body weight to achieve peak plasma concentrations of 2500 to 3500 mg/dL. The optimal dosage, duration, and frequency are usually determined based on the indication, response to treatment, adverse effects, relapse rate, infectious episodes, patient preferences, and affordability. In general, a high-dose IVIG protocol, usually but not always, involves an initial dose, maintenance dose, tapering/intensifying dose, and discontinuation. [63] In general, a protocol of 2 mg/kg/course divides into 400 mg/day for five days and is a universally employed administration strategy for autoimmune diseases. [64] It is modifiable in certain conditions; for instance, in the case of ITP, a dose of 1000 mg/kg is given for 1 to 2 days. [65] Weekly regimens may also be employed depending on the clinical situation and the particular patient. [63]

What is IVIG in a patient?

IVIG contains natural IgG antibodies which are germline encoded and occur in the absence of infection or vaccination and the importance of these has been demonstrated in a study into the in vitrodifferentiation of dendritic cells (DCs) from patients with X-linked agammaglobulinaemia who lack B cells and antibodies. Differentiation of DCs was shown to be impaired, and the defect was reversed by natural antibodies reactive with CD40 [15]. Anti-idiotypes present in IVIG may also be responsible for the success of IVIG treatment of ITP; IVIG prepared from multiparous women contains many more anti-idiotypes to human HLA antigens, and can inhibit alloimmunization to HLA [16]. IVIG may also contain antibodies to a range of immunologically important molecules such as interleukin (IL)-1α, tumour necrosis factor (TNF)-α and interferon (IFN)-γ[17–19] as these have been demonstrated in the sera of healthy individuals. IVIG contains antibodies against the beta chain of the T cell receptor and also against CD5 and CD4 [20–22]

What is IVIG blood?

Intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of between 1000 and 15 000 donors per batch. It is the treatment of choice for patients with antibody deficiencies.

What is MG in medical terms?

Myasthenia gravis (MG), an archetypal autoimmune neurological disorder is characterized by fluctuating, fatiguable muscle weakness caused by antibodies to the acetylcholine receptor. The only RCT [55] to date showed that IVIG was as effective as plasma exchange for myasthenic exacerbations.

When was immunoglobulin replaced?

At the inception of immunoglobulin replacement for primary antibody deficiency (PAD) in the 1950s no studies comparing intramuscular immunoglobulin (IMIG) with either placebo or a no treatment arm were contemplated or undertaken because immunoglobulin replacement made intuitive good sense in patients with endogenous B cell failure. Indeed, when the UK Medical Research Council trial of the efficacy of immunoglobulin replacement therapy in hypogammaglobulinaemia was set up in 1955 it was felt that a placebo arm would be unethical because of strong presumptive evidence from the United States that Ig replacement was effective in decreasing the frequency of infections in hypogammaglobulinaemia.

Does IVIG reduce adhesion?

IVIG has also been shown to reduce adhesion of T cells to extracel lular matrix following activation by phytohaemagglutinin (PHA) or phorbol myristate acetate (PMA) [13] and contains antibodies to the Arg-Gly-Asp (RGD) motif, the attachment site for a number of adhesive extracellular matrix proteins and β1, β3 and β5 integrins [14].

Does IVIG inhibit apoptosis?

In addition in atopic dermatitis T cell-mediated, Fas-induced keratinocyte apoptosis is inhibitied by IVIG [10]. Additional studies show that IVIG causes the arrest of cells at the G0/G1 phase of the cell cycle, and inhibits cells from entering S-phase [11]. In contrast to these studies IVIG has been demonstrated to induce apoptosis in leukaemic lymphocytes and monocytes as well as normal tonsillar B cells, an effect mediated at least in part by anti-CD95 antibodies present within the IVIG preparations [12]. Taken together, these studies show that although IVIG appears to be broadly anti-apoptotic and cause cell cycle arrest, under certain conditions it may also induce apoptosis.

Does IVIG contain cytokines?

IVIG itself may contain cytokines and other molecules including soluble cytokine inhibitors, soluble CD4 and major histocompatibility complex (MHC) class II [38]. Stabilizing agents, mainly various sugars, can also exert an effect, both maltose and sucrose, at concentrations present in commercial IVIG preparations, can inhibit PHA- and to a lesser extent, PMA-induced proliferative responses in vitro[39] (reviewed in [2]).

What is IVIG therapy?

Intravenous immunoglobin therapy (IVIg) is FDA approved for immune-mediated peripheral nerve disorders including Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. While not yet FDA approved, immunoglobulin therapy can be beneficial for patients with disabling autoimmune forms of dysautonomia, including small fiber polyneuropathy. IVIG showed improvement in approximately 80% of people with small fiber polyneuropathy. Caution is warranted, however, as patients with autonomic dysfunction develop aseptic meningitis or severe lingering headache when used in traditional fashion (1-2 g/kg given over 2-5 days).

Is immunoglobulin therapy safe for dysautonomia?

While not yet FDA approved, immunoglobulin therapy can be beneficial for patients with disa bling autoimmune forms of dysautonomia, including small fiber polyneuropathy. IVIG showed improvement in approximately 80% of people with small fiber polyneuropathy.

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