What does IVIG do to the body?
IVIg gives you antibodies that your body can't make on its own so you can fight infections. In autoimmune diseases like lupus, the treatment may help your body raise low red-blood-cell counts. IVIg helps stop the white blood cells of people with lupus from destroying their red blood cells.
What is IVIG and what does IVIG treat?
intravenous immune globulin (IVIG). You will receive your doses of IVIG in the hospital. It may take many hours to receive a single dose. What is IVIG used for? IVIG is used to treat a wide variety of conditions. Some of these are: • Immune deficiency (when someone does not produce enough immune globulin) • Idiopathic thrombocytic purpura
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
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.
How do you administer IVIG?
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.
How often are IVIG infusions given?
IVIG is typically given every three-four weeks at a dose determined by the prescriber. Infusions can be given in various settings including an inpatient or outpatient infusion suite, physician office, or in the home. IVIG is administered by a healthcare professional, and the procedure is scheduled in advance.
What is IVIG infusion protocol?
RHA/site/unit policy may dictate more frequent monitoring during administration of IVIG. For first infusion or if greater than 8 weeks since last treatment, it is recommended to initiate infusion at 0.01 mL/kg/min for 30 minutes. Gradually increase rate every 15-30 minutes, as tolerated, according to steps in table.
Is IVIG infusion painful?
Most infusion medications are not painful to receive. The placement of the IV catheter may feel painful to some people.
How do you prepare for IVIg infusion?
Being fully hydrated before your IVIG infusion can help minimize symptoms like headaches after the treatment. IV nurses also administer pre-medications which can include Benadryl, Tylenol or Advil, and other medications to reduce the severity of the common side effects associated with Ig treatment.
What is the success rate of IVIg?
Several clinical trials have shown that IVIg (up to 1 g/kg) is an effective treatment in 70–80% of patient with ITP (39-42). The aim of this review is to focus on the efficacy and the general mechanisms of IVIg therapy used to treat adults with primary ITP.
How long does IVIG infusion take?
IVIG is given into a vein ("intravenously"), in an infusion that usually takes one to four hours.
Is IVIG inpatient?
More IVIG is used to treat outpatients than inpatients. Half of the hospital pharmacies dispensing for inpatients use less than 100 grams/month, and about one-third use 100-499 grams monthly. In the 47 hospitals treating inpatients only, the average amount of IVIG dispensed is even lower (not shown in table).
Do you need a port for IVIG?
IVIG is given through a vein which may be accessed from your arm, a port or PICC line. Your doctor may prescribe pre-medications such as acetaminophen or diphenhydramine to prevent side effects such as headache and infusion reactions. During your infusion, your nurse or doctor will likely monitor your blood pressure.
Does IVIG work immediately?
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 can last for a few months.
Why does IVIG make you sick?
Aseptic meningitis occurs when the IG drug has caused irritation of the meninges in the brain, resulting in symptoms that present like meningitis. This unexpected side effect can occur during an infusion or after an infusion.
How many IVIG treatments do I need?
Typically you'll have treatments every 3 to 4 weeks to keep your immune system strong. Your blood may break down about half of the immunoglobulin over that period, so you'll need another dose to keep fighting infections.
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.
Who can take IVIg?
Before you start IVIg, your doctor will check the levels of immunoglobulins in your blood. If one type of immunoglobulin, known as IgA, is very low, then you may not be given IVIg.
What is IVIg?
Immunoglobulins are the antibodies produced naturally by the body’s immune system, which help fight infection and disease.
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 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 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.
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 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]
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]
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.
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 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]
Why are IVIG products not recommended for post transplantation?
Hyperosmolar IVIG products are not for post-transplantation patients due to the risk of renal failure and osmotic nephropathy.
What is IVIG therapy?
Intravenous Immunoglobulin Therapy (IVIg) This therapy can help people with weakened immune systems or other diseases fight off infections. Some of the diseases that intravenous immunoglobulin ( IVIg) can treat include: People who receive bone marrow transplants may also use IVIg to prevent infections.
How does IVIG help?
Then it can be given to you through a vein in your arm, or IV. If you get IVIg, it can help strengthen your immune system so you can fight infections and stay healthy.
Where is liquid immunoglobulin taken from?
Liquid immunoglobulin is taken from the blood plasma of donors who are screened to make sure they are healthy. The plasma is tested for serious infections like hepatitis and AIDS. The plasma is purified before it's used for IVIg therapy.
Why do people use IVIG?
People who receive bone marrow transplants may also use IVIg to prevent infections.
How often do you get shots with IVIG?
You'd get shots with small amounts of immunoglobulin under your skin either once a week or every few days.
How long does it take for a vein to get a needle?
A health care provider uses a needle to get into your vein. Then the medicine can flow from a bag through a tube into your arm. This takes about 2 to 4 hours. You'll probably go to an infusion center, hospital, clinic, or doctor’s office to get the treatment.
Does IVIG help with lupus?
Not enough of these and you can become anemic and feel very tired. IVIg helps stop the white blood cells of people with lupus from destroying their red blood cells . In people with myositis, the treatment may block your immune system’s destruction of muscle cells.
Is Visser LH a double blind study?
Visser LH, Beekman R, Tijssen CC, et al. A randomized, double-blind, place-controlled pilot study of IV immune globulins in combination with IV methylprednisolone in the treatment of relapses in patients with MS. Mult Scler 2004;10:89Y91. FDA labeling information.
Is IVIG a third line?
In general we consider IVIG as a third line for treatment of acute MS relapses after IVMP and plasma exchange (PLEX). We will consider IVIG treatment in the setting of acute relapse only if the patient was intolerant or fails to respond to both IVMP and PLEX.
Can IVIG be used for NMO relapse?
A: There are some anecdotal reports of acute NMO relapses successfully treated with IVIG, following failure of intravenous corticosteroid administration. Patients in whom corticosteroids or plasma exchange are contraindicated or are impractical can also be candidates for IVIG.
Can IVIG cause headaches?
A: Generally, IVIG infusion can cause migrainelike headaches, nausea, and dizziness. Infusion reactions including severe allergic reactions have been reported especially in patients with IgA deficiency. It may also promote thrombosis and may result in thromboembolic venous or arterial events. Other adverse effects include acute renal failure, aseptic meningitis, hemolysis, transfusion-related acute lung injury, and transmission of blood-borne infections. In some cases, IVIG can cause aseptic meningitis which will manifest with severe headache associated with neck stiffness, photophobia, no fever or low grade fever, and accentuation of pain with head movement. Patients who develop aseptic meningitis with IVIG may have increased cell count and protein in their CSF but their culture is typically negative for infectious microorganisms. IVIG is contraindicated in patients with known hypersensitivity to IVIG.
Can IVIG be used for relapse prevention?
In a study of 8 NMO patients treated with IVIG the mean relapse rate decreased from 1.0 in the year pre-IVIG to 0.006 during followup. We generally would consider IVIG for relapse prevention only if other first line agents were not tolerated or were unavailable. As in MS, IVIG can be an option for pregnant or nursing females.
Understanding immune globulin
Immune globulin (Ig for short) is a protein found in the blood that is as important to your body as nutrients and oxygen and is a necessary part of the immune system.
Whom does IVIg therapy benefit?
Those with immune deficiencies unable to produce enough (or any in some cases) antibodies to fight off antigens. As a result, the body becomes susceptible to infections and inflammation.
How does IVIg work and how is it administered?
The immune globulin is delivered directly into the bloodstream intravenously through a catheter on your arm or through a central line in the chest area.
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?
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.
