Immediate infusion-related adverse reactions to intravenous immunoglobulin in a prospective cohort of 1765 infusions

Immediate infusion-related adverse reactions to intravenous immunoglobulin in a prospective cohort of 1765 infusions

Author Bichuetti-Silva, Danielli C. Autor UNIFESP Google Scholar
Furlan, Fernanda P. Autor UNIFESP Google Scholar
Nobre, Fernanda A. Autor UNIFESP Google Scholar
Pereira, Camila T. M. Autor UNIFESP Google Scholar
Goncalves, Tessa R. T. Autor UNIFESP Google Scholar
Gouveia-Pereira, Mariana Autor UNIFESP Google Scholar
Rota, Rafael Autor UNIFESP Google Scholar
Tavares, Lusinete Autor UNIFESP Google Scholar
Mazzucchelli, Juliana T. L. Autor UNIFESP Google Scholar
Costa-Carvalho, Beatriz T. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Intravenous immunoglobulin (WIG) is increasingly recommended for many diseases apart from primary immunodeficiency diseases (PID). Although effective and safe, adverse reactions may occur. We conducted a 2-year prospective observational study in 117 patients with PID who received regular IVIG replacement therapy at a median dose of 600 mg/kg every 3 to 4 weeks to examine IVIG's adverse effects; 1765 infusions were performed (mean = 15/patient) in 75 males and 42 females (aged 3 months to 77 years) in 3 groups: <= 9 years (34.2%), 10-19 years (26.5%), and >= 20 years (39.3%). Fifty patients had common variable immunodeficiency (CVID), 11 had X-linked agammaglobulinemia (XLA), and 55 had other immune system disorders. the drugs administered were Octagam (R) (49.1%), Tegeline (R) (17.3%), Imunoglobulin (R) (18.6%), Flebogama (R) (12.9%), Vigam (R) (1.2%), and Kiovig (R) (0.4%). Immediate infusion-related adverse reactions occurred in the cases of 38 out 1765 infusions (2.15%, IC95% 1.53%-2.94%), which were classified as mild (81.6%), moderate (10.5%), or severe (7.9%). Time until reaction ranged from 10 to 240 min (mean = 85.7, median = 60). Reaction rates were similar across age groups. the most common reactions were malaise, headache, and abdominal pain. Reported severe events were tightness of the throat and seizure. All symptoms improved with temporary or complete WIG interruption and symptomatic medications. Sixteen of 38 reactions to infusions occurred in the presence of an acute infection (p = 0.09). Tegeline (R) represented a greater reaction risk factor than Octagam (R) (p < 0.001). These results indicate that IVIG infusion can be considered a safe procedure. Low reaction incidence and few severe immediate infusion-related adverse reactions were observed. (C) 2014 Elsevier B.V. All rights reserved.
Keywords Intravenous immunoglobulin
Antibody
Infusion-related
Adverse reactions
Primary immunodeficiency
Language English
Date 2014-12-01
Published in International Immunopharmacology. Amsterdam: Elsevier B.V., v. 23, n. 2, p. 442-446, 2014.
ISSN 1567-5769 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 442-446
Origin http://dx.doi.org/10.1016/j.intimp.2014.09.015
Access rights Closed access
Type Article
Web of Science ID WOS:000346954000010
URI http://repositorio.unifesp.br/handle/11600/38509

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