PMID- 21913738
OWN - NLM
STAT- MEDLINE
DCOM- 20120504
LR  - 20211020
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 28
IP  - 9
DP  - 2011 Sep 1
TI  - Special considerations with the use of intravenous immunoglobulin in older 
      persons.
PG  - 729-36
LID - 10.2165/11592740-000000000-00000 [doi]
AB  - There are currently six labelled indications in the US for intravenous 
      immunoglobulin (IVIG) and over 150 unlabelled uses, ranging from some of the most 
      studied indications through to those mentioned only in anecdotal reports. A 
      downstream effect of the varied uses of IVIG is its increased utilization for 
      disease processes that significantly affect the older population. In general, 
      IVIG is considered a safe therapy, and the common adverse events (AEs) associated 
      with IVIG administration are mild and transient. Serious AEs are fortunately 
      uncommon with IVIG infusion. However, most safety data are collated from case 
      reports and case series, with a modest amount of data from well controlled 
      clinical studies that have limited power to detect uncommon AEs. Among the 
      reported serious AEs, older patients appear to be particularly at risk of acute 
      renal failure and arterial and venous thrombosis. The incidence of AEs appears to 
      vary with the IVIG product composition, rate of infusion, the study population's 
      disease process and underlying co-morbidities. Approaches to minimizing AEs, 
      particularly in the older patient population, include ensuring sufficient 
      hydration prior to infusion of IVIG, using the minimal effective dose possible 
      during infusion, considering use of preparations with lower concentrations of 
      sucrose, and monitoring renal function. Research is expanding to inform possible 
      uses of a subcutaneous formulation of IVIG that, if proven to be effective, 
      offers a potential reduction in AEs and lower cost of administration.
FAU - Cheng, M Jennifer
AU  - Cheng MJ
AD  - Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
FAU - Christmas, Colleen
AU  - Christmas C
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Acute Kidney Injury/chemically induced
MH  - Aged
MH  - Arteries/drug effects
MH  - Headache/chemically induced
MH  - Humans
MH  - Immunoglobulins, Intravenous/*adverse effects
MH  - Venous Thrombosis/chemically induced
EDAT- 2011/09/15 06:00
MHDA- 2012/05/05 06:00
CRDT- 2011/09/15 06:00
PHST- 2011/09/15 06:00 [entrez]
PHST- 2011/09/15 06:00 [pubmed]
PHST- 2012/05/05 06:00 [medline]
AID - 4 [pii]
AID - 10.2165/11592740-000000000-00000 [doi]
PST - ppublish
SO  - Drugs Aging. 2011 Sep 1;28(9):729-36. doi: 10.2165/11592740-000000000-00000.