PMID- 32124273
OWN - NLM
STAT- MEDLINE
DCOM- 20201207
LR  - 20220408
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 37
IP  - 4
DP  - 2020 Apr
TI  - Clinical Practice Experience with HyQvia in Adults Using Alternative Dosing 
      Regimens and Pediatric Patients: A Retrospective Study.
PG  - 1536-1549
LID - 10.1007/s12325-020-01264-7 [doi]
AB  - INTRODUCTION: HyQvia (Immune Globulin Infusion 10% [Human] with Recombinant Human 
      Hyaluronidase) was developed to combine the advantages of intravenous and 
      subcutaneous immune globulin (SCIG), allowing administration of larger volumes at 
      a single subcutaneous site with less frequent dosing when compared to other SCIG 
      products. Current US prescribing guidelines for HyQvia are limited to adults and 
      do not encompass the flexibility required to achieve success in all patients with 
      primary immunodeficiency (PID). METHODS: This retrospective study was designed to 
      evaluate the clinical experience of treating patients with PID with HyQvia 
      regimens outside of package insert recommendations as well as in pediatric 
      patients. Data were abstracted from 38 patient records (317 HyQvia infusions), 
      including five patients less than 16 years of age, from seven US immunology 
      clinics. RESULTS: Among 37 patients receiving HyQvia regimens differing from 
      prescribing guidelines, the most notable variations included shorter ramp-up 
      periods, use of two rather than one infusion site, and slower than maximal 
      infusion rates to mitigate local adverse events (AEs). The medication volume 
      infused for single site doses ranged from 75 to 200 mL and doses split between 
      two sites ranged from 100 to 750 mL. The most common type of regimen variation 
      was a condensed ramp-up phase (shorter schedule, higher doses), and 96% (24/25) 
      of patients managed in this way completed ramp-up. The most common ramp-up 
      schedule was three infusions (one at 25-45%, another at 50-75%, and the final at 
      100% of target dose) spread over 2-4 weeks. CONCLUSIONS: A shorter ramp-up 
      schedule did not appear to increase the number of AEs compared to standard 
      ramp-up schedules. For patients with AEs, slower infusion rates and the use of 
      two sites may improve medication tolerability. Four of five pediatric patients 
      reported no AEs, and only one discontinued, stating a fear of needles. HyQvia may 
      be tailored to adults requiring alternative rates, ramp-up, and/or dosing 
      regimens and may be especially well-suited to children.
FAU - Wasserman, Richard L
AU  - Wasserman RL
AD  - Allergy Partners of North Texas, Dallas, TX, USA. drrichwasserman@gmail.com.
CN  - HyQvia Experience Study Group
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200302
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Immunoglobulin G)
RN  - 0 (Immunoglobulins, Intravenous)
MH  - Administration, Intravenous
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Clinical Protocols
MH  - Drug Tolerance
MH  - Female
MH  - Humans
MH  - Immunoglobulin G/adverse effects/*therapeutic use
MH  - Immunoglobulins, Intravenous/adverse effects/*therapeutic use
MH  - Infusions, Subcutaneous
MH  - Male
MH  - Medical Records
MH  - Primary Immunodeficiency Diseases/*drug therapy
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC7140738
OTO - NOTNLM
OT  - Enzyme-facilitated subcutaneous IgG replacement
OT  - HyQvia, subcutaneous immunoglobulin
OT  - Pediatrics
OT  - Primary immunodeficiency (PID)
OT  - Recombinant human hyaluronidase
OT  - SCIG
OT  - Subcutaneous IgG replacement
OT  - fSCIG
EDAT- 2020/03/04 06:00
MHDA- 2020/12/15 06:00
PMCR- 2020/03/02
CRDT- 2020/03/04 06:00
PHST- 2019/12/12 00:00 [received]
PHST- 2020/03/04 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2020/03/04 06:00 [entrez]
PHST- 2020/03/02 00:00 [pmc-release]
AID - 10.1007/s12325-020-01264-7 [pii]
AID - 1264 [pii]
AID - 10.1007/s12325-020-01264-7 [doi]
PST - ppublish
SO  - Adv Ther. 2020 Apr;37(4):1536-1549. doi: 10.1007/s12325-020-01264-7. Epub 2020 
      Mar 2.