PMID- 33763019
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210326
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 12
DP  - 2021
TI  - Individualizing Therapy in CIDP: A Mini-Review Comparing the Pharmacokinetics of 
      Ig With SCIg and IVIg.
PG  - 638816
LID - 10.3389/fneur.2021.638816 [doi]
LID - 638816
AB  - Immunoglobulin (Ig) therapy is a first-line treatment for CIDP, which can be 
      administered intravenously (IVIg) or subcutaneously (SCIg) and is often required 
      long term. The differences between these modes of administration and how they can 
      affect dosing strategies and treatment optimization need to be understood. In 
      general, the efficacy of IVIg and SCIg appear comparable in CIDP, but SCIg may 
      offer some safety and quality of life advantages to some patients. The 
      differences in pharmacokinetic (PK) profile and infusion regimens account for 
      many of the differences between IVIg and SCIg. IVIg is administered as a large 
      bolus every 3-4 weeks resulting in cyclic fluctuations in Ig concentration that 
      have been linked to systemic adverse events (AEs) (potentially caused by high Ig 
      levels) and end of dose "wear-off" effects (potentially caused by low Ig 
      concentration). SCIg is administered as a smaller weekly, or twice weekly, volume 
      resulting in near steady-state Ig levels that have been linked to continuously 
      maintained function and reduced systemic AEs, but an increase in local reactions 
      at the infusion site. The reduced frequency of systemic AEs observed with SCIg is 
      likely related to the avoidance of high Ig concentrations. Some small studies in 
      immune-mediated neuropathies have focused on serum Ig data to evaluate its 
      potential use as a biomarker to aid clinical decision-making. Analyzing dose data 
      may help understand how establishing and monitoring patients' Ig concentration 
      could aid dose optimization and the transition from IVIg to SCIg therapy.
CI  - Copyright (c) 2021 Beydoun, Sharma, Bassam, Pulley, Shije and Kafal.
FAU - Beydoun, Said R
AU  - Beydoun SR
AD  - Neuromuscular Division, Keck School of Medicine of University of Southern 
      California (USC), Los Angeles, CA, United States.
FAU - Sharma, Khema R
AU  - Sharma KR
AD  - Neurology Department, Miller School of Medicine, University of Miami, Miami, FL, 
      United States.
FAU - Bassam, Bassam A
AU  - Bassam BA
AD  - Neurology Department, University of South Alabama College of Medicine, Mobile, 
      AL, United States.
FAU - Pulley, Michael T
AU  - Pulley MT
AD  - Department of Neurology, University of Florida College of Medicine, Jacksonville, 
      FL, United States.
FAU - Shije, Jeffrey Z
AU  - Shije JZ
AD  - Department of Neurology, University of Florida College of Medicine, Jacksonville, 
      FL, United States.
FAU - Kafal, Ayman
AU  - Kafal A
AD  - CSL Behring, King of Prussia, PA, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210308
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7982536
OTO - NOTNLM
OT  - CIDP
OT  - IG therapy
OT  - IVIg
OT  - Ig concentrations
OT  - SCIg
OT  - dosing strategies
OT  - pharmacokinetics
OT  - wear-off effect
COIS- SB had received research grants from Alexion, Argenx, Catalyst, Ra Pharma, and 
      UCB. He has also received honoraria for consulting or speaking for Akcea, 
      Alnylam, CSL Behring, Grifols, Mitsubishi Pharma, and Takeda. BB has received 
      honoraria for consulting or participation in advisory boards for Alexion 
      Pharmaceuticals and CSL Behring. MP has received honoraria for consulting or 
      participation in regional advisory boards from Alexion Pharmaceuticals, Argenx 
      BioProducts Laboratory, Catalyst Pharmaceuticals, CSL Behring, and UCB/Ra Pharma. 
      JS has received honoraria for consulting on an advisory board for Alnylam 
      Pharmaceuticals. AK was a former employee of CSL Behring. The remaining authors 
      declare that the research was conducted in the absence of any commercial or 
      financial relationships that could be construed as a potential conflict of 
      interest.
EDAT- 2021/03/26 06:00
MHDA- 2021/03/26 06:01
PMCR- 2021/03/08
CRDT- 2021/03/25 06:26
PHST- 2020/12/07 00:00 [received]
PHST- 2021/02/10 00:00 [accepted]
PHST- 2021/03/25 06:26 [entrez]
PHST- 2021/03/26 06:00 [pubmed]
PHST- 2021/03/26 06:01 [medline]
PHST- 2021/03/08 00:00 [pmc-release]
AID - 10.3389/fneur.2021.638816 [doi]
PST - epublish
SO  - Front Neurol. 2021 Mar 8;12:638816. doi: 10.3389/fneur.2021.638816. eCollection 
      2021.