Which medications in the drug class Blood Product Derivatives are used in the treatment of Hypogammaglobulinemia?

Updated: Dec 26, 2018
  • Author: Elizabeth A Secord, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Blood Product Derivatives

There are many FDA approved IgG preparations available in market with distinct features. The products used in the United States are derived from the plasma of screened donors in the United States The product undergoes several specific treatments to inactivate or remove blood borne pathogens that could be present. The preparations contain highly purified (generally >95 percent) polyvalent IgG. However, there are slight differences in the manufacturing procedures used by different producers, and different stabilizers (eg, sucrose, glucose, maltose or amino acids) used in the excipients making them unique and warrant precaution during substitution of immunoglobulin during treatment. Products also differ in storage requirements and shelf life. It is important for physician to familiarize and select appropriate product for his/her patient. Some of the products are listed below.2

FDA approved Immunoglobulin products available in US 2

A. Intravenous use (IV)

-Liquid-Bivigam 10%, Flebogamma DIF (5%, 10%), Gammaplex 5%, Octagam liquid (5%, 10%), Privigen 10%

-Lyophilized-Gammagard S/D 5%, Carimune NF 5%         

B. Intravenous and Subcutaneous use (SC)

-Liquid-Gammagard 10%, Gammaked 10%, Gamunex 10%

C. Subcutaneous use (SC)

                -Liquid-Cuvitru 20%, Hizentra 20%

                -Liquid with hyaluronidase-Hyqvia 10%

Immune globulin IV (IGIV; Bivigam, Flebogamma DIF, Gammaplex, Octagam, Privigen, Gammagard S/D, Carimune NF)

Immune globulins may work via several mechanisms, including the blockage of macrophage receptors, the inhibition of antibody production, the inhibition of complement binding, and the neutralization of pathologic antibodies.

Immune globulin SC (Gammaked, Gamunex, Cuvitru, Hizentra, Hyqvia)

Immune globulins neutralize circulating myelin antibodies through anti-idiotypic antibodies; downregulates proinflammatory cytokines, including interferon gamma; block Fc receptors on macrophages; suppress inducer T and B cells while augmenting suppressor T cells; block the complement cascade; promote remyelination; and may increase immunoglobulin G (IgG) in cerebrospinal fluid (10% of cases).


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