Pharmacokinetic modeling and simulation of biweekly subcutaneous immunoglobulin dosing in primary immunodeficiency

Postgrad Med. 2013 Nov;125(6):53-61. doi: 10.3810/pgm.2013.11.2712.

Abstract

Replacement therapy with immunoglobulin G (IgG) given as intravenous or subcutaneous (SC) infusions is the standard treatment for patients with primary immunodeficiency. Due to the life-long need for replacement, increased flexibility in the administration and dosage regimens would improve patients' quality of life. A population pharmacokinetic model that can predict plasma IgG concentrations for various routes, dosage regimens, and patient groups is a valuable tool to improve patient therapy. Such a model was developed based on IgG concentrations from 151 unique adult and pediatric patients who participated in 4 clinical trials of intravenous and SC IgG replacement therapy. Simulations predicted that the same total IgG dose, delivered SC, either in 1 biweekly dose (once every 2 weeks), or in 2 weekly doses, results in IgG peak and trough concentrations that remain within ± 10% of each other throughout the 14-day period. The developed population pharmacokinetic model predicted that biweekly SC Hizentra dosing offers a viable alternative to weekly SC therapy, allowing more flexible and optimized dosage regimens for patients with primary immunodeficiency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Area Under Curve
  • Clinical Trials, Phase III as Topic
  • Computer Simulation
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Half-Life
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Immunoglobulin G / metabolism*
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / pharmacokinetics*
  • Immunologic Deficiency Syndromes / drug therapy*
  • Injections, Intravenous
  • Injections, Subcutaneous
  • Metabolic Clearance Rate
  • Models, Biological

Substances

  • Hizentra
  • Immunoglobulin G
  • Immunoglobulins, Intravenous