Pharmacokinetics and Pharmacodynamics of Intravenous Immunoglobulin G Maintenance Therapy in Chronic Immune-mediated Neuropathies

Clin Pharmacol Ther. 2017 Oct;102(4):709-716. doi: 10.1002/cpt.693. Epub 2017 Jun 5.

Abstract

The regimen for IVIg maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics (PK) of IVIg have not yet been established. We aimed to determine the PK of IVIg maintenance treatment in patients with clinically stable, treatment-dependent, chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 g (range, 15-70 g) every 14 days (range, 7-28 days) resulting in high IgG peak levels (median, 25.9 g/L; range, 16.7-41.0 g/L) and trough levels (median, 16.1 g/L; range, 9.7-23.6 g/L). IgG PK parameters, including half-life (median, 23.1 days; range, 11-60 days), were constant during subsequent courses in the same patients, but varied considerably between patients. The IgG levels at 1 week after infusion correlated with grip strength. These results provide insight into the PK of IVIg maintenance treatment in patients with chronic immune-mediated neuropathies.

MeSH terms

  • Aged
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Female
  • Half-Life
  • Hand Strength
  • Humans
  • Immune System Diseases / drug therapy*
  • Immune System Diseases / physiopathology
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / pharmacokinetics
  • Immunoglobulins, Intravenous / pharmacology
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / pharmacokinetics
  • Immunologic Factors / pharmacology
  • Male
  • Middle Aged
  • Nervous System Diseases / drug therapy*
  • Nervous System Diseases / physiopathology

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors