Human normal immunoglobulin in the treatment of primary immunodeficiency diseases

Figures & data

Table 1A Intravenous immunoglobulin products currently available in the UK

Product	Manufacturer	Concentration (% v/v)
Kiovig^®	Baxter	10
Vigam^®	BPL	5
Gammaplex^®	BPL	5
Intratect^®	Biotest	10
Privigen	CSL Behring	10
Flebogamma^® DIF 5%	Grifols	5
Flebogamma^® DIF 10%	Grifols	10
Octagam^® 5%	Octapharma	5
Octagam^® 10%	Octapharma	10

Table 1B Subcutanous immunoglobulin products currently available in the UK

Product	Manufacturer	Concentration (% v/v)
Subcuvia^®	Baxter	16
Subgam^®	BPL	16
Vivaglobin^®	CSL Behring	16
Hizentra^®	CSL Behring	20

Table 2 Clinical benefits of immunoglobulin replacement therapy in primary antibody deficiency

Issue	Grade of evidence
Increased life expectancy	2++
Reduction in rate of bacterial infection	2++
Greater morbidity from diagnostic and treatment delay	2++
Reduction in infections with increased dose	1++
Improved quality of life with replacement therapy	2++
Grade of evidence
1++	High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias
1+	Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias
1−	Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias
2++	High quality systematic reviews of case-control or cohort studies High quality case-control or cohort studies with a very low risk of confounding bias, or chance and a high probability that the relationship is causal
2+	Well conducted case-control or cohort studies with a very low risk of confounding bias, or chance and a moderate probability that the relationship is causal
2−	Case-control or cohort studies with a high risk of confounding bias, or chance and a significant risk that the relationship is not causal
3	Nonanalytic studies, eg, case reports, case series
4	Expert opinion

Abbreviation: RCT, randomized controlled trial.