BT595, a 10% Human Normal Immunoglobulin, for Replacement Therapy of Primary Immunodeficiency Disease: Results of a Subcohort Analysis in Children

J Clin Immunol. 2023 Apr;43(3):557-567. doi: 10.1007/s10875-022-01397-0. Epub 2022 Nov 16.

Abstract

Purpose: To assess the efficacy, pharmacokinetics, and safety of a new, highly purified 10% IVIg (BT595, Yimmugo®) administered in children with PID.

Methods: This was an open-label, prospective, uncontrolled, multicenter Phase III pivotal trial. Among the 67 subjects in the trial were 18 pediatric patients aged 2 to 17 years with diagnosis of PID included in this analysis. They received doses between 0.2 and 0.8 g/kg body weight for approximately 12 months at intervals of either 3 or 4 weeks. Dosage and dosing interval were based on each patient's pre-trial infusion schedule. The rates of acute serious bacterial infections (SBI), secondary efficacy, safety, and pharmacokinetic outcomes were evaluated.

Results: No SBI occurred in the pediatric population. Two hundred sixty infusions were administered to the 18 pediatric patients. The mean (SD) IgG trough level was 8.55 (1.67) g/L at baseline and 8.84 (2.17) g/L at the follow-up visit after the last BT595 infusion. At the single infusions respectively, the average mean IgG trough levels ranged between 8.52 and 10.58 g/L. More than 85% of all infusions administered were not associated with any infusional AE (start during or within 72 h post-infusion). None of the severe or serious AEs were related to the investigational medicinal product (IMP). No premedication was used. Thirteen children reached a maximum infusion rate between > 2.0 and 8 mL/kg/h; no AE with an onset during the infusion occurred at these infusion rates.

Conclusion: BT595 is effective, convenient, well tolerated, and safe for the treatment of children with PID.

Trial registration: EudraCT: 2015-003652-52; NCT02810444, registered June 23, 2016.

Keywords: Children; Clinical trial; Efficacy; Intravenous immunoglobulin (IVIg); Pharmacokinetics; Primary immunodeficiency (diseases) (PID); Safety; Serious bacterial infections; Tolerability.

Publication types

  • Multicenter Study

MeSH terms

  • Bacterial Infections* / drug therapy
  • Child
  • Humans
  • Immunoglobulin G / therapeutic use
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Deficiency Syndromes* / diagnosis
  • Primary Immunodeficiency Diseases* / drug therapy
  • Prospective Studies

Substances

  • Immunoglobulin G
  • Immunoglobulins, Intravenous

Associated data

  • ClinicalTrials.gov/NCT02810444