Clinical outcomes of immunoglobulin treatment for patients with secondary antibody deficiency: Data from the Ontario immunoglobulin treatment case registry

Armin Abadeh; Sarah Shehadeh; Stephen Betschel; Susan Waserman; Donald William Cameron; Juthaporn Cowan

doi:10.1371/journal.pone.0294408

Clinical outcomes of immunoglobulin treatment for patients with secondary antibody deficiency: Data from the Ontario immunoglobulin treatment case registry

PLoS One. 2023 Nov 16;18(11):e0294408. doi: 10.1371/journal.pone.0294408. eCollection 2023.

Authors

Armin Abadeh¹, Sarah Shehadeh², Stephen Betschel¹, Susan Waserman³, Donald William Cameron^{2

4}, Juthaporn Cowan^{2

4}

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
³ Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁴ Department of Medicine, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada.

Abstract

Background: Despite the increasing number of cases of secondary antibody deficiency (SAD) and immunoglobulin (Ig) utilization, there is a paucity of data in the literature on clinical and patient-reported outcomes in this population.

Objective: To describe immunoglobulin utilization patterns, clinical and patient-reported outcomes in patients with SAD on immunoglobulin replacement therapy (IgRT).

Methods: A cross-sectional study of patients with secondary antibody deficiency enrolled in the Ontario Immunoglobulin Treatment (ONIT) Case Registry from June 2020 to September 2022 was completed. Demographics, comorbidities, indications for immunoglobulin treatment, clinical infections at baseline and post IgRT, and patient-reported outcomes were collected and analyzed.

Results: There were 140 patients (58 males; 82 females; median age 68) with SAD during the study period; 131 were on subcutaneous Ig (SCIG) and 9 were on intravenous Ig (IVIG). The most common indication was chronic lymphocytic leukemia (CLL) (N = 52). IgRT reduced the average annual number of infections by 82.6%, emergency room (ER) visits by 84.6%, and hospitalizations by 83.3%. Overall, 84.6% of patients reported their health as better compared to before IgRT. Among those patients who switched from IVIG to SCIG (N = 35), 33.3% reported their health as the same, and 62.9% reported their health as better.

Conclusions: This study demonstrates that IgRT significantly improved clinical outcomes and patient-reported general health state in patients with SAD. This study also further supports the use of SCIG in patients with SAD.

Copyright: © 2023 Abadeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Aged
Cross-Sectional Studies
Female
Humans
Immunoglobulin G
Immunoglobulins, Intravenous* / therapeutic use
Immunologic Deficiency Syndromes* / drug therapy
Male
Ontario
Registries

Substances

Immunoglobulins, Intravenous
Immunoglobulin G

Grants and funding

JC received honoraria and consultation fees from AstraZeneca, Merck, GSK, Sanofi, Genzyme, Takeda, CSL Behring, Octapharma, and Biogen. SB received advisory, speaker and committee fees and operational research funds to the institution, not in the form of salaries personally from Astria, Canadian Blood Services, CSL Behring, Grifols, Ionis Pharmaceuticals, Kalvista Novartis, Octapharma, Pharvaris, Sanofi, and Takeda. SW received speaker and consultation fees from CAAIF, ALK Abello, Pfizer, Aimmune Schroeder Foundation, Sean Delaney foundation, GSK, Novartis, CSL Behring, Sanofi, Astrazaneca, Takeda, Teva, Medexus, Mylan, AbbVie, Miravohealth, Bausch Lomb, Avir Pharma and Covis. DWC received consultation and speaker fees from Takeda and CSL Behring. SS and AA have declared that no competing interests exist. The funder did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials.