Immunoglobulin (IG) therapy – what you need to know

Immunoglobulin (IG or IGIV) therapy is often chosen by doctors to help patients suffering from several kinds of disease. IG therapy can be very helpful for:

  1. Patients whose supply of antibodies is insufficient to effective fight a current infection or state of disease. These patients are said to be in a state of “immunodeficiency;” such a condition may be inherited or may be caused by diseases or treatments for disease (for example, chemotherapy). This kind of IG therapy is often called “replacement therapy” and is often used for patients for whom antibiotics have not proven effective.
  2. Patients suffering from specific diseases of the immune system. These may include CIDP (Chronic inflammatory demyelinating polyneuropathy), Kawasaki’s disease, Guillain-Barré syndrome, polymyositis/dermatomyositis, and other conditions. These “auto-immune” disorders cause the normally functioning immune system to mistakenly attack itself, causing inflammation and other serious problems. This kind of IG therapy is often called “immunomodulation therapy” because of its regulatory effect on the operation of the immune system.

Therapy using IG was initially developed in the early 1950s to treat polio and was at that time administered using injection into muscle tissue. In more recent decades, forms of Immunoglobin have been developed that are suitable for infusion – either via IV or subcutaneously (below the skin).

What you can expect
IG therapy can be accomplished at home or may take place at an infusion (outpatient) center. The typical way to infuse IG is with a small electric pump. IV treatments typically occur every few weeks; subcutaneous infusions typically happen once a week.

Because the kind of Immunoglobulin used in IG therapy is hard to make, both in terms of the manufacturing requirements for its production — plus the fact that the supply of blood donors is limited — such therapy can be expensive. Fortunately, many of the costs associated with IG therapy are covered by Medicare, which states:

Medicare helps pay for IVIG for people with a diagnosis of primary immune deficiency disease. A doctor must decide that it’s medically appropriate for the IVIG to be given in the patient’s home. Part B covers the IVIG itself, but Part B doesn’t pay for other items and services related to the patient getting the IVIG in his or her home.

Doctors and pharmacists need to work closely together to custom-tailor an effective IG therapy plan. Care must also be taken to ensure that the patient receives the correct kind of Immunoglobulin (multiple IG products are available, but they differ in formulation, as well as in respect to cost).

Also, key is maintaining the integrity and purity of the IG material itself, and guarding against the possibility of infection; although infections are rare, the IG material is of course sourced from human blood plasma and so appropriate precautions must always be taken.

Successful IG therapy means keeping a close eye out for side effects. While rare, these side effects can be severe and include fever, chills, dizziness, headache, chest pain, muscle cramps, and other unpleasant symptoms. Consequently, close monitoring is essential throughout the therapy process. A qualified specialty infusion pharmacy – working closely with your doctor – will design and implement an appropriate IG therapy care p