By Huda Jawad, PharmD, CSP, IgCP, Lead Specialty Pharmacist at California Specialty Pharmacy 

From autoimmune diseases to primary immunodeficiencies, immunoglobulin (IG) therapy plays a crucial role in managing – and sometimes even transforming – the lives of patients. IG therapy involves the administration of concentrated antibodies critical to the immune system. 

As a specialty infusion provider, California Specialty Pharmacy (CSP) has extensive clinical expertise with IG therapy and has created an Immunoglobulin Center of Excellence to provide comprehensive, specialized support to patients requiring IG therapy.  

What Is Immunoglobulin (IG) Therapy?

Immunoglobulins (also known as antibodies) are derived from healthy blood donors’ plasma. For immunoglobulin therapy, the immunoglobulins are extracted from pooled plasma donations and are sterile packaged and highly purified to minimize the transmission of pathogens.  

Immunoglobulin therapy is used to treat diseases caused by harmful autoantibodies or for people who have insufficient immunoglobulin needed to fight infectious diseases. In both scenarios, immunoglobulins are a highly effective treatment.   

They can be administered intravenously (called intravenous IG, or IVIG therapy) or subcutaneously (called subcutaneous IG, or SCIG therapy). No formulation is currently available for oral administration. 

IG therapy is personalized for each patient based on factors including their medical condition, the severity of their condition and symptoms, demographics (height, weight, age), and other medications being taken. 

Once infused into a patient, the antibodies help bolster the body’s immune response, reducing inflammation and improving disease management. 

What conditions are primarily treated by IG therapy?

IG is primarily used to treat patients with immune deficiencies, autoimmune disorders, and inflammatory conditions. Patients should speak to their provider about other indications for IG therapy. 

• Immune deficiencies: IG acts as a replacement therapy by providing immunoglobulins (antibodies) that the patient’s body may not be adequately producing. These antibodies are crucial for recognizing and neutralizing pathogens like bacteria and viruses. Hypogammaglobulinemia is an immune deficiency.  

• Autoimmune disorders: IG therapy may help balance the immune system. It may reduce an overly active immune response, which helps lower inflammation and manage autoimmune disorders where the body mistakenly attacks itself. These autoimmune disorders include chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). 

• Antiviral prophylaxis: IG therapy can neutralize pathogens and activate immune cells to protect against disease or modify certain viral syndromes, including hepatitis A, hepatitis B, measles, and varicella. 

• Infectious diseases: IG may also be used in the treatment of certain infections, particularly for individuals with compromised immune systems who may benefit from additional antibodies to fight off pathogens. 

• Hematological disorder: Diseases like Kawasaki and immune thrombocytopenia may be treated with IG therapy. 

How does IG therapy work and what are its benefits?

IG therapy aims to normalize a compromised immune system through several mechanisms that vary by the condition being treated. 

IG has a complex effect on the immune system in patients with autoimmune and inflammatory diseases due to several different mechanisms. It helps balance the immune response by both boosting and slowing down certain processes in autoimmune conditions. Its ability to reduce inflammation comes from how it interacts with different immune factors. 

A common use of IG therapy is treating chronic inflammatory demyelinating polyneuropathy (CIDP), an autoimmune condition that affects the myelin sheath around the peripheral nerves. Treating CIPD with IG therapy can reduce this overly active immune response, reduce inflammation and improve nerve function.       

IG therapy treats immune deficiencies effectively, providing the body with antibodies it cannot produce on its own, reducing the likelihood of recurrent infections. It is quite effective in preventing upper respiratory infections. 

For many patients, IG therapy may offer better disease management. IG may enhance daily functioning and well-being by managing symptoms and reducing disease activity. Regular IG therapy may help prevent exacerbations of certain conditions, reducing the need for hospital admissions. In chronic conditions, IG therapy may be part of a long-term treatment plan, providing consistent support to maintain health. 

What are the potential side effects of IG therapy and how can patients manage those side effects?

The most common side effects are headaches and flu-like symptoms, which usually resolve within 24 to 72 hours with rest, good hydration, and over-the-counter medications like acetaminophen and Benadryl. The patient may feel fatigued and weak, especially if receiving IG therapy for the first time. Patients should better tolerate IG therapy with ongoing administration.  

Other side effects may include moderate to severe symptoms like migraine, nausea, vomiting, and aseptic meningitis characterized by headache, neck stiffness, and light sensitivity. With proper counseling and patient assessments by nurses and pharmacists, many side effects can be well managed and perhaps even prevented.  

Pharmacists must pay attention to kidney function and the presence of comorbidities such as hypertension, stroke risk, and thromboembolic events, which increase a patient’s chances of developing side effects. 

Nurses, along with pharmacists, monitor several key aspects including vital signs, infusion rates, allergic and infusion reactions, neurological status, and patient comfort to ensure patient safety and the effectiveness of treatment.  

What is the California Specialty Pharmacy (CSP) IG Center of Excellence? 

CSP is a center of excellence for IG therapy and other specialty treatments, focused on understanding and knowing each patient while making the process as seamless as possible for everyone involved. 

We provide IG therapy and other infusion therapy services in patients’ homes and in our comfortable and convenient ambulatory infusion centers (AICs). CSP’s dedicated team includes pharmacists, nurses, patient coordinators, pharmacy technicians, and authorization staff.  

CSP pharmacists are certified in IG therapy and have extensive experience with managing patients. Pharmacists carefully check medication orders, review clinical notes, and communicate with patients to ensure they can self-manage their care. They provide guidance on medication storage and side effects.  

Our infusion nurses administer IVIG (if the patient is receiving their IG therapy via infusion), handle scheduling, and work with our staff to support patient needs. The authorization team works with insurance to ensure proper documentation and explain covered benefits, and to help patients find and access financial assistance programs, if appropriate. Throughout the entire IG therapy process, from ordering to administration and follow-up care, our clinical team provides excellent services and support, including a 24/7 on-call pharmacist and nurse, patient education, monthly assessments, and coordination with the prescribing provider to ensure treatment effectiveness and safety.  

CSP is well regarded for our modern specialty AICs, which have the latest technology that monitors and communicates patient progress and allows us to adjust treatments as needed for the best results. AICs offer a calming, comfortable, caring environment that enhances the experience provided by our passionate and dedicated team.  

CSP is taking IG therapy to another level, and our patients regularly tell us about the great experience they had with our team and facilities. 

If you would like more information on CSP’s IVIG Center of Excellence, visit NEED URL or call PHONE NO. 

 

Legal Disclaimer: 

The content provided on this blog is for informational purposes only and is not intended to serve as medical advice, diagnosis, or treatment. While we make every effort to provide accurate and up-to-date information regarding immunoglobulin (IVIg) therapy, the details shared here are based on general knowledge and should not be considered a substitute for professional medical consultation or advice. 

Immunoglobulin therapy is a specialized medical treatment that should only be prescribed and administered by a licensed healthcare provider. Individuals considering or undergoing immunoglobulin therapy should consult with their physician or healthcare provider to discuss their specific medical needs, potential risks, benefits, and any alternatives. Only a qualified healthcare professional can assess your individual health conditions and determine the most appropriate treatment plan. 

By accessing this blog, you agree to hold harmless the author, publisher, and any associated parties from any claims, liabilities, or damages arising from the use or interpretation of this content. 

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