Immunoglobulin Replacement Therapy in Primary Immunodeficiencies

Immunoglobulin (antibody) replacement therapy (IRT) is one of the most effective and commonly used therapies for some primary immunodeficiency diseases (PIDs).  Many people with PIDs have insufficient antibodies to adequately fight infections, and this therapy can be life saving.   

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Why is IRT used?

In people with PIDs, IRT can: 

How is IRT made?

Immunoglobulin products are purified from pooled plasma of many healthy blood donors. Plasma is the liquid part of blood that remains when all red blood cells have been removed.  When donors give blood, the red cells and plasma are separated. The plasma is pooled together and processed in highly specialised and regulated facilities to produce immunoglobulin, which contains a wide variety of antibodies.

How is IRT given?

There are two ways that IRT can be given: 

Are there any side effects of IRT?

IRT is normally very well tolerated and serious side effects are very rare.  However, there are some side effects that people receiving IRT should be aware of:

You should notify your doctor of any side effects you might experience.

Limitations of IRT

IRT does not cure the antibody deficiency, and does not usually reverse long term organ injury from chronic infections. IRT contains only one of the important components of the immune system's response to infection. For these reasons it is best to start IRT before organ damage has occurred.

Availability of IRT

IRT is derived from blood (plasma), are in limited supply, and access is restricted. Doctors must follow specific guidelines to ensure that the product goes to people most in need.

IRT should only be used in these cases where scientific and clinical evidence supports its use, and where other therapies are considered less favorable.

IRT is reserved for those people with confirmed abnormalities in antibody production, and who experience recurrent infections.

IRT is also of great benefit for patients with certain autoimmune diseases (such as immune thrombocytopenia and Guillain Barre syndrome), where it is used to alter the course of the disease (immunomodulation) rather than to replace antibodies that are deficient.

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Content last updated March 2019