The Use of Immunoglobulin Therapy for Patients With Primary Immune Deficiency: An Evidence-Based Practice Guideline
The standard treatment for patients with primary antibody deficiency is immunoglobulin (IG), but the care of these patients is complex. These guidelines, initiated by the Canadian Blood Services and the National Advisory Committee on Blood and Blood Products, have been developed to facilitate and standardize the care of these patients by the various physician specialties that are responsible for their care. A panel of national expert immunologists and methodologists developed salient clinical questions; and a systematic, expert, and bibliography literature search up to July 2008 was conducted. One thousand eighty-seven citations were retrieved, and 102 reports were used in the preparation of this guideline. The recommendations provide guidance (1) on the complexity of the treatment of these patients; (2) the established benefits of IG on morbidity and mortality; (3) dosage, routes of administration, and management of reactions; (4) the various IG formulations available; (5) vaccination of these patients; and (6) research priorities.
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STATEMENT OF CONFLICT OF INTEREST: Dr Richard Warrington has received funding from Bayer Canada and from Baxter Canada. Dr Bruce Mazer has received research funding from the Bayer/Talecris Canadian Blood Services/Hema-Quebec Partnership Fund since 1995. He has received additional research funding from Bayer and Talecris. His department has received unrestricted educational grants from Bayer and CSL Behring. Dr Elie Haddad has received research funding from the Bayer/Talecris Canadian Blood Services/Hema-Quebec Partnership Fund since 2007. His department has received unrestricted educational grants from Bayer-Talecris and Baxter. He is an advisory board member for CSL Behring and Bristoll Myers Squibb. He has also received honoraria from Talecris, Novartis, and Baxter. Dr Bob Schellenberg is an advisory board member for CSL Behring and in previous years Bayer and Baxter. He is a recipient of a Grant-in-Aid from Bayer (now Talecris). Dr Nadine Shehata is an employee of Canadian Blood Services, as was Dr Heather Hume during the period of the development of these guidelines.
Funding was provided from an unrestricted education grant from Bayer, Inc, to Canadian Blood Services. Bayer did not have any role in the selection of panel members, the literature search, the selection of articles, or in the development of the recommendations.
PII: S0887-7963(09)00091-1
doi:10.1016/j.tmrv.2009.09.011
© 2010 Elsevier Inc. All rights reserved.
