THERAPEUTICS

Brands

• Gamunex, Polygam, Gammagard S/D, Gammagard liquid, Iveegam, Octagam, Flebogamma, Carimune, Panglobulin, Privigen, Gammaked, Bivigam

Generic?

• No

Class

• Immunomodulator

Commonly Prescribed for

(FDA approved in bold)

• Chronic inflammatory demyelinating polyneuropathy (CIDP) (Gamunex-C, Gammaked only)

• Multifocal motor neuropathy (MMN) (Gammagard liquid only)

• Primary humoral immunodeficiency (PHI) in adults or children 2 years and older

• Immune thrombocytopenic purpura (ITP)

• Prevention of bacterial infection associated with B-cell chronic lymphocytic leukemia (Gammagard S/D only)

• Prevention of coronary artery aneurysms associated with Kawasaki syndrome in pediatric patients (Gammagard S/D only)

• Kidney transplant with a high antibody recipient or with an ABO incompatible donor

• Prevention of bacterial infection in pediatric HIV

• Guillain-Barré syndrome (GBS)

• Myasthenia gravis (MG)

• Inflammatory myopathies: dermatomyositis (DM) and polymyositis (PM)

• Stiff-person syndrome

• Adrenoleukodystrophy

• Paraneoplastic syndromes

• Paraproteinemic immunoglobulin M demyelinating polyneuropathy

• Intractable childhood epilepsy including West syndrome, Lennox-Gastaut and Rasmussen syndromes

• Multiple myeloma

• Acute demyelinating encephalomyelitis (ADEM)

• Optic neuritis and multiple sclerosis (MS)

• Central pontine myelinolysis

• Diabetic amyotrophy

• Peripheral polyneuropathy

• Myelopathy associated with human T-cell lymphotropic virus-1 (HTLV-1) infection

• Wegener's granulomatosis

• Churg-Strauss syndrome

• Amyotrophic lateral sclerosis (ALS)

• Alzheimer's dementia

How the Drug Works

• IVIg preparations are derived from a pool of at least 1000 donors. They contain antiidiotypic antibodies that bind to and neutralize pathogenic autoantibodies. The infused Ig may downregulate production of endogenous Ig. The Ig from IVIg may block Fc receptors on immune cells

• IVIg contains high-affinity neutralizing antibodies against interleukin (IL)-1a, IL-6, and tumor necrosis factor-α (TNF-α), which may downregulate synthesis of cytokines by T cells

• It forms complexes with products of complement activation, preventing the formation and deposition of attack complexes on target cells

• IVIg also causes transient lymphopenia and reduces the number of natural killer cells