Title:Optimal Weight-based Dosing of Intravenous Immunoglobulin (IVIG)
among Overweight and Obese Patients
Volume: 19
Issue: 4
Author(s): Shima Heidari, Bita Shahrami and Kourosh Sadeghi*
Affiliation:
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Keywords:
Intravenous immunoglobulin (IVIG), obesity, weight-based dosing, body mass index (BMI), pharmacokinetic, ideal body weight.
Abstract:
Background: Intravenous immunoglobulin (IVIG), as an expensive medication under a national
shortage, has been widely used for the treatment of several autoimmune diseases and immunodeficiency
syndromes. Although conducting studies on therapeutic indications of IVIG has increased
significantly, a limited number of researches have investigated individualized dosing in terms of the drug,
disease state, and some patient-specific factors like obesity.
Objective: The objective of the review was to describe the impact of various weight-based dosing regimens
on the pharmacokinetics parameters, efficacy, safety, and cost of IVIG and to choose the best dosing
approach for obese patients.
Methods and Results: Thirteen of the total 128 manuscripts collected, reviewed, and analyzed were
found from Scopus, PubMed, and Google scholar.
Discussion: The evidence suggests that obesity may have an impact on IVIG pharmacokinetics, safety,
and efficacy.
Conclusion: The logical approach is to initial the dose based on the ideal or adjusted body weight and
then modify the maintenance dose according to the patient's clinical response.
