The European Society for Immunodeficiencies
Management of Secondary Immune Deficiencies & The Potential Use of Immunoglobulin in Fighting COVID-19
Octapharma is proud to support the ESID 2020 online meeting. As a silver sponsor, we offer a virtual webinar on the management of secondary immunodeficiency in haematological, neurological and rheumatic diseases, and on the potential use of immunoglobulin in the treatment of COVID-19. An oral abstract presentation about an international Delphi consensus in patient assessment and the use of IgG therapy in patients with haematological malignancies and secondary immune deficiency (SID) is also presented during the congress.
Welcome and Introduction
Chair: Carlo Agostini, University of Padua, Italy
Recommendations and Consensus for the Use of IgG Therapy in Patients with Haematological Malignancies and Secondary Immune Deficiency
Stephen Jolles, University Hospital of Wales, UK
This talk describes the background to the growth in secondary antibody deficiency in the context of haematological malignancies (HM) and aims to offer practical guidance for the treatment of secondary immunodeficiencies (SID) in HM, extending and refining the EMA guidance. This involved a Delphi process with 32 experts in Haemato-Oncology and Immunology who reviewed infection definitions and therapy and monitoring practice. Definitions for severe, recurrent and persistent infection were agreed and consensus was achieved across 18 of 20 statements covering five areas of practice in SID in HM – IgG measurement, Initiation and discontinuation of immunoglobulin replacement therapy (IgRT), IgG dosing and the use of SCIg.
Secondary Immune Deficiency Following Immune Therapy in Neurological Disorders
Mark Stettner, University Clinic Essen, Germany
Secondary immunodeficiencies (SID) are acquired conditions that may occur as sequelae of immune therapy. In neurology, over the past decade, a handful of novel disease modifying therapies (DMTs) has been incorporated into the armamentarium for multiple sclerosis, such as monoclonal antibodies for B-cell depletion, which was recently approved. Beside this, B-cell therapy is commonly used as off-label therapy in conditions such as chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, and myositis, encephalitis.
The talk focuses on B-cell therapy in neurology and the risk developing SID. Findings from clinical trials as well as long-term observational studies related to the patients’ immune status and risks of severe infections are taken into consideration and therapeutic strategies for SID are discussed.
Iatrogenic secondary Immune Deficiency in Rheumatic and Musculoskeletal Diseases (RMDs)
Sinisa Savic, University Hospital Leeds, UK
This talk discusses the link between the immunosuppressive therapies for rheumatic diseases and the risks for development of severe infections and secondary immunodeficiencies. The focus is on B-cell targeted treatments. It is known that such treatments when used in patients with pre-existing hypogammaglobulinaemia can lead to a higher incidence of serious infections. Dr Savic presents the data from a large retrospective study which analyzed predictors for developing severe infections and hypogammglobulinaemia in a cohort of rheumatological patients treated with rituximab. Data is presented on the use of immunoglobulin replacement therapy as an effective way of reducing the frequency and severity of the infections.
Is There a Benefit Using Immunoglobulin Treatment in COVID-19 Illness?
George Sakoulas, University of California San Diego, USA
Dysregulated neutrophil and platelet interactions mediate microvascular immunothrombosis and may cause lung and other organ injury in COVID-19. Intravenous immunoglobulin (IVIG) may modulate neutrophil activation and vascular injury through FcγRIIb binding. Patients with COVID-19 pneumonia and an A-a gradient of >200 mmHg who received IVIG group showed a significantly lower rate of progression to mechanical ventilation, shorter hospital stays, shorter ICU stays, and greater improvement in PaO2/FiO2 at 7 days than standard of care controls in an open-label prospective randomized trial. A Phase 3 multicenter randomized double-blinded clinical trial is under way to further validate these findings.
This symposium is available to healthcare professionals only.