Evidence map›Paper›PMID 30072997›Full record

ArticleFrontiers in immunology2018

Is It Safe to Switch From Intravenous Immunoglobulin to Subcutaneous Immunoglobulin in Patients With Common Variable Immunodeficiency and Autoimmune Thrombocytopenia?

Philipp Scheuerlein, Larissa Pietsch, Nadezhda Camacho-Ordonez, Veronika Reiser, Smita Patel, Siobhan O Burns, Klaus Warnatz, Bodo Grimbacher

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Common variable immune deficiency: case studies.Hematology. American Society of Hematology. Education Program · 2019
    Article
  7. Review
  8. Autoimmunity in common variable immunodeficiency.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2019
    Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Philipp ScheuerleinCenter for Chronic Immunodeficiency, University Hospital, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
Larissa PietschCenter for Chronic Immunodeficiency, University Hospital, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
Nadezhda Camacho-OrdonezCenter for Chronic Immunodeficiency, University Hospital, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
Veronika ReiserInstitute for Medical Biometry and Statistics, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
Smita PatelDepartment of Clinical Immunology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
Siobhan O BurnsDepartment of Immunology, Royal Free Hospital, Institute of Immunity and Transplantation, University College London, London, United Kingdom.
Klaus WarnatzCenter for Chronic Immunodeficiency, University Hospital, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
Bodo GrimbacherCenter for Chronic Immunodeficiency, University Hospital, Medical Faculty, Albert-Ludwigs University, Freiburg, Germany.
University Medical Center Freiburg · DEJohn Radcliffe Hospital · GBThe Royal Free Hospital · GBUniversity College London · GBUniversity of Freiburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA significant amount of common variable immunodeficiency (CVID) patients manifest with autoimmunity. Particularly, autoimmune thrombocytopenia (AITP) is commonly seen. Intravenous immunoglobulins (IVIG) are an established treatment option for both, CVID and AITP. Nonetheless, due to fewer systemic side effects, immunoglobulins are increasingly applied subcutaneously (SCIG).

objectiveTo compare the efficacy and safety of IVIG and SCIG treatment in patients with both CVID and clinical relevant thrombocytopenia in the prevention of AITP bouts.

methodsPatients with both CVID and AITP were enrolled at the Centre for Chronic Immunodeficiency in Freiburg, Germany and at the Royal Free Hospital, London, UK. Clinical and laboratory features of patients were collected and analyzed.

resultsThis retrospective study recruited 61 adult patients between 19 and 71 years of age who had a diagnosis of CVID and at least one bout of thrombocytopenia defined as a platelet count of <50,000/μl if bleeding episodes occurred, or a platelet count of <20,000/μl without bleeding. Thirty patients received immunoglobulin through IVIG, and 31 patients were on SCIG replacement. One patient of the IVIG-group was excluded, because of a diffuse large B-cell lymphoma. We did not find a higher occurrence of thrombocytopenic events in CVID patients who received SCIG, compared to CVID patients who had IVIG, but we identified a low IgG through level as a risk factor for AITP bouts.

conclusionSCIG is at least as safe as IVIG for patients with CVID and concomitant AITP. However, an IgG through level under 7 g/l is a key factor for the development of AITP.

Indexed as

autoimmune thrombocytopeniacommon variable immunodeficiencyimmunoglobulin replacement therapyintravenous immunoglobulinsubcutaneous immunoglobulin

Identifiers

PMID30072997
PMCPMC6060403
OpenAlexW2881034373

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.