What is IVIG, when will it be prescribed, and how does it work?

What is IVIG? When will it be prescribed and how does it work?

So intravenous immunoglobulin is a pooled donor antibody which is manufactured and is available in the intravenous form. And so it goes as an I.V. drip and it can be dosed as once monthly in patients in whom we feel the risk of infection is high, or if they have manifested with severe infections like pneumonias requiring hospital admission. And so IVIG essentially provides already preformed healthy immunoglobulin G antibodies that are collected from sort of herd immunity from the wide spectrum of donors and help patients overcome severe bacterial infections.

We give people the recommendation to consider intravenous gamma globulin.  What that is, it's essentially antibodies collected from multiple donors and given usually on a monthly basis. These are primarily IgG antibodies. And the recommendations expert opinion is to consider giving that to people who have low levels of IgG. But I think one of the things that we're still lacking, in my opinion, is very solid evidence about how helpful this is. There have not been randomized studies, for example, saying, “This group of people gets IVIG and this does not.” I think because of concerns of infection, many people who've received CAR-T transplants have been asked to receive that. Part of the reason I think it is given out is in terms of any negative effects, I don't think we're really aware of any except potentially a reaction maybe the first time you have it, but otherwise it needs to be studied.