Immunoglobulin Therapy

Immunoglobulin treatment 

Information provided on this page is intended to assist patients, carers and health professionals to understand how therapeutic decisions about Immunoglobulin (Ig) are made and to manage Ig treatment. Some of the resources provided below were developed by NPS MedicineWise before it ceased operations in late 2022. The information remains current, and the NBA will update the resources as necessary. 

Information for patients and carers

Immunoglobulins (also known as antibodies) play a vital role in the immune system. Immunoglobulins only occur naturally and cannot be made using synthetic chemicals. Ig products are made from immunoglobulins from plasma donated by healthy volunteers.

Ig products are necessary for people whose immune systems don’t make enough of them or make ones that don’t work effectively. They are also important for the management of some autoimmune and inflammatory conditions where the immune system mistakenly attacks normal cells.

In Australia, government-funded Ig products are restricted to conditions where:

• use is supported by scientific and clinical evidence, and
• other treatments are less effective or can’t be used.

This is because there is a limited supply of Ig products and are expensive to manufacture. Careful management is needed to ensure that there is an adequate, secure and affordable supply of Ig products for Australians who need them. 

To ensure treatments go to those most likely to benefit, we manage access to Ig through a governance framework. The conditions and circumstances under which government-funded Ig products can be considered for use are set out in Criteria for the clinical use of intravenous immunoglobulin in Australia (the Criteria). 

The following materials may help you to understand and manage your Ig treatment.

• Choosing wisely – Immunoglobulin products fact sheet
  This factsheet contains helpful information about immunoglobulin products and a list of five important questions to ask your doctor if you or someone you care for has been prescribed one of these products.

• Immunoglobulin products in Australia: Information about access and consent fact sheet
  Immunoglobulin products are a precious resource. This fact sheet outlines the careful management process required to ensure adequate and affordable supply of immunoglobulin products to Australians who need them. This fact sheet also provides helpful information on the types of consent you should provide during your treatment with immunoglobulin products.

• Switching immunoglobulin products – What should I know? What can I do information sheet
  Find out more about why product changes sometimes occur, what you can expect when you change products (and why), and what you can do to prepare if you are asked to change.

• Immunoglobulin Treatment and wellbeing management plan 
  This fillable plan allows you to keep track of your appointments, treatment and condition.

• Intravenous Immunoglobulin therapy in myasthenia gravis fact sheet 
  This fact sheet explains how immunoglobulin products can be used to treat myasthenia gravis, to help you make informed decisions about the care that is right for you.

• Immunoglobulin products for CIDP (chronic inflammatory demyelinating polyradiculoneuropathy, also known as chronic inflammatory demyelinating polyneuropathy) fact sheet 
  This fact sheet explains how immunoglobulin products can be used to treat CIDP, to help you make informed decisions about the care that is right for you.

• Sharps Disposal information sheet
  This information sheet provides direct links in each state and territory within Australia to assist you and your support network with up-to-date information. This resource clarifies what a sharp is, how to safety dispose of used sharps and where across Australia this can be done. 

Support materials for patients using Subcutaneous Immunoglobulin (SCIg)

A range of materials have been developed for healthcare providers supporting patients using SCIg. They are available here.

Videos

• Video 1: About immunoglobulins 
  In this short video, Professor John Ziegler, Immunologist, introduces immunoglobulins and describes how immunoglobulin products are used for the treatment of immune-related conditions. You will learn about the conditions that immunoglobulin products can treat, how immunoglobulin products are made, their safety, and why they need to be carefully managed. 
   
• Video 2: Immunoglobulins and me: Catherine
  In this video, Catherine, a working mother with three children, talks about her diagnosis with an immune deficiency disorder, the treatment she receives with intravenous immunoglobulin products, and how her treatment helps her live a full, productive and active life.  
   
• Video 3: Immunoglobulins and me: Cheryl
  In this video, Cheryl talks about her diagnosis with an immune deficiency disorder after suffering infections since childhood, how she worked with her specialist to find the right treatment for her, and how she treats herself at home with immunoglobulin products.

Patient Support Organisations

Australasian Society of Clinical Immunology and Allergy

https://www.allergy.org.au/(Opens in a new tab/window)

Australasian Society of Clinical Immunology and Allergy (ASCIA) was established in 1990 as the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA's purpose is to advance the science and practice of allergy and clinical immunology. This is achieved by promoting the highest standard of medical practice, training, education and research, to improve the quality of life and health of people with immune system disorders. These include allergic conditions, immune deficiencies and other immune diseases. 

ASCIA has developed a range of resources for patients and carers about Inborn errors of immunity (IEI), a group of more than 480 potentially serious chronic medical conditions. The resources include specific information about immunoglobulins and the conditions that require this treatment.

ASCIA has also developed a range of health professional resources about IEI which are available open access at https://www.allergy.org.au/hp/papers/immunodeficiency(Opens in a new tab/window)

ASCIA Immunoglobulin Replacement Therapy (IRT) and Subcutaneous Immunoglobulin (SCIg) information is also available from this website. 

Australia Primary Immunodeficiency Patient Support 

https://www.auspips.org.au/index(Opens in a new tab/window)

Australia Primary Immunodeficiency Patient Support (AusPIPS) Inc. is a collective of people who have Inborn Errors of Immunity (IEI) diagnosis along with parents of children who have had the same. AusPIPS also has supporters who have no personal connection to IEI.

AusPIPS Inc. formed to meet a very clear need in Australia — for a patient-led organisation to be able to provide advocacy, support and education for people who have an IEI diagnosis and secondary chronic medical conditions, along with their carers. 

The AusPIPS committee is patient led, and patient focused. There are resources available to assist with empowering individuals to make health choices that best suit their needs. The website also provides an opportunity for people to connect with others who are in similar situations. This connection allows for sharing and support to assist with the difficulties of living with a chronic condition.

AusPIPS, in collaboration with IDFA, Myasthenia alliance and myeloma have developed a patient-centred brochure explaining the uses of immunoglobulin replacement therapy and tips for new and existing patients receiving this important treatment. This brochure is available in multiple different languages including an AUSLAN video format.

Immune Deficiencies Foundation Australia 

Immune Deficiencies Foundation Australia(Opens in a new tab/window) 

https://www.idfa.org.au/

Immune Deficiencies Foundation Australia (IDFA) is a national not-for-profit and leading peak body offering education, advocacy and awareness for Australians living with an Inborn Errors of Immunity (IEI) and Secondary Immunodeficiency (SID). In conjunction with our community-focused model of care, IDFA assists in achieving improved patient outcomes and quality of life. IDFA’s vision is “A future where primary and secondary immunodeficiency are diagnosed and treated early, with affected people supported by clinicians, community and government to enable optimal quality of life”. With the support of a medical advisory panel and through national and international relationships, IDFA is a respected organisation within the medical and patient community.

Information for health professionals

• Immunoglobulin dose adjustment, weaning and cessation. A conversation guide for health professionals
  It is common for patients to feel reluctant to make changes to their treatment. This conversation guide supports clinician-led discussions around changes to immunoglobulin treatment plans.

• Immunoglobulin products: When to reduce or stop treatment
  This action plan informs and empowers patients to participate in changes to their treatment.

The NBA funds BloodSafe eLearning Australia's courses on behalf of all Australian governments. BloodSafe eLearning Australia's immunoglobulin focused courses include:

• Immunoglobulin: Essentials
• Immunoglobulin: Governance and access
• Immunoglobulin: Prescribing
• Immunoglobulin: Administration
• Immunoglobulin: Adverse events.

The courses are aimed at healthcare staff involved with the prescription, administration and reporting of immunoglobulin product use, including:

• specialists who prescribe immunoglobulin
• medical officers who are responsible for seeking authorisation for patient access to government-funded immunoglobulin
• laboratory and pharmacy staff who store and dispense immunoglobulin products
• nurses and midwives responsible for ordering immunoglobulin product from the laboratory or pharmacy and administering treatment to patients.

BloodSafe eLearning Australia has developed these courses in conjunction with a multidisciplinary group of expert clinicians. The courses are free and provide guidance on implementing the National Safety and Quality Health Service Blood Management Standard(Opens in a new tab/window)

Explore BloodSafe eLearning's immunoglobulin education courses(Opens in a new tab/window).

Immunology

• How I treat primary immunodeficiency 
  Three hypothetical scenarios in which patients present with Inborn Errors of Immunity (IEI) highlight the complexities of treating patients with immunological conditions.

• Immunoglobulin replacement therapy for primary immunodeficiencies. Clinical guidance article
  An up-to-date evidence summary on access to immunoglobulin, approved indications and diagnostic challenges among patients with Inborn Errors of Immunity (IEI).

• Immunoglobulin replacement therapy for primary immunodeficiency: recommendations for moving from paediatric to adult care
  This fact sheet highlights important considerations for patients preparing to transition from paediatric to adult care. 

• Immunoglobulin replacement therapy for primary immunodeficiencies 
  This fact sheet explains how immunoglobulin products can be used to treat Inborn Errors of Immunity (IEI).

Haematology

• How I treat acquired hypogammaglobulinaemia
  A series of hypothetical case studies developed by leading clinical experts to assist physicians and trainees gain a broader understanding of clinical diagnoses, treatments and outcomes.

• Immunoglobulin replacement therapy for acquired hypogammaglobulinaemia secondary to haematological malignancies and stem cell transplantation. Clinical guidance article
  A contemporary evidence summary written by leading clinical experts on access to immunoglobulin, including approved indications, route of administration and optimising dosage, for patients with hypogammaglobulinaemia secondary to haematological malignancies and stem cell transplantation.

• Immunoglobulin replacement therapy for secondary hypogammaglobulinaemia 
  This fact sheet explains how immunoglobulin products can be used to treat Inborn Errors of Immunity (IEI). 

Neurology

• How I treat Myasthenia Gravis tailoring treatment and examining the options
  Five hypothetical case studies in which patients present with Myasthenia Gravis How would you progress their care?

• Myasthenia Gravis and immunoglobulin therapy. Clinical guidance article 
  Written by a team of leading neurologists, this article provides the foundations and evidence for prescribing immunoglobulin to patients with Myasthenia Gravis in Australia.

• How I treat Chronic Inflammatory Demyelinating Polyradiculoneuropathy
  Three hypothetical case studies in which patients present with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), or conditions easily mistaken for CIDP. How would you progress their care?

• Diagnosing and treating Chronic Inflammatory Demyelinating Polyradiculoneuropathy with immunoglobulin. Indications, advice, and evidence. Clinical guidance article
  Written by a team of leading neurologists, this article provides the foundations and evidence for prescribing immunoglobulin to patients with CIDP in Australia.