Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Shortage of human intravenous immunoglobulin—reasons and possible solutions

Nature Clinical Practice Neurology volume 3, pages 120–121 (2007)Cite this article

A Corrigendum to this article was published on 01 July 2008

Intravenous immunoglobulin (IVIg) is a therapeutic preparation of normal human polyclonal IgG obtained by pooling plasma from a large number of healthy blood donors. Initially used as replacement therapy in primary and secondary immune deficiencies, IVIg is also widely used for the treatment of a number of autoimmune and systemic inflammatory diseases, including many that affect the nervous system, such as Guillain–Barré syndrome and multifocal motor neuropathy.1 IVIg has become the main plasma product on the global market: its worldwide consumption nearly tripled in the period 1992–2004, from 19.4 to 55 tons/year, corresponding to a plasma supply of over 12 million liters.2,3 Presently, the consumption of IVIg is increasing at an annual rate of 5% in Europe and 11% in the US.

In recent years, we have witnessed an alarming shortage of IVIg, first encountered during the late 1990s, with demand exceeding supply by about 20% in 1997 and by 30% in 1998.2 There are several reasons for this shortage, some of them related to the rationale for therapeutic usage of the preparation. In addition to its increasing use in diseases in which clinical benefit has been well established through randomized trials, IVIg is also used in an off-label manner for nearly 100 conditions, including chronic neuropathies. Off-label use accounts for an estimated 50–70% of the current consumption of IVIg.4

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Kazatchkine MD and Kaveri SV (2001) Immunomodulation of autoimmune and inflammatory diseases with intravenous immune globulin. N Engl J Med 345: 747–755

    Article  CAS  Google Scholar 

  2. Pendergrast JM et al. (2005) Changes in intravenous immunoglobulin prescribing patterns during a period of severe product shortages, 1995–2000. Vox Sang 89: 150–160

    Article  CAS  Google Scholar 

  3. Buchacher A and Iberer G (2006) Purification of intravenous immunoglobulin G from human plasma: aspects of yield and virus safety. Biotechnol J 1: 148–163

    Article  CAS  Google Scholar 

  4. Darabi K et al. (2006) Current usage of intravenous immune globulin and the rationale behind it: the Massachusetts General Hospital data and a review of the literature. Transfusion 46: 741–753

    Article  CAS  Google Scholar 

  5. Lebing W et al. (2003) Properties of a new intravenous immunoglobulin (IGIV-C, 10%) produced by virus inactivation with caprylate and column chromatography. Vox Sang 84: 193–201

    Article  CAS  Google Scholar 

  6. Ahmed AR et al. (2006) Treatment of pemphigus vulgaris with rituximab and intravenous immune globulin. N Engl J Med 355: 1772–1779

    Article  CAS  Google Scholar 

  7. Vassilev T et al. (1999) Normal human immunoglobulin suppresses experimental myasthenia gravis in SCID mice. Eur J Immunol 29: 2436–2442

    Article  CAS  Google Scholar 

  8. Debre M et al. (1993) Infusion of Fc gamma fragments for treatment of children with acute immune thrombocytopenic purpura. Lancet 342: 945–949

    Article  CAS  Google Scholar 

  9. Kaneko Y et al. (2006) Anti-inflammatory activity of immunoglobulin G resulting from Fc sialylation. Science 313: 670–673

    Article  CAS  Google Scholar 

  10. Siragam V et al. (2005) Can antibodies with specificity for soluble antigens mimic the therapeutic effects of intravenous IgG in the treatment of autoimmune disease? J Clin Invest 115: 155–160

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by Institut National de la Santé et de la Recherche Médicale (INSERM) and Centre National de la Recherche Scientifique (CNRS), France.

Author information

Authors and Affiliations

  1. J Bayry is a scientist at the Institut National de la Santé et de la Recherche Médicale (INSERM), MD Kazatchkine is Professor of Immunology at the Université René Descartes, and SV Kaveri is Director of Research with the Centre National de la Recherche Scientifique (CNRS).,

    Jagadeesh Bayry, Michel D Kazatchkine & Srini V Kaveri

Authors
  1. Jagadeesh Bayry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michel D Kazatchkine
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Srini V Kaveri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jagadeesh Bayry.

Ethics declarations

Competing interests

The authors have received financial support from Laboratoire Français du Fractionnement et des Biotechnologies, France; Octapharma, Austria; Talecris, USA; and ZLB Behring, Switzerland for their research activities at INSERM Unité 681.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bayry, J., Kazatchkine, M. & Kaveri, S. Shortage of human intravenous immunoglobulin—reasons and possible solutions. Nat Rev Neurol 3, 120–121 (2007). https://doi.org/10.1038/ncpneuro0429

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpneuro0429

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing