Immunology

, ,

Autoimmune Disorders and Primary Immunodeficiencies: Exploring the Differences and Connections

, ,

Though autoimmune disorders and primary immunodeficiency diseases (PIDD) are both conditions that involve the immune system, they represent very different states of immune function. While autoimmune disorders are characterized by an overactive immune system that attacks the body's own healthy cells, PIDD are marked by an underactive or dysfunctional immune system that leaves the body vulnerable to infections.

Autoimmune disorders occur when the immune system mistakenly identifies the body's own tissues as foreign invaders and mounts an attack against them. This can lead to a wide range of autoimmune diseases, such as type 1 diabetes, rheumatoid arthritis, lupus, and inflammatory bowel diseases. The exact causes of autoimmunity are not fully understood, but they are believed to involve a combination of genetic and environmental factors, including infections, exposure to chemicals or toxins, and chronic stress.

In contrast, PIDD are a group of over 350 rare, genetic disorders that result from defects in the development or function of the immune system. These defects can lead to an increased susceptibility to infections, as well as an increased risk of autoimmune disorders. Some of the most common PIDD include common variable immunodeficiency (CVID), selective IgA deficiency, and severe combined immunodeficiency (SCID).

While autoimmune disorders and PIDD may seem like opposite ends of the spectrum, they can actually be closely linked. In fact, autoimmune manifestations are observed with considerable frequency in patients with certain types of PIDD, particularly those involving primary antibody deficiencies like CVID and selective IgA deficiency. The underlying mechanisms behind this association are complex and not fully understood, but they likely involve a combination of factors, such as impaired B cell differentiation, altered T cell tolerance, and dysregulation of the innate immune system.

Interestingly, the presence of autoimmunity can sometimes be the first sign of an underlying PIDD, and early recognition and treatment of these symptoms is critical for optimizing the patient's quality of life and reducing complications. Maintaining the delicate balance between the immunosuppression needed to control the autoimmune process and the need to avoid further compromising the already weakened immune system in PIDD can be a significant challenge, requiring close collaboration between the patient, their caregivers, and their healthcare providers.

By continuing to explore the underlying mechanisms and genetic factors that link autoimmunity and immunodeficiency, researchers and clinicians can work towards developing more targeted and effective therapies for patients affected by these complex and often intertwined conditions.

How BioMatrix Can Help

We provide specialty infusion pharmacy and support services for patients with autoimmune disorders and primary immunodeficiency diseases (PIDD). Our immunology program includes a full line of specialty medications used to treat immune deficiencies, including Immune Globulin (IG) which has become the standard treatment option in practices throughout the U.S. 

BioMatrix helps manage the individual needs of patients requiring IG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

As a specialty infusion pharmacy, our clinical teams have extensive training and experience in rare diseases, infusion therapies, and complex medical conditions. Our nursing staff coordinates with pharmacists, healthcare providers, and other caregivers ensuring the best treatment outcomes possible.

Learn more about our individualized specialty pharmacy services for patients with CIDP and other neurological conditions.

Insurance Appeal Letter Sample & Template

Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. Rosenblum, M. D., Remedios, K. A., & Abbas, A. K. (2015). Mechanisms of human autoimmunity. The Journal of Clinical Investigation, 125(6), 2228-2233.

  2. Bonilla, F. A., Khan, D. A., Ballas, Z. K., Chinen, J., Frank, M. M., Hsu, J. T., ... & Shearer, W. T. (2015). Practice parameter for the diagnosis and management of primary immunodeficiency. The Journal of Allergy and Clinical Immunology, 136(5), 1186-1205.

  3. Cunningham-Rundles, C. (2008). The many faces of common variable immunodeficiency. Hematology, 2008(1), 1-14.

Read More

, ,

Common Variable Immune Deficiency (CVID): Signs, Symptoms, and Treatment Options

, ,

Common variable immune deficiency (CVID) is one of the most frequently diagnosed primary immunodeficiencies—meaning the immune system has low levels of antibodies that help fight infections. Those with CVID often develop recurring infection in the lungs, sinuses, and ears. The exact cause of CVID is unknown, though genetic defects may play a role.1

It’s important to note that CVID is not an autoimmune disorder. Autoimmune disorders occur when your immune system can’t tell the difference between foreign cells (like bacteria and viruses) and your own cells. Because of this, your immune system will attack healthy cells in your body in addition to unhealthy foreign cells. CVID, on the other hand, occurs when your body has existing low levels of antibodies.

Signs and Symptoms

People with CVID experience frequent and often severe infections, primarily affecting the respiratory system, ears, and sinuses. The most common types of infections include pneumonia, sinusitis, ear infections, and gastrointestinal infections. These recurrent infections can lead to permanent damage to the respiratory tract, known as bronchiectasis.2,3

In addition to frequent infections, CVID can also be associated with a variety of other health issues. Even though CVID is not an autoimmune disorder, some individuals with CVID can develop autoimmune disorders that affect their blood cells, causing low numbers of white cells or platelets, anemia, arthritis, and other conditions. Gastrointestinal problems, such as chronic diarrhea, weight loss, nausea, vomiting, and abdominal pain, can also occur. In some cases, patients with CVID develop granulomas (small nodules) in the lungs, lymph nodes, liver, skin, or other organs. CVID also increases the risk of certain cancers—primarily lymphoid and gastrointestinal cancers.3

Diagnosis

To diagnose CVID, healthcare providers will typically order blood tests to measure immunoglobulin levels and evaluate the function of the immune system. If CVID is suspected, further testing may be done to rule out other potential causes of the symptoms.

Treatment

CVID is typically treated with immunoglobulin (IG) (subcutaneous) infusions—especially for those with substantial decreased IG production and nonresponse to both protein and polysaccharide vaccines.4 The IG therapy provides antibodies from the blood of healthy donors. Other problems caused by CVID, like bacterial infections, may require additional, tailored treatments.5

Helpful Resources

The Immune Deficiency Foundation provides support and resources for CVID patients and their families. Some of these resources include: 

  • Articles, videos, podcasts, and more to help deepen your understanding of CVID and other primary immunodeficiencies

  • Peer and group support

  • Opportunities for advocacy and volunteering

Summary

In summary, common variable immune deficiency (CVID) is a complex and challenging condition that requires ongoing medical care and management. While there is no cure, with proper treatment and management, many people with the condition are able to live active and fulfilling lives. By understanding the signs, symptoms, and available treatment options, individuals with CVID can take steps to improve their overall health and quality of life.

How BioMatrix Can Help

Though a CVID diagnosis can feel overwhelming for you or a loved one, it’s important to know that you are not alone. Organizations like the Immune Deficiency Foundation mentioned above can provide a wealth of information and support as well as connect you to others in the community who have experienced the same diagnosis. In addition, your specialty pharmacy can offer individualized support to help manage treatment.

BioMatrix helps manage the individual needs of patients requiring IG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

As a specialty infusion pharmacy, our clinical teams have extensive training and experience in rare diseases, infusion therapies, and complex medical conditions. Our nursing staff coordinates with pharmacists, healthcare providers, and other caregivers ensuring the best treatment outcomes possible.

Learn more about our individualized specialty pharmacy services for patients with CVID and other primary immunodeficiency diseases.

Financial Resource Guide

Living with a chronic condition can create additional healthcare costs while also impeding one’s ability to work. Our financial resource guide can help. 

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

1. (Updated 2023 May 8). Pescador Ruschel MA, Vaqar S. Common Variable Immunodeficiency. . In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549787/

2. (2024, March 5). Common variable immunodeficiency - Symptoms and causes - Mayo Clinic. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/common-variable-immunodeficiency/symptoms-causes/syc-20355821

3. Common variable immune deficiency (CVID) | Immune Deficiency Foundation. (n.d.). https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/common-variable-immune-deficiency-cvid#:~:text=The%20usual%20presenting%20features%20of,condition%20termed%20bronchiectasis%2C%20may%20develop.

4. Cunningham-Rundles C. Treatment and Prognosis of Common Variable Immunodeficiency. https://www.uptodate.com/contents/treatment-and-prognosis-of-common-variable-immunodeficiency

5. (2019). Common Variable Immunodeficiency (CVID). National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/common-variable-immunodeficiency-cvid

Read More

, , ,

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): Signs, Symptoms, and Treatment Options

, , ,

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare autoimmune disorder affecting the peripheral nervous system (where your brain controls all of your muscles and nerves that allow you to move and feel). With CIDP, the body's immune system mistakenly attacks the protective covering of peripheral nerves (the myelin sheath), leading to nerve inflammation and damage.1,2

This makes it hard for nerves to work properly, causing weakness, numbness, and sensory disturbances. While it shares some similarities with Guillain-Barré Syndrome (GBS), CIDP is characterized by a more gradual onset and is therefore considered chronic.3 Here we’ll discuss CIDP signs, symptoms, treatment options, and helpful resources.

Signs and Symptoms

Though signs and symptoms of CIDP can vary widely among people, when someone has CIDP, they might start to feel weak in their muscles—especially in their legs and arms. It's like their body is running out of energy. They might also feel tingling or numbness in their arms and legs, as well as cramping. Sometimes, they might even have trouble keeping their balance or feel tired all the time. These feelings can be uncomfortable and also painful.4

Diagnosis

Finding out if someone has CIDP isn't always easy because it can look like other nerve conditions. A thorough medical history, neurological examination, and diagnostic tests such as nerve conduction studies and electromyography (EMG) are essential for an accurate diagnosis.5 Additionally, cerebrospinal fluid analysis and nerve biopsies may be performed to rule out other conditions.

Treatment Options

Although there is no cure for CIDP, various treatment options can help manage symptoms, slow disease progression, and help people keep doing the things they love. Common treatments include:6,7,8,9,10

  • Intravenous Immunoglobulin (IVIG) Therapy: Healthy antibodies from donors are given to patients through infusions to help suppress the overactive immune response and lower inflammation. This reduces symptoms for many patients.

  • Corticosteroids: High-dose corticosteroids such as prednisone may be prescribed to suppress inflammation and alleviate symptoms, particularly during flare-ups.

  • Plasma Exchange (Plasmapheresis): This procedure involves removing and replacing plasma to remove harmful antibodies and inflammatory factors from the bloodstream, providing temporary relief from CIDP symptoms.

  • Immunosuppressive Medications: Drugs like azathioprine, cyclophosphamide, or rituximab may be prescribed to dampen the immune system's activity and reduce inflammation, particularly in individuals who do not respond to other treatments.

  • Physical Therapy: Rehabilitation exercises and physical therapy play a crucial role in managing CIDP, helping to improve muscle strength, flexibility, and mobility and reducing the risk of complications such as falls and injuries.

Helpful Resources

The GBS/CIDP Foundation International provides support and resources for CIDP patients and their families. Some of these resources include: 

  • Local community groups and chapter meetings

Summary

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a rare but debilitating autoimmune disorder affecting the peripheral nervous system. While there is no cure for CIDP, by knowing what to look for and getting the right treatment, people with CIDP can keep living their lives and doing the things they love. Through ongoing research and advancements in medical care, there is hope for better outcomes and increased understanding of this complex condition.

How BioMatrix Can Help

Though a CIDP diagnosis can feel overwhelming for you or a loved one, it’s important to know that you are not alone. Organizations like GBS/CIDP Foundation International mentioned above can provide a wealth of information and support as well as connect you to others in the community who have experienced the same diagnosis. In addition, your specialty pharmacy can offer individualized support to help manage treatment.

BioMatrix helps manage the individual needs of patients requiring IVIG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

As a specialty infusion pharmacy, our clinical teams have extensive training and experience in rare diseases, infusion therapies, and complex medical conditions. Our nursing staff coordinates with pharmacists, healthcare providers, and other caregivers ensuring the best treatment outcomes possible.

Learn more about our individualized specialty pharmacy services for patients with CIDP and other neurological conditions.

Insurance Appeal Letter Sample & Template

Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. National Institute of Neurological Disorders and Stroke. (2019). Chronic Inflammatory Demyelinating Polyneuropathy Information Page. https://www.ninds.nih.gov/Disorders/All-Disorders/Chronic-Inflammatory-Demyelinating-Polyneuropathy-Information-Page

  2. Dalakas, M. C. (2014). Advances in the diagnosis, pathogenesis and treatment of CIDP. Nature Reviews Neurology, 10(3), 160-171.

  3. Markey, K. A., et al. (2018). CIDP and variants as a disease continuum: Evidence from nerve histology. Neurology, 90(13), e1157-e1166.

  4. Gorson, K. C. (2014). An update on the management of chronic inflammatory demyelinating polyneuropathy. Therapeutic Advances in Neurological Disorders, 7(5), 227-237.

  5. Van den Bergh, P. Y., et al. (2010). European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society–first revision. European Journal of Neurology, 17(3), 356-363.

  6. Hughes, R. A., et al. (2006). Intravenous immunoglobulin (IVIg) for CIDP and related disorders. Cochrane Database of Systematic Reviews, 2, CD002062.

  7. Gorson, K. C. (2010). An update on the management of chronic inflammatory demyelinating polyneuropathy. Therapeutic Advances in Neurological Disorders, 3(5), 249-258.

  8. Léger, J. M., et al. (2011). Plasmapheresis in chronic inflammatory demyelinating polyneuropathy: A randomized, double-blind, sham-controlled study. Brain, 134(7), 1889-1899.

  9. Mahdi-Rogers, M., & Hughes, R. A. (2017). Immunosuppressive agents for chronic inflammatory demyelinating polyradiculoneuropathy. Cochrane Database of Systematic Reviews, 8, CD003557.

  10. Latov, N., et al. (2010). Peripheral neuropathy: Diagnosis and management. Cambridge University Press.

Read More

, ,

Neonatal Alloimmune Thrombocytopenia (NAIT): Signs, Symptoms, and Treatment Options

, ,
A pregnant person holds a mug of tea on their belly and is wearing a shawl

Neonatal alloimmune thrombocytopenia (NAIT) is a rare but serious condition that affects newborns, with an incidence of one in 1,000 to 1,500 live births.1 NAIT occurs when the mother's immune system forms antibodies against fetal platelets. These antibodies cross the placenta and destroy the baby's platelets, leading to thrombocytopenia (a low platelet count).

Signs and Symptoms

Signs and symptoms of NAIT in newborns can range from no symptoms to severe bleeding. Common signs include petechiae (small red or purple spots on the skin), purpura (larger areas of bleeding under the skin), and bruising. The most feared complication is intracerebral hemorrhage (ICH), which can occur in utero or after birth and can lead to long-term neurological damage or death.1,2,3

Diagnosis

A diagnosis of NAIT should be considered in any newborn with unexplained thrombocytopenia. Confirming the diagnosis involves detecting maternal antibodies against specific platelet antigens and matching these against the antigens present on the baby's platelets.1

Prevention and Treatment

Once diagnosed, subsequent pregnancies are at risk for severe disease. Management strategies include close monitoring, the use of antenatal therapies such as intravenous immunoglobulin (IVIG) and steroids for high-risk mothers, and planning delivery where appropriate support is available.1 Treatment options for affected newborns include HPA-matched platelet transfusions and IVIG to raise the platelet count and reduce the risk of bleeding.1,4

Preventive measures are crucial, especially since the condition can recur in future pregnancies with increased severity.

The Role of Genetics

Recent studies have highlighted the impact of certain genetic factors, such as the HLA-DRB3*01:01 allele, on the risk of alloimmunization and severe neonatal thrombocytopenia. Mothers with this allele have a higher risk of having children with severe NAIT.2

Long-term Outlook

The long-term prognosis for infants with NAIT varies. While many recover with appropriate treatment, some may experience developmental delays or other long-term effects from ICH. Follow-up studies are essential for monitoring the neurodevelopmental outcomes of these children.1

How BioMatrix Can Help

Though a NAIT diagnosis can feel overwhelming, it’s important to know that you are not alone. BioMatrix helps manage the individual needs of patients requiring IVIG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of symptoms.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.

Learn more about our individualized specialty pharmacy services for patients with NAIT and other rare, and ultra-rare diseases.

Insurance Appeal Letter Sample & Template

Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. Mella, M. T., & Eddleman, K. (2015). Neonatal alloimmune thrombocytopenia. International Journal of Clinical Transfusion Medicine, 29. https://doi.org/10.2147/ijctm.s51926

  2. Kjeldsen‐Kragh, J., Fergusson, D., Kjær, M., Lieberman, L., Greinacher, A., Murphy, M., Bussel, J. B., Bakchoul, T., Corke, S., Bertrand, G., Oepkes, D., Baker, J. M., Hume, H., Massey, E., Kaplan, C., Callum, J., Baidya, S., Ryan, G., Savoia, H., . . . Shehata, N. (2020). Fetal/neonatal alloimmune thrombocytopenia: a systematic review of impact of HLA-DRB3*01:01 on fetal/neonatal outcome. Blood Advances, 4(14), 3368–3377. https://doi.org/10.1182/bloodadvances.2020002137

  3. Lablogatory, A. (2021, January 26). Case Study: Newborn with Thrombocytopenia and Bruising. Lablogatory. https://labmedicineblog.com/2021/01/26/case-study-newborn-with-thrombocytopenia-and-bruising/

  4. Conti, F. M., Hibner, S., Costa, T. H., Dezan, M. R., Aravechia, M. G., Pereira, R. A., Kondo, A. T., D'Amico, É. A., Mota, M., & Kutner, J. M. (2014). Successful management of neonatal alloimmune thrombocytopenia in the second pregnancy: a case report. Einstein (Sao Paulo, Brazil), 12(1), 96–99. https://doi.org/10.1590/s1679-45082014rc2729

Read More

, , , , ,

Enhancing Transplant Patient Care: The Vital Role of Qualified Home Nursing Services in Home Infusion

, , , , ,
An older white woman sits next to a smiling Asian nurse.

Home infusion therapy has transformed healthcare by allowing patients to receive treatment in the comfort of their own homes. For individuals undergoing organ transplant procedures, this plays a pivotal role in their recovery and ongoing care. Here we discuss how the success of home infusion, particularly for transplant patients, hinges significantly on the expertise and support provided by qualified home nursing services.

The Significance of Home Infusion for Transplant Patients

Transplant patients benefit from home infusion both before and after transplant. Before transplant, patients are dealing with chronic complications that have caused them to need a transplant. Getting their immune systems prepared can require timed medication therapies such as desensitization. Post-transplant, patients are at risk of infection because of immune-suppressing anti-rejection drugs and/or because they develop chronic or long-term conditions compromising their immune systems.

Hospitals and infusion centers can take every precaution available, yet in these environments patients still have the potential for exposure to bacteria or viruses they would likely not encounter in their homes. Home infusion provides a safe and effective means to help transplant patients manage their prescribed therapy. Patients can receive their medication in the secure and familiar environment of their own homes, administered by a clinically-trained infusion nurse. Benefits include safety, convenience, cost-savings, and patient well being. 

Challenges and the Need for Qualified Home Nursing Services

The complexity of post-transplant care demands meticulous attention and specialized knowledge. This is where qualified home nursing services come into play. These professionals bring a wealth of expertise providing personalized care, monitoring patients' health, administering medications, and offering vital guidance to patients and their families.

The expertise of qualified home nurses extends beyond administering medications. They serve as educators, ensuring that patients and their caregivers understand the treatment protocols, potential side effects, and the importance of adherence to prescribed regimens. Their vigilance in monitoring for any signs of complications or adverse reactions is crucial in preempting potential issues and ensuring timely interventions.

Extensive Vetting and Training

BioMatrix ensures a robust network of over 200 contracted nursing agencies nationwide, all meticulously vetted to align with Infusion Nurses Society guidelines. Similarly, individual home infusion nurses undergo a thorough assessment and preparation, including evaluations of their competency and detailed reviews of prescribed therapy. Prior to service, these nurses meet with BioMatrix nurse clinicians, ensuring a suitable match for the patient's needs. Should any nurse not meet their stringent competency standards, BioMatrix promptly reassigns the case to maintain their commitment to exceptional care.

Site-of-Care Coordination

We are well aware of how important it is for patients to avoid conflicts with work and other obligations. BioMatrix nurse clinicians aim to create plans that stay within the parameters of all protocols and instructions that their MD has ordered while causing the least possible disruption to patients' routines. When administering in-home with assistance from one of our home care nurses, our nurses work with patients and prescribers to make therapy administration as safe, convenient, and comfortable as possible. 

Safety Protocols and Clinical Interventions

All BioMatrix nurse professionals follow CDC guidelines for hygiene and germ reduction and help patients mitigate any issues to establish a safe environment for home infusion. When entering a patient’s home, the home infusion nurses follow all standard precautions and wear appropriate personal protective equipment. They also take the time to identify and review safety measures the patient can follow in the home both during and after infusion.

Following each home infusion, the home infusion nurse will submit a report to the BioMatrix clinical team to track response to therapy, monitor for adverse events, and help personalize and improve future care. By synthesizing clinical, social, and drug utilization information, our nursing team’s actionable interventions help improve health and save lives. Our interventions support patient adherence to therapy, reduce side effects, and help address both critical and every day issues related to life with a chronic health condition. 

Patient Education

We understand that starting a new therapy and navigating the treatment process can be challenging and confusing for a patient. Where appropriate, our nursing team provides self-administration training for injectable or infusible drugs, allowing patients to more independently manage their condition. Our nurses can also guide patients post administration to maintain therapy adherence, minimize or manage side effects, and answer questions that may arise throughout their treatment regimen.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. 

Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.

Watch our video here to learn more about our home infusion services.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Financial Resource Guide

Living with a chronic condition can create additional healthcare costs while also impeding one’s ability to work. Our financial resource guide can help. 

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

Read More

, ,

Idiopathic Thrombocytopenic Purpura (ITP): Signs, Symptoms, and Treatment Options

, ,

With fewer than 200,000 cases in the U.S. per year1, idiopathic thrombocytopenic purpura (ITP) is a rare, autoimmune disorder in which the body's immune system attacks its platelets—i.e. the cells that help blood clot. ITP is known for purple bruises and/or tiny red and purple dots that appear on the skin that look like a rash.

ITP is more common among young women, people over 60, and in those who have other autoimmune conditions such as rheumatoid arthritis or lupus. Those with an infection like HIV or hepatitis can also be more susceptible to ITP. Children can also have ITP, though it usually occurs directly following a virus such as the mumps or the flu. Children most often have the acute version of ITP (<12 months) while adults tend to have chronic ITP. There is evidence to suggest that ITP could also be a factor for the development of some other diseases.2

Signs and Symptoms

Though ITP may not have any symptoms at all, these symptoms may occur:3

  • Easy bruising

  • Petechiae—bleeding into the skin that looks like a rash made of tiny reddish-purple spots, mostly on the lower legs

  • Purpura—bleeding into the skin that's larger than petechiae 

  • Nosebleeds or bleeding in the gums

  • Blood in urine or stools

  • Abnormally heavy menstrual flow


It’s important to note that bleeding that doesn’t stop is a medical emergency. Also, those with ITP shouldn’t take drugs like aspirin or ibuprofen as these can increase bleeding.

Treatment Options

Whether it be a mild case or more severe, those with ITP need regular platelet checks. Though children with acute ITP typically improve without treatment, most adults will eventually need treatment. First lines of treatment can include steroids as well as an infusion of immune globulin (IG). IG can treat serious bleeding by increasing blood count quickly. Drugs may also be prescribed that increase platelets as well as surgery to remove the spleen.

Helpful Resources

The Platelet Disorder Support Association provides support, education, and assistance programs for patients and their families and/or caretakers. Some of these resources include: 

How BioMatrix Can Help

If you or a loved one has been diagnosed with ITP, it’s important to know that you are not alone. Organizations like the Platelet Disorder Support Association mentioned above can provide a wealth of information and support as well as connect you to others in the community who have experienced the same diagnosis. In addition, your specialty pharmacy can offer individualized support to help manage treatment.

BioMatrix Specialty Pharmacy helps manage the individual needs of patients requiring IG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of symptoms.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.

Learn more about our individualized specialty pharmacy services for patients with ITP and other rare, and ultra-rare diseases.

Insurance Appeal Letter Sample & Template

Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. Michel M. Immune thrombocytopenic purpura: epidemiology and implications for patients. Eur J Haematol Suppl. 2009;82(s71):3-7. doi:10.1111/j.1600-0609.2008.01206.x

  2. Aboud N, Depré F, Salama A. Is Autoimmune Thrombocytopenia Itself the Primary Disease in the Presence of Second Diseases Data from a Long-Term Observation. Transfus Med Hemother. 2017;44(1):23-28. doi:10.1159/000449038

  3. Mayo Clinic. Immune thrombocytopenia (ITP). https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325

Read More

, , , ,

Lambert-Eaton Myasthenic Syndrome (LEMS): Signs, Symptoms, and Treatment Options

, , , ,

With an estimated 400 known cases in the U.S.1, Lambert-Eaton Myasthenic Syndrome (LEMS) is a rare, autoimmune, neurological disorder in which the body's immune system attacks its own tissues. With LEMS, the body specifically attacks the neuromuscular junction—i.e. the connections between nerves and muscles. This causes weakness in the upper legs, hips, upper arms, and shoulders. Both walking and self-care can be difficult.

More than 50% of LEMS cases happen in middle aged or older people, with symptoms often occurring prior to the diagnosis of lung cancer.2 Because cancer cells share some of the same proteins as nerve endings, it’s thought that the body attacks nerve endings in an attempt to kill cancer cells. In the other half of LEMS cases, the cause is unknown and typically occurs around age 35.

Signs and Symptoms

LEMS is characterized by weakness starting in the legs and hips, progressing to the arms and shoulders. Onset of signs and symptoms is typically gradual. Additional signs and symptoms may include:

  • Muscle aches

  • Muscle weakness that gets worse with time

  • Fatigue

  • Difficulty walking and climbing stairs

  • Difficulty lifting objects and raising arms

  • Drooping eyelids

  • Dry eyes

  • Dry mouth

  • Blurred vision

  • Difficulty swallowing

  • Dizziness upon standing

  • Constipation

  • Erectile dysfunction

It’s important to note that because of similar symptoms of muscle weakness, LEMS is often misdiagnosed as Myasthenia gravis (MG). However key differences are in the severity and type of muscle weakness. For example, eye weakness tends to be milder in LEMS patients and unlike MG, is typically not the only symptom. Severe respiratory muscle weakness found in MG is also rare for people with LEMS.

Treatment Options

Although there is no cure for LEMS, treatment can help relieve and lessen symptoms. If LEMS is connected to a cancer diagnosis, treatment is first targeted at the cancer which may then greatly improve LEMS symptoms.

Medicines to help nerve signals reach the muscles as well as immunosuppressants (like steroids) can help relieve symptoms. If symptoms are advancing and other treatments have not helped, both plasmapheresis (plasma exchange) and intravenous immunoglobulin (IVIG) are used to treat LEMS. 

Plasmapheresis redirects blood through a machine which filters out the antibodies attacking the nerves. IVIG, which is immunoglobulin given intravenously or through a vein, suppresses the inflammatory response. Derived from thousands of healthy blood plasma donations, immunoglobulin therapy can help suppress an overactive immune system by preventing it from attacking healthy cells.

Helpful Resources

The Muscular Dystrophy Association provides support, education, care, and advocacy for patients with neuromuscular diseases, like LEMS, and their families and/or caretakers. Some of these resources include: 

Community resources like access to transportation, clinical trials finder tool, and equipment assistance

How BioMatrix Can Help

Though an LEMS diagnosis can feel overwhelming for you or a loved one, it’s important to know that you are not alone. Organizations like the Muscular Dystrophy Association mentioned above can provide a wealth of information and support as well as connect you to others in the community who have experienced the same diagnosis as well as others with neuromuscular conditions. In addition, your specialty pharmacy can offer individualized support to help manage treatment.

BioMatrix helps manage the individual needs of patients requiring IVIG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of symptoms.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.

Learn more about how our individualized specialty pharmacy services for patients with LEMS and other neurological and neuromuscular conditions.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. (2019). Lambert-Eaton Myasthenic Syndrome. National Organization for Rare Disorders (NORD). https://rarediseases.org/rare-diseases/lambert-eaton-myasthenic-syndrome/

  2. (2023). Jayarangaiah A, Theetha Kariyanna P. Lambert-Eaton Myasthenic Syndrome. National Library of Medicine (NIH). https://www.ncbi.nlm.nih.gov/books/NBK507891/

Read More

, , , ,

Guillain-Barré syndrome (GBS): Signs, Symptoms, and Treatment Options

, , , ,

With an estimated 3,000 to 6,000 people in the U.S. developing Guillain-Barré syndrome (GBS) every year1, GBS is a rare neurological disorder in which the body's immune system attacks its own nerves causing muscle weakness and sometimes complete paralysis. It’s most common between ages 30-50, though onset can happen at any age.2

Though the cause of GBS is not fully understood, two-thirds of patients report a viral or bacterial infection in the weeks prior to GBS symptoms—typically gastrointestinal or respiratory. Evidence suggests that this infection triggers the immune response which damages the myelin sheath that protects the nerves, leading to numbness and weakness. Most people recover fully from GBS and are able to walk within 6 months to two years of when symptoms began. However, some have lasting effects, and for some, the disease can be fatal.3

Signs and Symptoms

Early signs of GBS often include a rapid onset of tingling, weakness, and numbness that start in the feet and legs and spread to the upper body. Some people notice these symptoms first in their arms or face. While initial weakness may be mild, symptoms can progress rapidly over just a few days. Additional signs and symptoms may include:

  • Difficulty raising a foot or walking without assistance

  • Paralysis or the loss of ability to move one’s legs, arms, breathing muscles, and face

  • Paralysis that travels up the limbs from fingers and toes towards the torso

  • Loss of reflexes such as the knee jerk

  • Pain in the muscles

  • Blurred vision

  • Difficulty swallowing or chewing

  • Difficulty speaking

  • Shortness of breath or difficulty breathing

  • Low or high blood pressure

  • Difficulty with bladder control or bowel function

  • Rapid heart rate

It’s important to note that not all patients with GBS experience paralysis. Some with mild cases may just experience tingling and weakness throughout their body.

Treatment Options

For some with mild symptoms, no treatment is necessary. For most new cases of GBS, however, patients need to be hospitalized. To monitor breathing and other body functions, patients are typically admitted to the ICU (Intensive Care) until the condition is stabilized. Although there is no cure for GBS, immune-suppressing treatments can prevent breathing problems and relieve symptoms by reducing the inflammation caused by the immune system’s response to the disease. Both plasmapheresis (plasma exchange) and intravenous immunoglobulin (IVIG) are used to treat GBS, and IVIG suppresses the inflammatory response.

Derived from thousands of healthy blood plasma donations, immunoglobulin therapy can help suppress an overactive immune system by preventing it from attacking healthy cells. Immunoglobulin given intravenously, or through a vein, is called intravenous immunoglobulin (IVIG).

Helpful Resources

The GBS/CIDP Foundation International provides support and resources for GBS patients and their families. Some of these resources include:

  • Local community groups and chapter meetings

  • Community forums

  • GPS educational webinars and conferences

  • Rehabilitation guide for caregivers

How BioMatrix Can Help

Though a GBS diagnosis can feel overwhelming for you or a loved one, it’s important to know that you are not alone. Organizations like GBS/CIDP Foundation International mentioned above can provide a wealth of information and support as well as connect you to others in the community who have experienced the same diagnosis. In addition, your specialty pharmacy can offer individualized support to help manage treatment.

BioMatrix helps manage the individual needs of patients requiring IVIG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.

Learn more about our individualized specialty pharmacy services for patients with GPS and other neurological conditions.

Insurance Appeal Letter Sample & Template

Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. (2023). Guillain-Barré Syndrome and Vaccines. CDC. https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html

  2. Guillain-Barré Syndrome. Mount Sinai Today Blog. https://www.mountsinai.org/health-library/diseases-conditions/guillain-barr-syndrome

  3. (2022). Guillain-Barré Syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793

Read More

, , , ,

Myasthenia Gravis (MG): Signs, Symptoms, Positive Self-Management, and Treatment Options

, , , ,

Myasthenia gravis (MG) is a rare, autoimmune neuromuscular disease that’s characterized by weakness in the voluntary muscles (muscles you can control) such as the eyes, face, jaw, neck, arms, and legs. With MG, the immune system attacks the communication between the nerve signals and the muscles, causing weakness and loss of control of these muscles.

Though MG can occur at any age, the onset of symptoms most commonly happens in women under 40 and men over 60.1

Signs and Symptoms

Ocular weakness is typically one of the first signs of MG. This is when muscles that control eye and eyelid movement cause a partial paralysis of eye movements, double vision, and droopy eyelids. Roughly half of those who first experience these symptoms will go on to develop muscle weakness and/or fatigue in the rest of their body within two years—typically in their neck and arms first, then their legs.2 Lifting one’s arms over their head, standing up from a seated position, walking long distances, and climbing stairs may become more and more difficult. MG symptoms can appear suddenly with rapid fatigue and loss of muscle control.

Positive Self Management

The Myasthenia Gravis Foundation provides a wealth of resources for MG patients and their families including disease education, research, community events, and wellness strategies. In addition to a patient’s medical/treatment protocol, wellness strategies and positive self management can improve day-to-day quality of life for those living with MG. According to the Myasthenia Gravis Foundation, some of those strategies include:

  • Sharing facts about MG with family, friends, and coworkers as you feel comfortable

  • Learning ways to cope

  • Conserving energy

  • Staying cool

  • Accepting help

  • Potentially recovering some strength through low impact movement and exercise

  • Proper nutrition and diet modification to help with chewing and swallowing

  • Learning your rights in the workplace

You can learn more and dive deeper into these wellness strategies here.

Treatment Options

Although there is no cure for MG, treatment can help relieve and lessen symptoms. The type of treatment depends on age, disease severity, and how fast it’s progressing. Medications like cholinesterase inhibitors can improve muscle contraction and muscle strength in some people. Corticosteroids, like prednisone, can lessen the immune system attacks. Immunosuppressants can help alter the immune system. All of these medications, however, can cause serious side effects with prolonged use.3

Infusion treatments such as IVIG and other infused medications are typically used to treat worsening MG symptoms. Because medication is infused directly into the bloodstream, a healthcare professional should be present to administer the infusion and monitor the patient for side effects.

How BioMatrix Can Help

BioMatrix helps manage the individual needs of patients requiring infused medications by providing options for administration site of care, education, and support to help improve quality of life. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care (including home infusion), conduct nursing interventions, and provide patient education.

Learn more about our individualized specialty pharmacy services for patients with MG and other neurological disorders.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. (2023). Myasthenia Gravis. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/myasthenia-gravis

  2. Myasthenia Gravis (MG) Signs and Symptoms. Muscular Dystrophy Association. https://www.mda.org/disease/myasthenia-gravis/signs-and-symptoms

  3. (2021). Myasthenia Gravis Diagnosis & Treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/myasthenia-gravis/diagnosis-treatment/drc-20352040

Read More

, , ,

Polymyositis and Dermatomyositis: Signs, Symptoms, and Treatment Options

, , ,

More than 50,000 people in the U.S. are living with myositis, and roughly 7,000 people are diagnosed every year.1 Myositis is a neurological, autoimmune disease that causes chronic inflammation of the skeletal muscles due to cell damage. This inflammation and swelling can cause muscle weakness and pain as well as skin conditions.

There are different types of myositis. While polymyositis affects just muscles, dermatomyositis affects both muscles and skin. We’ll examine both polymyositis and dermatomyositis more below.

Polymyositis Signs and Symptoms

Polymyositis is characterized by muscle weakness and pain particularly in the abdomen, shoulders, upper arms, and hips. Muscles in the center of the body tend to be affected the most, though any skeletal muscles can be affected. The skeletal muscles are connected to your bones, allowing you to control movements. When these muscles are inflamed and damaged, it can affect the ability to walk, run, sit, and stand. This inflammation can also cause challenges for eating and breathing. 

Polymyositis signs and symptoms include:

  • Muscle pain

  • Muscle stiffness

  • Muscle weakness

  • Joint pain and stiffness

  • Trouble breathing

  • Difficulty swallowing

  • Inflammation of the heart causing irregular heart rhythms

Dermatomyositis Signs and Symptoms

In addition to affecting the muscles, dermatomyositis also affects the skin. In addition to signs and symptoms of polymyositis involving muscle weakness and pain, symptoms of dermatomyositis include:2

  • Painful, itchy red or purple rash on sun exposed areas

  • Red or purple swelling of upper eyelids

  • Red or purple spots on knuckles, elbows, knees, and toes

  • Joint pain in cold conditions that lessons in warmer conditions

  • Scaly, dry skin that can cause hair thinning

  • Surrounding areas of fingernails that get swollen and red

  • Hard lumps under the skin caused by calcium deposits

Polymyositis and Dermatomyositis Treatment Options

Though there is no cure for polymyositis or dermatomyositis, symptoms can be managed. Treatment may include anti-inflammatory medicines like steroids or corticosteroids and/or immunosuppressive medicines that suppress the body’s immune system. Rituxan, an infusion therapy, is typically prescribed if anti-inflammatory medicines don’t provide adequate control of symptoms. Immune Globulin (IG) therapy may also be prescribed if there’s no response to other treatments. Administered via an infusion, IG therapy consists of donated blood products that help boost your body's immune system. Antihistamine drugs or anti-inflammatory steroid creams may also be prescribed for skin rashes.

In addition to treatment, physical therapy, heat therapy, rest, and/or special devices can help support muscles and movement. Avoiding sun exposure and wearing sunscreen can also help prevent skin rashes.

How BioMatrix Can Help

The treatment of neurological disorders using infusion therapies has become the standard of care in many neurological practices throughout the United States. BioMatrix helps manage the individual needs of patients needing infusions, providing education and support to help improve quality of life. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care (including home infusion), conduct nursing interventions, and provide patient education.

Learn more about our individualized specialty pharmacy services for patients with neurological disorders.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. (2017). Facts About Myositis Infographic. Hospital for Special Surgery (HSS). https://www.hss.edu/conditions_infographic-facts-about-myositis.asp#

  2. Dermatomyositis. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases

Read More

, , , ,

Multiple Sclerosis (MS): Signs, Symptoms, Positive Self-Management, and Treatment Options

, , , ,

Multiple sclerosis (MS) is a disease of the central nervous system (CNS)—i.e. the brain, spinal cord, and optic nerves. The CNS, which controls the entire body, is attacked by the body’s own immune system, damaging the protective layer, or myelin, that insulates the wire-like nerve fibers.

This nerve damage disrupts signals to and from the brain. MS is an immune-mediated disease, which is when the body’s immune system overreacts and attacks itself. Though similar, an immune-mediated disease is different from an autoimmune disease. Both involve the immune system attacking and damaging the body’s own healthy cells via proteins (or autoantigens—antigens produced by one’s own body). However with an autoimmune disease, the proteins/autoantigens which attack the cells have been identified. With an immune-mediated disease, these proteins/autoantigens have not been identified.1

Signs and Symptoms

Though everyone’s experience with MS is different, there are some common signs and symptoms to look out for. These include:3

  • Numbness or weakness in one or more limbs, typically occurring on one side of the body at a time

  • Tingling

  • Electric-shock sensations that occur with certain neck movements, especially when bending the neck forward (Lhermitte sign)

  • Lack of coordination

  • Unsteady gait (having trouble with balance) or inability to walk

  • Partial or complete loss of vision, usually in one eye at a time with pain during eye movement

  • Prolonged double vision

  • Blurry vision

  • Vertigo

  • Problems with sexual, bowel, and bladder function

  • Fatigue

  • Slurred speech

  • Cognitive problems

  • Mood disturbances

Positive Self Management

In addition to a patient’s medical/treatment protocol, positive self management can improve day-to-day quality of life for those living with MS. Patients who self-manage their condition have the skillset to accept and communicate with others their need to move at their own pace. Research has shown that those who have developed self-management skills have more confidence to better communicate their needs to others, therefore receiving improved support.4 Found to be an empowering strategy to improve health for many people living with chronic conditions, self management is a philosophy that acknowledges living with a condition like MS is an ongoing experience.

The National Multiple Sclerosis Society and Multiple Sclerosis Foundation both give resources for developing positive self management skills. 

The National Multiple Sclerosis Society has a section on their website dedicated to “Living Well with MS”. They provide guidance and resources for diet, exercise, and healthy behaviors; emotional well-being (i.e. managing stress and coping skills); spiritual well-being (i.e. building on values and beliefs that provide purpose); and cognitive health (i.e. keeping your mind engaged and challenged). Learn more about these resources here. 

The Multiple Sclerosis Foundation is helping MS patients get connected to support groups and grants. Some of their grants and programs include help with rent or utilities, homecare assistance, and transportation. They also host multiple events for the MS community to join together and learn more about managing their condition. To learn more about these resources and events, click here.

Treatment Options

For some with mild symptoms, no treatment is necessary. For others, treatment to help ease MS symptoms may include corticosteroids or plasma exchange. Although there is no cure for MS, treatment can also help slow disease progression by reducing the amount of damage and scarring to the myelin—the layer surrounding the nerves. This reduction in damage can help MS patients have fewer and less severe relapses. Treatment to slow progression may include injectable, oral, and infusion medications. 

Infusion treatments may help slow the progression of MS and lessen flare-ups for those with aggressive or advanced MS. Because medication is infused directly into the bloodstream, a healthcare professional should be present to administer the infusion and monitor the patient for side effects.

How BioMatrix Can Help

BioMatrix helps manage the individual needs of patients requiring infused medications by providing options for administration site of care, education, and support to help improve quality of life. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of relapses.

The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care (including home infusion), conduct nursing interventions, and provide patient education.

Learn more about how our individualized specialty pharmacy services for MS patients.

Financial Resource Guide

Living with a chronic condition can create additional healthcare costs while also impeding one’s ability to work. Our financial resource guide can help. 

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. What is an immune-mediated disease? The National Multiple Sclerosis Society. https://www.nationalmssociety.org/What-is-MS/Definition-of-MS/Immune-mediated-disease

  2. About Multiple Sclerosis (MS). Penn Medicine. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/multiple-sclerosis-ms

  3. (2022). Multiple Sclerosis. Mayo Foundation for Medical Education and Research (MFMER). https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

  4. (2010). Wazenkewitz, J., McMullen, K., Ehde, D. Self-Management: Keys to Taking Charge of Your MS. Multiple Sclerosis Foundation.

Read More

, ,

Pemphigus—Types, Symptoms, and Treatment Options

, ,

Pemphigus is a rare group of autoimmune diseases that causes blistering of the skin and the inside of the mouth, nose, throat, eyes, and genitals. With these diseases, the immune system mistakenly attacks healthy proteins that bind skin cells to one another, causing the skin to become fragile. Blisters then form from fluid that collects between the skin’s fragile layers.1,2

Though researchers do not know what causes the immune system to fight the body’s own proteins, they believe that both genetic and environmental factors are involved. Some people may be predisposed to the condition due to their genetic makeup, and something in their environment may trigger an immune response.

Pemphigus Types and Symptoms

Signs and symptoms vary based on the type of pemphigus:1

Pemphigus vulgaris: The most common type in the US, blisters form within the mouth and other mucosal surfaces, as well as in a deep layer of the skin. They are often painful. Blisters can also form in the groin and under the arms in a subtype of the disease called pemphigus vegetans. Blisters typically start in the mouth and then appear on areas on the skin. The skin may become so fragile that it peels off by rubbing a finger on it.

Pemphigus foliaceus: Only affecting the skin, itchy or painful blisters form in upper skin layers. They typically appear first on the face, scalp, chest, or upper back, but can spread to other areas of skin on the body. The affected areas of skin may become inflamed and peel off in layers or scales.

Paraneoplastic pemphigus: Blisters or inflamed lesions typically form in the mouth and on the lips but may also develop on the skin and other mucosal surfaces. People with this type of pemphigus usually have a tumor and may have severe lung problems. If the tumor is surgically removed, the disease may improve.

IgA pemphigus: Caused by the IgA antibody, blisters or pimple-like bumps often form in groups or rings on the skin. 

Drug-induced pemphigus: Pemphigus-like blisters or sores are triggered by certain medicines like antibiotics and blood pressure medications, as well as drugs that contain a chemical group called a thiol. When one stops taking the medication or drug, these blisters and sores typically go away.

Diagnosis and Treatment

Pemphigus is typically diagnosed through a skin biopsy, blood tests, and sometimes an endoscopy to check for sores in the throat.

Treatment is dependent on the type and severity of the disease. Medications like corticosteroid cream and prednisone pills are often prescribed as the first line of treatment intended to suppress blisters. To help suppress the immune system and keep it from attacking healthy proteins, medications such as azathioprine (Imuran, Azasan), mycophenolate (Cellcept) and cyclophosphamide are typically prescribed. If these treatment methods aren’t working, treatments such as intravenous immunoglobulin (IG) therapy are typically prescribed as a second or third-line treatment option.3

Intravenous immunoglobulin (IG) therapy is usually well tolerated with few rare serious side effects. It’s been used to treat dermatological conditions for more than two decades.4

How BioMatrix Can Help

BioMatrix has extensive experience with IG-related support services. As a national provider of IG, BioMatrix has broad access to all brands and inventory. Our IG treatment plans are designed to:

  • Prevent infections

  • Boost the immune system

  • Avoid complications of therapy

  • Prevent long-term organ damage

  • Decrease hospitalizations

  • Encourage patients to participate in disease management

  • Prolong life

  • Improve general health and quality of life

Our nursing team coordinates the best site of care for scheduled infusions—whether in the patient’s home or physician’s office. Providing site-of-care options offers convenience for patients and cost savings to insurance providers.

Together, our clinicians, support staff, and digital health technology offer a comprehensive approach improving quality of life for patients and producing positive outcomes along the entire healthcare continuum.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. (2021). Pemphigus. National Institutes of Health. https://www.niams.nih.gov/health-topics/pemphigus

  2. Pemphigus Vulgaris. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pemphigus-vulgaris

  3. (2022). Pemphigus. Mayo Foundation for Medical Education and Research (MFMER). https://www.mayoclinic.org/diseases-conditions/pemphigus/diagnosis-treatment/drc-20350409

  4. Hoffmann, J.H.O. and Enk, A.H. (2017), High-dose intravenous immunoglobulins for the treatment of dermatological autoimmune diseases. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 15: 1211-1226. https://doi.org/10.1111/ddg.13389

Read More

, ,

Similarities, Differences, and Correlations Between Allergies, Common Variable Immunodeficiency (CVID), and Autoimmune Disorders

, ,

Allergies, common variable immunodeficiency (CVID), and autoimmune disorders all share similarities and can commonly be mistaken for one another. This article explores those similarities as well as major differences, evidence for potential links, and treatment options.

What is common variable immune deficiency (CVID)?

Let’s first take a look at common variable immunodeficiency (CVID). Characterized by low levels of serum immunoglobulins and antibodies, CVID is a form of primary immunodeficiency—meaning the immune system is deficient in what it needs to fight infection which therefore causes an increased susceptibility to infection. Those with CVID often develop recurring infection in the lungs, sinuses, and ears. The exact cause of CVID is unknown, though genetic defects may play a role.1

What are allergies and how are they related to autoimmune disorders and CVID?

An allergy occurs when your immune system reacts to a foreign substance that is typically not harmful to other people—i.e. pollen or pet dander. Both an allergic reaction and an autoimmune response happen when your body tries to expel a foreign substance. The difference is that with an allergic response, the foreign substance is an allergen (again, typically harmless to most people) while with an autoimmune response, the foreign substance is indeed harmful—i.e. a virus, parasite, or bacteria. Steve Ziegler, PhD, Director of the Immunology Research Program at Benaroya Research Institute states that “In autoimmunity, there is a different type of T-cell involved than in allergies. In an autoimmune response, tissue destruction occurs. With allergies, the immune system overreacts to harmless allergens. Interestingly, this is the same type of response that expels viruses, parasites, and bacteria from the body.”2

It’s important to note that CVID is not an autoimmune disorder. Autoimmune disorders occur when your immune system can’t tell the difference between foreign cells (like bacteria and viruses) and your own cells. Because of this, your immune system will attack healthy cells in your body in addition to unhealthy foreign cells. CVID, on the other hand, occurs when your body has existing low levels of antibodies.

Is there a link between CVID, autoimmune disorders, and allergies?

With 25% of CVID patients having an autoimmune disorder3, there seems to be a positive correlation between CVID and autoimmune disorders. Research has demonstrated that those with defects in their immune system (like having lower amounts of antibodies) carry a high risk for the development of autoimmune disease.4 When compared to the general population, CVID patients also have a greater risk for granulomata (a mass of granulation tissue), tumors, and an increased susceptibility to cancer.1 In a 2021 study, allergic-like disorders and autoimmunity were diagnosed in 41.3% of CVID subjects.5 Though further testing was needed to determine the cause, in a 2009 study, 86.1% of participating CVID patients had rhinosinusitis (inflammation of the nasal cavity and paranasal sinuses).6 With these findings, though a possible link seems likely to exist between these three conditions, researches are still trying to figure out why exactly these conditions occur in the first place. This could lead to finding further causes for these positive correlations as well as even more effective, targeted treatment options.

Treatment

Treatment for allergies and autoimmune conditions varies greatly depending on the type and severity. An allergy treatment plan may involve avoiding allergens, medicine, and/or immunotherapy.7 An autoimmune treatment plan may involve a wide range of therapies—from anti-inflammatory medication to IG treatment.8 CVID is typically treated with immunoglobulin (IG) (subcutaneous) infusions—especially for those with substantial decreased IG production and nonresponse to both protein and polysaccharide vaccines.9 The IG therapy provides antibodies from the blood of healthy donors. Other problems caused by CVID, like bacterial infections, may require additional, tailored treatments.10

Our team has extensive experience with IG related support services. As a national provider of IG, BioMatrix has broad access to leading brands and inventory. Our IG treatment plans are designed to:

  • Prevent infections
  • Boost the immune system
  • Avoid complications of therapy
  • Prevent long-term organ damage
  • Decrease hospitalizations
  • Encourage patients to participate in disease management
  • Prolong life
  • Improve general health and quality of life

Our nursing team coordinates the best site of care for scheduled infusions—whether in the patient’s home or physician’s office. Providing site-of-care options offers convenience for patients and cost savings to insurance providers.

Together, our clinicians, support staff, and digital health technology offer a comprehensive approach improving quality of life for patients and producing positive outcomes along the entire healthcare continuum.

DISCLAIMER: THIS IS NOT MEDICAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. Overview of Common Variable Immune Deficiency. Immune Deficiency Foundation. https://primaryimmune.org/about-primary-immunodeficiencies/specific-disease-types/common-variable-immune-deficiency

  2. (2017). Connecting the Dots Between Allergies and Autoimmune Disease. Benaroya Research Institute. https://www.benaroyaresearch.org/blog/post/connecting-dots-between-allergies-and-autoimmune-disease

  3. Common Variable Immune Deficiency. MedlinePlus. https://medlineplus.gov/genetics/condition/common-variable-immune-deficiency

  4. Sleasman J. W. (1996). The association between immunodeficiency and the development of autoimmune disease. Advances in dental research, 10(1), 57–61. https://doi.org/10.1177/08959374960100011101

  5. Rubin, L., Shamriz, O., Toker, O., Kadish, E., Ribak, Y., Talmon, A., Hershko, A. Y., & Tal, Y. (2022). Allergic-like disorders and asthma in patients with common variable immunodeficiency: a multi-center experience. The Journal of asthma : official journal of the Association for the Care of Asthma, 59(3), 476–483. https://doi.org/10.1080/02770903.2020.1862185

  6. Agondi, R. C., Barros, M. T., Kokron, C. M., Cohon, A., Oliveira, A. K., Kalil, J., & Giavina-Bianchi, P. (2013). Can patients with common variable immunodeficiency have allergic rhinitis?. American journal of rhinology & allergy, 27(2), 79–83. https://doi.org/10.2500/ajra.2013.27.3855

  7. (2018). What Are the Best Treatments for Allergies? Asthma and Allergy Foundation of America. https://aafa.org/allergies/allergy-treatments/

  8. (2021). Autoimmune Diseases. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases

  9. Cunningham-Rundles C. Treatment And Prognosis Of Common Variable Immunodeficiency. (https://www.uptodate.com/contents/treatment-and-prognosis-of-common-variable-immunodeficiency

  10. (2019). Common Variable Immunodeficiency (CVID). National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/common-variable-immunodeficiency-cvid

Read More

, , ,

Neurological Disorders and Intravenous Immunoglobulin (IVIG) Therapy

, , ,

Intravenous immunoglobulin (IVIG) is a type of immunotherapy that has been used for nearly 30 years to treat neurological disorders. IVIG was first approved by US regulatory agencies to treat chronic inflammatory demyelinating polyneuropathy (CIDP), Guillain-Barré syndrome (GBS), and multifocal motor neuropathy (MMN) in 2008. In 2021, IVIG was approved to treat dermatomyositis.1

Neurological conditions for which IVIG currently has indicated use includes CIDP, severe dermatomyositis/polymyositis, Kawasaki syndrome, and multifocal motor neuropathy. IVIG has off-label use for Guillain-Barré syndrome and myasthenia gravis.2 While just as effective as plasmapheresis and steroids, unlike plasmapheresis and steroids, IVIG is found to be safe and effective long term.3

What is intravenous immunoglobulin (IVIG)?

Immunoglobulin (IG) given intravenously, or through a vein, is called intravenous immunoglobulin (IVIG). Immunoglobulin is a human blood product containing proteins that likely link themselves with antibodies or other substances directed at the nerve.4 It’s made from the donated antibodies of between 1,000-15,000 human donors per batch.5 The human body has different antibodies to fight different infections, like how there are different keys for different locks. If the body does not have enough antibodies or has damaged antibodies, IVIG can help replace them.

Where can a patient receive IVIG therapy?

A patient can typically receive IVIG therapy in their home or physician’s office. At BioMatrix, our nursing team coordinates the best site of care for scheduled infusions. For many patients needing regular infusions, choosing home as their site of care is a convenient and comfortable option. Research indicates that home infusion is a safe method of receiving IVIG therapy for neurological conditions.6,7,8

Additional benefits to home infusion include:

  • Less risk of infection. Hospitals and infusion centers can take every precaution available, yet in these environments patients still have the potential for exposure to bacteria or viruses they would likely not encounter in their homes.
  • Cost savings. Home infusion reduces the burden on costlier sites of care, saving money for both patients and payers.9
  • Patient wellbeing. Patients report significantly better physical and mental wellbeing with less disruption to daily activities, overwhelmingly preferring home infusion.10

Summary

The treatment of Neurological disorders using IVIG has become the standard of care in many neurological practices throughout the United States. BioMatrix provides site-of-care options for IVIG that offer convenience for patients and cost-savings to insurance providers. 

As a national provider of IG, BioMatrix also has broad access to brands and inventory supply. We purchase IG directly from manufacturers or manufacturers’ approved distributors, ensuring distribution channel integrity, proper handling, and quality control. 

To learn more about our IVIG capabilities to treat neurological conditions, visit:

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

References

  1. Dalakas M. C. (2021). Update on Intravenous Immunoglobulin in Neurology: Modulating Neuro-autoimmunity, Evolving Factors on Efficacy and Dosing and Challenges on Stopping Chronic IVIg Therapy. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 18(4), 2397–2418. https://doi.org/10.1007/s13311-021-01108-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585501/#:~:text=IVIg%20inhibits%20the%20differentiation%20and,IVIg%2Dresponding%20autoimmune%20neurological%20diseases.

  2. (2023). Indications. Lexicomp. https://online.lexi.com/lco/action/doc/retrieve/docid/fc_dfc/6647276?cesid=1cTY1wl5C8I&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DIVIG%26t%3Dname%26acs%3Dfalse%26acq%3DIVIG%26nq%3Dtrue

  3. Zandman-Goddard, G., Krauthammer, A., Levy, Y., Langevitz, P., & Shoenfeld, Y. (2012). Long-term therapy with intravenous immunoglobulin is beneficial in patients with autoimmune diseases. Clinical reviews in allergy & immunology, 42(2), 247–255. https://doi.org/10.1007/s12016-011-8278-7. https://pubmed.ncbi.nlm.nih.gov/21732045/

  4. Shehata N. (2023) Patient education: Intravenous immune globulin (IVIG) (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/intravenous-immune-globulin-ivig-beyond-the-basics#:~:text=WHAT%20IS%20IVIG%3F,to%20help%20you%20fight%20infection

  5. Jolles S, Sewell WA, Misbah SA. Clinical uses of intravenous immunoglobulin. Clin Exp Immunol. 2005 Oct;142(1):1-11. doi: 10.1111/j.1365-2249.2005.02834.x. PMID: 16178850; PMCID: PMC1809480.

  6. Le Masson G, Solé G, Desnuelle C, et al. (2018). Home versus hospital immunoglobulin treatment for autoimmune neuropathies: a cost minimization analysis. Brain Behav. 2018;8(2):e00923. doi: 10.1002/brb3.923

  7. Luthra R, Quimbo R, Iyer R, Luo M. (2014). An analysis of intravenous immunoglobin site of care: home versus outpatient hospital. Am J Pharm Benefits. 2014;6(2):e41-e49.

  8. Schmidt R. (2012). Home Infusion Therapy: Safety, Efficacy, and Cost-Savings. PSQH. https://www.psqh.com/analysis/home-infusion-therapy-safety-efficacy-and-cost-savings/

  9. Home Infusion Creates Savings for Patients, Taxpayers. NHIA. https://nhia.org/wp-content/uploads/2020/03/Home_Infusion_Creates_Savings_for_Patients_Taxpayers.pdf

  10. Polinski J, Kowal M, Gagnon M, Brennan T, Shrank W. (2016). Home infusion: Safe, clinically effective, patient preferred, and cost saving. NIH. https://pubmed.ncbi.nlm.nih.gov/28668202/

Read More

, , ,

Home Infusion for Transplant Patients

, , ,

BioMatrix Specialty Pharmacy provides home infusion services allowing patients to receive therapy from the comfort and safety of home. This article provides a brief overview of how our clinical team works to support home infusion for transplant patients.

Home infusion provides a safe and effective means to help transplant patients manage their prescribed therapy. Hospitals and infusion centers can take every precaution available, yet in these environments patients still have the potential for exposure to bacteria or viruses they would likely not encounter in their homes. Transplant patients benefit from home infusion both before and after transplant. Before the transplant, many patients are at greater risk for infection given their diagnosis and the procedures they have endured. Post-transplant, patients are at risk of infection because of immune-suppressing anti-rejection drugs and/or because they develop comorbidities compromising their immune systems. 

BioMatrix’s focus on safety begins well before the patient is infused with their first dose of medication in the home. 

Even before the pandemic, our transplant professionals followed rigorous safety protocols to ensure the health and safety of the patients we serve. Our clinical team includes nurses and pharmacists who are experts in transplant therapy. Many have years of transplant experience, and team members stay up to date on all current literature surrounding the use of specialty medications provided for transplant-related diagnoses. Our team follows transplant-specific protocols to promote the health and safety of our patients and home infusion nurses. Each clinician has the responsibility of not only knowing each transplant-specific or medication-specific protocol, but also ensuring that the protocol is strictly followed for optimal results.  

Our nursing and pharmacy teams work hand in hand at every step of the patient journey. This includes our efforts around home infusion services. To support our patients across the country, BioMatrix has contracted with over 200 Nursing agencies nationwide. We continually bring new agencies into the fold. Each agency is thoroughly vetted to ensure that they meet our rigorous standards and are knowledgeable regarding the Infusion Nurses Society guidelines for infusion therapy in the home.   

Just as the nursing agencies we contract with are thoroughly vetted, so too are the individual home infusion nurses. Every home infusion nurse assigned to enter a patient’s home is required to meet (over the phone or virtually) with our nurse clinicians prior to providing service. Our nurses evaluate the infusion RN’s level of competency to provide the care ordered. If further education or training is needed this is arranged and completed before the start of care. Prescribed therapy is reviewed in detail to make sure the appropriate protocols are followed and the services provided are safe and seamless. If at any time our nurse clinicians determine that a particular home infusion nurse does not meet the standard of competency that we at BioMatrix strive for, we re-group and re-staff the case with an alternate home infusion nurse.  

When entering a patient’s home, the home infusion nurses we work with follow all standard precautions and wear appropriate personal protective equipment. They also take the time to identify and review safety measures the patient can follow in the home both during and after infusion. Working together our team helps patients mitigate any issues to establish a safe environment for home infusion.  

BioMatrix is committed to providing the highest level of specialty pharmacy service and support.

Our team has years of transplant experience and follows highly coordinated, transplant-specific protocols promoting the health, safety, and well-being of every patient served.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

Read More

,

Plasma: The Need for Donors & What You Can Do to Help

,
PLASMA.jpg

America needs blood and plasma donors.

This article discusses what plasma is, the important functions it serves, and who’s eligible to donate.

Plasma is the liquid part of your blood that carries cells and proteins throughout the body. It’s made up of mostly water (92%+), but contains vital proteins and antibodies such as albumin, gamma globulin, and anti-hemophilic factor along with mineral salts, sugars, fats, hormones, vitamins, carbon dioxide, and oxygen.

According to The American Red Cross, plasma serves four important functions in our bodies:

  1. Helps maintain blood pressure and volume.

  2. Supplies critical proteins for blood clotting and immunity against certain diseases.

  3. Carries electrolytes such as sodium and potassium to our muscles.

  4. Helps maintain a proper pH balance in the body, which supports cell function.

The Plasma Protein Therapeutics Association (PPTA) says that “plasma often is referred to as the ‘gift of life’ because it’s the essential starting material needed to manufacture therapies that help thousands of people worldwide with rare, chronic diseases to live healthier, productive and fulfilling lives.”

Donated plasma is typically used to manufacture therapies to treat people with (but not limited to):

  • Bleeding disorders

  • Cancer

  • Organ transplant recipients

  • Immune deficiencies

  • Severe liver disease

  • Trauma and burns

Our specialty pharmacy manages several medications manufactured from plasma. These treatments include Immune Globulin (IG) for neurology, immunology, and transplant patients as well as factor replacement products for bleeding disorders.

Our IG medication guides make it easy to compare products and reach decisions to fit the needs of your patients. Download these free charts now.

The Growing Need for Plasma

Because of the number of people who rely on plasma for medical treatment, there has been a growing need for years.

Nearly 10,000 units of plasma are needed daily in the U.S.

Who is Eligible to Donate Plasma?

The FDA provides guidelines for eligibility and recently announced expanded guidance to address the urgent need for donations.

In general, you must be at least 18 yrs old, weigh at least 110 lbs, and be in general good health. As a new donor, you must also possess and present both a document with your Social Security number or an INS number and a valid picture ID (driver’s license, student or military ID) with your current local address. There may be some additional restrictions preventing you from donating such as recent tattoos, body piercings, prolonged residence in certain parts of the world, and/or other medical conditions. Check with your local donation center regarding restrictions or questions regarding your ability to donate.

It’s also important to note that as a new donor, you must donate twice within 6 months for your plasma to be used.

Both donations must pass certain tests and screenings needed to assure the safety and quality of the supply. Because of the time commitment it takes to donate plasma, plasma donation is eligible for compensation. The amount of compensation depends on the donation center.

If you have type AB blood, American Red Cross urges you to donate. AB is the only universal plasma that can be given to patients of any blood type. It can be given to patients immediately without determining compatibility. This time saved can mean the difference between life and death. 

Type AB plasma donations – which the Red Cross calls “AB Elite” – can be made every 28 days, up to 13 times per year. The average donation takes one hour and 15 minutes, just a few minutes longer than donating whole blood.

Where Can I Donate Plasma?

To find a plasma donation center in your area, click the button below to visiting donatingplasma.org.

PLASMA-HEART.jpg

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

Read More

,

Patient Perspective: Carolyn

,
Blog-image.jpg

I was newly retired from the United States Army and planning for some family time after a simple outpatient surgical procedure in October 2015. The procedure went well. But, within 24-hours small itchy blisters slowly began to appear on my chest, back, as well as in my mouth.

My doctor prescribed a topical steroid for what she thought was a fungal infection. I also saw my dentist who encouraged me to brush my teeth more, use mouthwash, and to see the dental hygienist.

However, by late November, the small blisters blossomed into silver dollar size hives covering my scalp, neck, chest, back, upper and lower arms, thighs, legs, and my mouth was a mess. By this time I had seen 15 doctors, and I was misdiagnosed with everything from shingles, celiac disease, Lyme disease, chickenpox, acne, to various skin related allergies. I was given routine referrals.

By late December 2015, I had been hospitalized twice due to infection, dehydration, and an alarming collection of symptoms that included severely blistered skin over 60% of my body, and I couldn’t eat due to a severely blistered mouth. I itched horribly, my skin oozed blood constantly, my hair was falling out, and I was exhausted. My husband was now carrying me up and down the stairs of our home and buying Boost for me to keep weight on.

After weeks of extensive exams, blood work, and skin biopsies I was finally diagnosed with Bullous Pemphigoid (BP) in February of 2016. Bullous Pemphigoid is a rare autoimmune skin blistering condition that has no cure. Some of the current therapies used to treat BP include the following: corticosteroids, immunosuppressants, Intravenous Immunoglobulin (IVIG), anti-inflammatory agents, and Rituximab.

My arms and legs were wrapped in sterile dressings after topical steroids (Clobetasol) and Vaseline was applied. Additionally, oral steroids (Prednisolone), Doxycycline, Niacidimine, Vitamin D, Benadryl, Phosomax, probiotics, Triamcinolog (steroid dental paste), and magic mouthwash were all prescribed. It was painful going through months of wound care, bandage changes, and specialty appointments. I would spend the next six months regaining my strength so that I could walk, climb the stairs, eat normally, and do basic household chores. The International Pemphigus/Pemphigoid Foundation (IPPF) was an outstanding resource of information and support. We learned that we were not alone, and this knowledge was an incredible source of strength to us.

Today, I am doing better. I’m active in family activities at home, church, and I’ve returned to work. I also volunteer with the International Pemphigus/Pemphigoid Foundation (IPPF) as a volunteer Peer Health Coach and Mid-Atlantic Support Group leader supporting Pemphigus/Pemphigoid patients and their families.

BioMatrix Specialty Pharmacy is proud to make a difference in the communities we serve, one patient at a time.

Our clinicians and support staff offer a tailored approach to every therapeutic category, improving quality of life for patients and producing positive outcomes along the healthcare continuum.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

By giving us your contact information and signing up to receive this content, you'll also be receiving marketing materials by email. You can unsubscribe at any time. We value your privacy. Our mailing list is private and will never be sold or shared with a third party. Review our Privacy Policy here.

Read More

,

April Spotlight: Three National Primary Immunodeficiency Disease (PIDD) Organizations & How You Can Get Involved

,
iStock-1093935162.jpg

April is National Primary Immunodeficiency Awareness Month. Primary Immunodeficiency Diseases (PIDD) are a group of more than 4001 rare, hereditary conditions characterized by the absence or malfunction of cells or proteins required by the immune system to function properly. There are approximately 500,000 people in the U.S. living with PIDD.2 Here we spotlight three organizations dedicated to advancing PIDD research, treatment, and education and how you can get involved.

1. Immune Deficiency Foundation (IDF)

logo-idf.png

Immune Deficiency Foundation (IDF) is dedicated to PIDD advocacy, education, and research in order to improve the diagnosis, treatment, and quality of life of those affected. IDF provides education and networking via online resources, in-person events, and virtual events. IDF also has nationwide volunteers serving as peer support, educational meeting hosts, public policy advocates, and fundraiser organizers. To learn more about IDF, volunteering, and/or additional ways to get involved, visit their website here.

2. Jeffrey Modell Foundation

download.jpg

The Jeffrey Modell Foundation helps people with PIDD find answers about their diagnosis, find expert Immunologists, and connect with other PIDD patients and their families/caregivers. The Jeffrey Modell Foundation has named and funded 150 Jeffrey Modell Diagnostic and Research Centers. It has a network of 821 Expert Physicians while spanning and serving 379 academic teaching hospitals, 294 cities, 86 countries, and 6 continents. Learn more about how this organization continues to drive for a cure as well as how you can participate here.

3. The American Academy of Allergy, Asthma & Immunology (AAAAI)

logo.png

The American Academy of Allergy, Asthma & Immunology (AAAAI) is a professional membership organization of more than 7,000 allergists / immunologists globally. It's also a patient resource for patients with allergies, asthma, and immune deficiency disorders. Specific to PIDD, AAAAI provides online educational resources on the types of PIDDS, research, and treatment. You can also find local Immunologists through their online database. Learn more about AAAI including its available resources and becoming a member here.

BioMatrix helps prevent infections from PIDD so you can live your best life. Together, our clinicians, support staff, and digital health technology offer a comprehensive approach improving quality of life for patients and producing positive outcomes along the entire healthcare continuum.

DISCLAIMER: THIS IS NOT MEDICAL OR LEGAL ADVICE. All information, content, and material is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider or as legal advice. Please consult a physician or other health care professional for your specific health care and/or medical needs or concerns and never disregard professional medical advice or delay in seeking it because of something you have read here or on our website.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

We value your privacy. Review our Privacy Policy here.

References

  1. https://primaryimmune.org/about-primary-immunodeficiencies 

  2. https://www.niaid.nih.gov/diseases-conditions/primary-immune-deficiency-diseases-pidds

Read More

, ,

An Overview of Intravenous and Subcutaneous Immunoglobulin (IVIG/SCIG) In Immunology

, ,
iStock-1180608900.jpg

IVIG and SCIG are pinnacle therapies for the treatment of primary humoral immunodeficiencies and are gaining utility across the scope of immunology.

Immunoglobulin may be used to increase serum IgG, modulate the immune system, and help prevent recurrent infections.1 Depending on the specific indication, immunoglobulin therapy may be FDA approved or used off-label with recommendations from clinical guidelines.

Indications with FDA approval for IVIG2

Chart-1.jpg

Indications with off-label use for IVIG

Chart-2.jpg

Monitoring

Monitoring for IVIG patients typically includes:

  • Blood pressure before, during and after the infusion2
    • - IVIG may cause hypotension or hypertension
  • Renal function3
    • - Monitor before initiating therapy, and then at appropriate intervals.
    - IVIG has a US boxed warning for renal dysfunction.
  • IgG concentrations2,11,12
    • - Monitor before initiating therapy, and then every 4-6 months. Measure every 2-3 months if switching from IV to SC IG.
    - IgG reference level: 700-1600 mg/dL
    - Goal trough level: >600 mg/dL OR at least as high as the previous trough level from the previous IVIG dose.
  • IgA concentrations2,11
    • - Low levels of IgA may lead to the formation of IgA antibodies.
    - Patients with IgA antibodies are at a greater risk of infusion reactions from IVIG.
    - Use low IgA IVIG for patients with low IgA and monitor closely for infusion reactions.
    - IgA reference level: 70-400 mg/dL
  • Signs of thrombosis2
    • - IVIG has box warning for increased risk of thrombosis.
    - Patients who have difficulties ambulating may be at a greater risk of thrombosis events.
  • Clinical response

The role of subcutaneous immunoglobulin (SCIG)

SCIG offers several benefits for patients who receive immunoglobulin therapy. The primary benefit is convenience, as the patient may be trained to self-administer SCIG or be able to have a caregiver trained to administer at home. Patients who have a busy schedule, live far away from infusion centers or who have transportation barriers may find great freedom in switching from IVIG to SCIG. SCIG produces a less dramatic spike in serum IgG levels which is beneficial in reducing systemic side effects. Additionally, more frequent dosing of SCIG has been shown to produce higher trough levels and patients may experience less variations in clinical response.13

The main limitations of SCIG are increased infusion-site reactions, increased dosing frequency and less opportunity for healthcare monitoring during infusions. For these reasons, SCIG should be reserved for patients whose disease states are well controlled. If patients experience a decrease in therapeutic response while on SCIG, they may need to be switched back to IVIG therapy.

SCIG therapy is currently FDA approved for primary immunodeficiencies.2 Refer to each product’s prescribing information leaflet for dosing guidance.

Final considerations

The use of IVIG and SCIG in immunology is an evolving topic with new research conducted on a regular basis. Consult your institution’s clinical databases to stay up to date with the latest information regarding IVIG in specific indications.

BioMatrix is proud to make a difference in the communities we serve, one patient at a time.

Our clinicians and support staff offer a tailored approach to every therapeutic category, improving quality of life for patients and producing positive outcomes along the healthcare continuum. Learn more.

References

  1. Perez EE, Orange JS, Bonilla F, et al. Update on the use of immunoglobulin in human disease: A review of evidence. J Allergy Clin Immunol. 2017;139(3S):S1-S46. doi:10.1016/j.jaci.2016.09.023 

  2. Lexi-Drugs. [cited 2020 June 23] In Lexicomp Online [Internet]. Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc. Available from:Available from: http://online.lexi.com.

  3. Boughton BJ, Jackson N, Lim S, Smith N. Randomized trial of intravenous immunoglobulin prophylaxis for patients with chronic lymphocytic leukaemia and secondary hypogammaglobulinaemia. Clin Lab Haematol. 1995;17(1):75-80.

  4. Chapel HM, Lee M, Hargreaves R, Pamphilon DH, Prentice AG. Randomised trial of intravenous immunoglobulin as prophylaxis against infection in plateau-phase multiple myeloma. The UK Group for Immunoglobulin Replacement Therapy in Multiple Myeloma. Lancet. 1994;343(8905):1059-1063.

  5. Intravenous immunoglobulin for the prevention of infection in chronic lymphocytic leukemia. A randomized, controlled clinical trial. Cooperative Group for the Study of Immunoglobulin in Chronic Lymphocytic Leukemia (CGSIGCLL). N Engl J Med. 1988;319(14):902-907.

  6. Griffiths H, Brennan V, Lea J, Bunch C, Lee M, Chapel H. Crossover study of immunoglobulin replacement therapy in patients with low-grade B-cell tumors. Blood. 1989;73(2):366-368.

  7. Anderson D, Ali K, Blanchette V, et al. Guidelines on the use of intravenous immune globulin for hematologic conditions. Transfus Med Rev. 2007;21(2)(suppl 1):s9-s56

  8. Feasby T, Banwell B, Benstead T, et al. Guidelines on the Use of Intravenous Immune Globulin for Neurologic Conditions. Transfus Med Rev. 2007;21(2)(suppl 1):57-107.

  9. Jahnke L1, Applebaum S, Sherman LA, et al. An evaluation of intravenous immunoglobulin in the treatment of human immunodeficiency virus-associated thrombocytopenia. Transfusion. 1994;34(9):759-764

Our entire team is committed to maintaining the health and wellbeing of those we are privileged to serve.

For updated information regarding our response to developments related to COVID-19, a letter from our CEO, and early refill requests, please click here.

Stay healthy, and be well.

We are with you and will get through this together.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

We value your privacy. Review our Privacy Policy here.

Read More

, ,

An Overview of Intravenous and Subcutaneous Immunoglobulin (IVIG/SCIG) In Neurology

, ,
iStock-1053434168.jpg

The utility of intravenous and subcutaneous immunoglobulin has evolved significantly from being a therapy narrowly used in primary immunodeficiencies, to becoming an option for patients in a wide array of clinical categories, including neurology.1

The exact role of IVIG in neurologic disorders varies based on the amount of clinical research for its use in each indication and can be categorized as being FDA approved (highest level of evidence), used off-label per guideline recommendations, or used with clinical caution in indications with more limited data.

Indications with FDA approval for IVIG

Chart-3.jpg

Indications with off-label use for IVIG

Chart-4.jpg

Indications with limited clinical support for IVIG

  • Stiff person syndrome12,13
  • Multiple sclerosis14,15,16
  • Childhood encephalitis17

IVIG is reserved as a last line treatment option in these indications if other treatments fail or cannot be tolerated by the patient. Dosing guidelines have yet to be clinically decided, and dosing is typically determined by the clinical judgement of the prescriber and individual, institutional protocols.

Monitoring

Monitoring for IVIG patients typically includes:

  • Blood pressure before, during and after the infusion3
    • - IVIG may cause hypotension or hypertension
  • Renal function3
    • - Monitor before initiating therapy, and then at appropriate intervals.
    - IVIG has a US boxed warning for renal dysfunction.
  • IgG concentrations3,18,19
    • - Monitor before initiating therapy, and then every 4-6 months. Measure every 2-3 months if switching from IV to SC IG.
    - IgG reference level: 700-1600 mg/dL
    - Goal trough level: >600 mg/dL OR at least as high as the previous trough level from the previous IVIG dose.
  • IgA concentrations3,18
    • - Low levels of IgA may lead to the formation of IgA antibodies.
    - Patients with IgA antibodies are at a greater risk of infusion reactions from IVIG.
    - Use low IgA IVIG for patients with low IgA and monitor closely for infusion reactions.
    - IgA reference level: 70-400 mg/dL
  • Signs of thrombosis3
    • - IVIG has box warning for increased risk of thrombosis.
    - Patients who have difficulties ambulating may be at a greater risk of thrombosis events.
  • Clinical response

The role of subcutaneous immunoglobulin (SCIG)

SCIG offers several benefits for patients who receive immunoglobulin therapy. The primary benefit is convenience, as the patient may be trained to self-administer SCIG or be able to have a caregiver trained to administer at home. Patients who have a busy schedule, live far away from infusion centers, or who have transportation barriers may find great freedom in switching from IVIG to SCIG. SCIG produces a less dramatic spike in serum IgG levels which is beneficial in reducing systemic side effects. Additionally, more frequent dosing of SCIG has been shown to produce higher trough levels, and patients may experience less variations in clinical response.20

The main limitations of SCIG are increased infusion-site reactions, increased dosing frequency, and less opportunity for healthcare monitoring during infusions. For these reasons, SCIG should be reserved for patients whose disease states are well controlled. If patients experience a decrease in therapeutic response while on SCIG, they may need to be switched back to IVIG therapy.

SCIG therapy, Hizentra, is currently FDA approved for CIDP.3 Refer to each product’s prescribing information leaflet for dosing guidance.

Final considerations

The use of IVIG and SCIG in immunology is an evolving topic with new research conducted on a regular basis. Consult your institution’s clinical databases to stay up to date with the latest information regarding IVIG in specific indications.

BioMatrix is proud to make a difference in the communities we serve, one patient at a time.

Our clinicians and support staff offer a tailored approach to every therapeutic category, improving quality of life for patients and producing positive outcomes along the healthcare continuum. Learn more.

References

  1. Hartung HP, Mouthon L, Ahmed R, Jordan S, Laupland KB, Jolles S. Clinical applications of intravenous immunoglobulins (IVIg)--beyond immunodeficiencies and neurology. Clin Exp Immunol. 2009 Dec;158 Suppl 1(Suppl 1):23-33. doi: 10.1111/j.1365-2249.2009.04024.x. PMID: 19883421; PMCID: PMC2801038.

  2. Hughes RA, Donofrio P, Bril V, et al., for the ICE Study Group. Intravenous immune globulin (10 percent caprylate-chromatography purified) for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (ICE study): a randomized, placebo-controlled trial. Lancet Neurol 2008 Feb;7(2):136–44.

  3. Lexi-Drugs. [cited 2020 June 23] In Lexicomp Online [Internet]. Hudson, Ohio: Wolters Kluwer Clinical Drug Information, Inc. Available from:Available from: http://online.lexi.com.

  4. Elovaara I, Apostolski S, van Doorn P, et al; EFNS. EFNS guidelines for the use of intravenous immunoglobulin in treatment of neurological diseases: EFNS Task Force on the Use of Intravenous Immunoglobulin in Treatment of Neurological Diseases [published correction appears in Eur J Neurol. 2009;16(4):547]. Eur J Neurol. 2008;15(9):893-908.[PubMed 18796075]

  5. Patwa HS, Chaudhry V, Katzberg H, Rae-Grant AD, So YT. Evidence-based guideline: intravenous immunoglobulin in the treatment of neuromuscular disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2012;78(13):1009-1015.[PubMed 22454268]

  6. Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Lancet. 1997;349(9047):225-230.[PubMed 9014908]

  7. Raphael JC, Chevret S, Harboun M, Jars-Guincestre MC; French Guillain-Barré Syndrome Cooperative Group. Intravenous immune globulins in patients with Guillain-Barré syndrome and contraindications to plasma exchange: 3 days versus 6 days. J Neurol Neurosurg Psychiatry. 2001;71(2):235-238.[PubMed 11459901]

  8. Bain PG, Motomura M, Newsom-Davis J, et al. Effects of Intravenous Immunoglobulin on Muscle Weakness and Calcium-Channel Autoantibodies in the Lambert-Eaton Myasthenic Syndrome. Neurology. 1996;47(3):678-683.[PubMed 8797464]

  9. Barth D, Nabavi Nouri M, Ng E, Nwe P, Bril V. Comparison of IVIg and PLEX in patients with myasthenia gravis. Neurology. 2011;76(23):2017-2023.[PubMed 21562253]

  10. Gajdos P, Tranchant C, Clair B, et al; Myasthenia Gravis Clinical Study Group. Treatment of myasthenia gravis exacerbation with intravenous immunoglobulin: a randomized double-blind clinical trial. Arch Neurol. 2005;62(11):1689-1693.[PubMed 16286541]

  11. Zinman L, Ng E, Bril V. IV immunoglobulin in patients with myasthenia gravis: a randomized controlled trial. Neurology. 2007;68(11):837-841.[PubMed 17353471]

  12. Dalakas MC, Fujii M, Li M, Lutfi B, Kyhos J, McElroy B. High-dose intravenous immune globulin for stiff-person syndrome. N Engl J Med. 2001.

  13. Dalakas MC, Fujii M, Li M, McElroy B. The clinical spectrum of anti-GAD antibody-positive patients with stiff-person syndrome. Neurology. 2000. 

  14. Fazekas F, Deisenhammer F, Strasser-Fuchs S, Nahler G, Mamoli B. Randomised placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing-remitting multiple sclerosis. Austrian Immunoglobulin in Multiple Sclerosis Study Group. Lancet. 1997.

  15. Achiron A, Kishner I, Dolev M, et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol. 2004.

  16. Sorensen PS, Haas J, Sellebjerg F, Olsson T, Ravnborg M, Group TS. IV immunoglobulins as add-on treatment to methylprednisolone for acute relapses in MS. Neurology. 2004.

  17. Iro MA, Martin NG, Absoud M, Pollard AJ. Intravenous immunoglobulin for the treatment of childhood encephalitis. Cochrane Database Syst Rev. 2017;10(10):CD011367. Published 2017 Oct 2. doi:10.1002/14651858.CD011367.pub2

  18. Dati F, Schumann G, Thomas L, et al. Consensus of a group of professional societies and diagnostic companies on guidelines for interim reference ranges for 14 proteins in serum based on the standardization against the IFCC/BCR/CAP Reference Material (CRM 470) Eur J Clin Chem Clin Biochem. 1996;34:517–20. International Federation of Clinical Chemistry, Community Bureau of Reference of the Commission of the European Communities, College of American Pathologists.

  19. Agarwal S, Cunningham-Rundles C. Assessment and clinical interpretation of reduced IgG values. Ann Allergy Asthma Immunol. 2007;99(3):281–283

  20. Shrestha P, Karmacharya P, Wang Z, Donato A, Joshi AY. Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies. World Allergy Organ J. 2019 Oct 9;12(10):100068. doi: 10.1016/j.waojou.2019.100068. PMID: 31641401; PMCID: PMC6796775.

Our entire team is committed to maintaining the health and wellbeing of those we are privileged to serve.

For updated information regarding our response to developments related to COVID-19, a letter from our CEO, and early refill requests, please click here.

Stay healthy, and be well.

We are with you and will get through this together.

Stay informed on the latest trends in healthcare and specialty pharmacy.

Sign up for our monthly e-newsletter, BioMatrix Abstract.

We value your privacy. Review our Privacy Policy here.

Read More