{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:27:32Z","timestamp":1790882852352,"version":"4.1.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T00:00:00Z","timestamp":1605657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T00:00:00Z","timestamp":1605657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Sanquin Plasma Products BV"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Immunol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with an IgG subclass deficiency (IgSD)\u2009\u00b1\u2009specific polysaccharide antibody deficiency (SPAD) often present with recurrent infections. Previous retrospective studies have shown that prophylactic antibiotics (PA) and immunoglobulin replacement therapy (IRT) can both be effective in preventing these infections; however, this has not been confirmed in a prospective study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To compare the efficacy of PA and IRT in a randomized crossover trial.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 64 patients (55 adults and 9 children) were randomized (2:2) between two treatment arms. Treatment arm A began with 12\u00a0months of PA, and treatment arm B began with 12\u00a0months of IRT. After a 3-month bridging period with cotrimoxazole, the treatment was switched to 12\u00a0months of IRT and PA, respectively. The efficacy (measured by the incidence of infections) and proportion of related adverse events in the two arms were compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The overall efficacy of the two regimens did not differ (<jats:italic>p<\/jats:italic>\u2009=\u20090.58, two-sided Wilcoxon signed-rank test). A smaller proportion of patients suffered a related adverse event while using PA (26.8% vs. 60.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0003, chi-squared test). Patients with persistent infections while using PA suffered fewer infections per year after switching to IRT (2.63 vs. 0.64, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We found comparable efficacy of IRT and PA in patients with IgSD \u00b1 SPAD. Patients with persistent infections during treatment with PA had less infections after switching to IRT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical Implication<\/jats:title>\n                <jats:p>Given the costs and associated side-effects of IRT, it should be reserved for patients with persistent infections despite treatment with PA.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10875-020-00841-3","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T15:03:32Z","timestamp":1605711812000},"page":"382-392","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Immunoglobulin Replacement Therapy Versus Antibiotic Prophylaxis as Treatment for Incomplete Primary Antibody Deficiency"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2363-3789","authenticated-orcid":false,"given":"Bas M.","family":"Smits","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Kleine Budde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ineke J. 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IKB is working at Sanquin Plasma Products, Market Authorization Holder of Nanogam. EdV received unrestricted research grants from Sanquin, CSLBehring and Shire\/Takeda, and served on an advisory board for CSLBehring and a patient awareness panel and professional education program sponsored by Sanquin. MvdF received funding from CSL Behring and Takeda. All other authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}