Multicenter study to determine antibody concentrations and assess the safety of administration of INH-A21, a donor-selected human staphylococcal immune globulin, in low-birth-weight infants

Edmund V. Capparelli, Barry T. Bloom, Tom J. Kueser, David G. Oelberg, Ellen M. Bifano, Robert D. White, Robert Schelonka, Stephen A. Pearlman, Joseph Patti, Seth V. Hetherington

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20 Scopus citations

Abstract

Nosocomial or late-onset sepsis is a common complication among premature infants, with a frequency inversely correlated with birth weight. Increased susceptibility to infection is due in part to an immature humoral (antibody-mediated) immune response. This study investigated the pharmacokinetics (PKs) and safety of a donor-selected specific intravenous immune globulin (IVIG) preparation, INH-A21 (Veronate), for prevention of sepsis in premature infants. Thirty-six infants weighing between 500 and 1,250 g during the first postnatal week were eligible to begin a series of up to four intravenous infusions of 500 or 750 mg/kg of body weight INH-A21. Blood samples were analyzed for antibodies against the Ser-Asp dipeptide repeat G (SdrG) and clumping factor A (ClfA) surface proteins of staphylococci. Sparse sampling and population PK analyses were performed to derive PK parameters. Following administration of the 500- and 750-mg/kg doses, the estimated average steady-state levels of anti-ClfA were 6.1 U/ml and 9.2 U/ml, respectively, and those of anti-SdrG were 5.2 U/ml and 7.7 U/ml, respectively. The elimination half-lives for anti-ClfA and anti-SdrG were 719 h and 701 h, respectively, and the clearances were 0.18 ml/h and 0.21 ml/h, respectively. In the final model, the values of the PK parameters were independent of gestational age. Both doses of INH-A21 were well tolerated, and the safety profile was similar to those of other IVIG preparations. These results suggest that a shorter dosing interval should be utilized between the first and second doses to achieve and maintain higher titers of anti-ClfA and anti-SdrG antibodies. Further studies examining INH-A21 for the prevention of late-onset sepsis in infants within the weight range studied are warranted.

Original languageEnglish (US)
Pages (from-to)4121-4127
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume49
Issue number10
DOIs
Publication statusPublished - Oct 2005
Externally publishedYes

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ASJC Scopus subject areas

  • Pharmacology (medical)

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