In patients with hypogammaglobulinemia secondary to chronic lymphocytic leukemia (CLL) or multiple myeloma (MM), intravenous immune globulin (IVIg) may be administered to reduce the risk of infection. Since 2013, IVIg products have carried a boxed safety warning about the risk of thromboembolic events (TEEs), with TEEs reported in 0.5-15% of patients treated with IVIg. In this retrospective cohort study of older patients with CLL or MM identified from the SEER-Medicare Linked Database, we assessed rates of clinically serious TEEs in 2724 new users of IVIg and a propensity-matched comparison group of 8035 non-users. For the primary endpoint, arterial TEE, we observed a transient increased risk of TEE during the day of an IVIg infusion and the day afterward (HR = 3.40; 95% CI: 1.25, 9.25); this risk declined over the remainder of the 30-day treatment cycle. When considered in terms of absolute risk averaged over a one-year treatment period, the increase in risk attributable to IVIg was estimated to be 0.7% (95% CI: -0.2%, 2.0%) compared to a baseline risk of 1.8% for the arterial TEE endpoint. A statistically non-significant risk increase of 0.3% (95% CI: -0.4%, 1.5%) compared to a baseline risk of 1.1% was observed for the venous TEE endpoint. Further research is needed to establish the generalizability of these results to patients receiving higher doses of IVIg for other indications.
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 May 2020.
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