Home therapy for immunity

Sara Ahrens pinches her thigh, inserts the needle and turns on the pump. She then sits down on the couch and watches the next episode of “The Surgeons” at her home in Long Beach, California. Meanwhile, a miraculous fluid seeps into her body to keep her healthy.

Ahrens is one of 10 million people in the world who do not make enough antibodies. As a result, they catch infections that healthy people deal with without going to a doctor. Last month, this 36-year-old teacher started injecting herself with an immune-boosting drug at home. It is called Hizentra, and its producer is CSL Ltd. Thanks to this, Ahrens was finally able to give up seven years of monthly trips to the clinic.

Previously, she had to go there regularly, because it was only in the clinic that she received injections with healing fluid. “It’s good that I now have the drug at home so that I don’t have to take time off work for these trips anymore,” says Ahrens. – Sometimes, while taking the preparation, I check the tests, sometimes I watch TV.

Doctors and analysts expect an increase in the number of patients wishing to switch to Hizentra, which is a much more convenient option compared to cumbersome visits to clinics. Today Hizentra sells best among similar products. As a result, CSL could soon push Baxter International Inc. out of its leadership position. And there is a lot to fight for: the global market of drugs that strengthen the human immune system, i.e. immunoglobulins, is worth $ 5 billion. These are the estimates of Shane Storey, a market analyst based in Brisbane, Australia.

After simple training by a nurse, patients using Hizentra can inject themselves at home. Once or twice a week they insert a needle through which the preparation is filtered for about an hour and a half. And the medicine does not have to be frozen as is the case with competing products. The needle is put just under the skin, usually in the abdomen, thigh, arm or hip.

The new drug, which was prepared through research conducted over a century ago by later Nobel laureate Emil von Behring, was approved by the US federal government in March. It can be taken by people like Ahrens who suffer from primary immunodeficiencies, resulting in 150 ailments. The Australian concern CSL has become the first to sell subcutaneously injected immunoglobulins on the world’s largest American drug market.

Deprived of immunoglobulins, patients risk many serious, recurring infections. And these can cause severe complications and even death. A professor of pediatrics at Seattle Children’s Hospital, Hans Ochs, who has been taking these drugs himself since 1973, mentions chronic lung disease, meningitis, and arthritis. Hizentra is to replace intravenous drugs, such as Gamunex from Talecris Therapeutics Holdings or Gammagard from Baxter, which usually force patients to stay in clinics or hospitals for many hours each month.

Ahrens points out that reaching for these preparations was a waste of time. In addition, they caused side effects that are not experienced with Hizentra. – After those drugs I felt nauseous. My head was spinning, my veins ached. And the nurses have always had problems getting a good puncture – she recalls.

Each gram of Hizentra contains more antibodies than competing drugs. This saves patients time and money. David Low, a health market analyst at Deutsche Bank in Sydney, says the drug will appeal to patients, doctors and insurance companies.

Competitive concerns are trying to catch up quickly. According to Deborah Spak, a spokeswoman for Baxter, the company is waiting for approval of its own subcutaneous immunoglobulin. Moreover, it has entered the final stage of work on a new product, thanks to which patients will be able to inject the preparation at home only once a month.

Talecris has also been authorized to trade its own product, which is put under the skin, Gamunex-C. This one, however, compared to Hizentra, contains only half of the antibodies in each gram. “Despite the understandable efforts of competitors, CSL still has an unmatched product,” says Low. – It is effective, recognizable, and is known to make treatment easier. He has a rosy future ahead of him.

A gram of Hizentry costs just over $ 74 in California. Ahrens consumes 25 grams of this preparation in a week. This means considerable expenses. But the investment will pay off. Because in patients who switched from intravenous to subcutaneous drugs, the average level of antibodies increased by 5,4 percent. And this is after a year of using the new therapy.

These patients also take 28 percent. less other drugs. These are the results of a study that was published in July in the Journal of Clinical Immunology. – The difference between drugs is huge. I mean, first of all, the satisfaction of people who no longer have to waste time flying around clinics – says Dr. Hans Ochs. – I am a big fan of this solution.

Simeon Bennett, Washington Post, 24.11.2010

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