A Guide to HYQVIA Dosing

Here you'll find an overview of dosing guidelines for HYQVIA [Immune Globulin Infusion 10% (Human) with Recombinant Human Hyaluronidase] Solution. For comprehensive guidelines, request a HYQVIA Dosing Guide from your Takeda representative.

Please click for Important Safety Information and Full Prescribing Information, including Boxed Warning regarding Thrombosis.

Dose Determination

HYQVIA is supplied in a dual vial unit containing one vial of Immune Globulin Infusion 10% (Human) Solution [IG 10%] and one vial of Recombinant Human Hyaluronidase.1

The dose of HYQVIA is based on the immune globulin (IG) component, which provides the therapeutic effect. The vial of Recombinant Human Hyaluronidase contains the appropriate amount to enable the administration of the contents of the vial of IG 10%.1

The dose determination of HYQVIA varies based on whether patients are switching from intravenous immune globulin (IVIG) treatment or conventional subcutaneous immune globulin (SCIG) treatment.1

Patients who are:

 

Switching from IVIG treatment

Same dose and frequency of IVIG*
(after initial ramp-up)

Switching from SCIG treatment

300 to 600 mg/kg at 3-4 week intervals
(after initial ramp-up)

Treatment with HYQVIA [Immune Globulin Infusion 10% (Human) with Recombinant Human Hyaluronidase] Solution is initiated by gradually increasing the dose and decreasing the frequency from a 1-week dose to a 3- to 4-week dose. This "ramp-up period" allowed subjects to become familiar with the volumes required for a full 3- or 4-week treatment.1

*During the 12-month clinical study, which included 83 subjects, patients were treated with HYQVIA at doses of 300 to 600 mg/kg, administered at 108% of the intravenous dose, which was considered pharmacokinetically equivalent to IVIG.1 For more information, please see the Clinical Study Design.

Initial Treatment and Ramp-Up Schedule

Treatment with HYQVIA [Immune Globulin Infusion 10% (Human) with Recombinant Human Hyaluronidase] Solution is initiated by gradually increasing the dose and decreasing the frequency from a 1-week dose to a 3- or 4-week dose to allow patients to acclimate to the volume of IG being administered subcutaneously.1

Dosage during the ramp-up period is calculated by dividing the total 3- or 4-week therapeutic dose, as shown below.1

For patients previously on another IG treatment, the first dose should be given approximately one week after the last infusion of their previous treatment.1

Ramp-Up Example for 30 g Dose (300 mL) of IG 10% on a 4-week Treatment Interval*
IG 10% Dose (g protein) vs. Week

*No infusion on week 3, week 5 or week 6
For more comprehensive information on HYQVIA dosing, request a HYQVIA Dosing Guide from your Takeda representative.

Please expand for Indication and Important Safety Information.

Important Safety Information
WARNING: THROMBOSIS

Thrombosis may occur with immune globulin (IG) products, including HYQVIA. Risk factors may include advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors; For patients at risk of thrombosis, administer HYQVIA at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration; Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk of hyperviscosity.

INDICATION AND LIMITATION OF USE

HYQVIA is indicated for the treatment of primary immunodeficiency (PI) in adults. HYQVIA is for subcutaneous use only. Safety and efficacy of chronic use of Recombinant Human Hyaluronidase in HYQVIA have not been established in conditions other than PI.

IMPORTANT SAFETY INFORMATION

WARNING: THROMBOSIS
  • Thrombosis may occur with immune globulin (IG) products, including HYQVIA. Risk factors may include advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity, and cardiovascular risk factors. Thrombosis may occur in the absence of known risk factors.
  • For patients at risk of thrombosis, administer HYQVIA at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration.
  • Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk of hyperviscosity.
CONTRAINDICATIONS

  • History of anaphylactic or severe systemic hypersensitivity reactions to human IG
  • IgA-deficient patients with antibodies to IgA and a history of hypersensitivity to human IG
  • Known systemic hypersensitivity to hyaluronidase including Recombinant Human Hyaluronidase of HYQVIA
  • Known systemic hypersensitivity to human albumin (in the hyaluronidase solution)
WARNINGS and PRECAUTIONS

Hypersensitivity: Severe hypersensitivity reactions may occur, even in patients who have tolerated previous treatment with human IG. If a hypersensitivity reaction occurs, discontinue infusion immediately and institute appropriate treatment. IgA-deficient patients with antibodies to IgA are at greater risk of developing potentially severe hypersensitivity reactions, including anaphylaxis.

Thrombosis: May occur following treatment with IG products and in the absence of known risk factors. In patients at risk, administer at the minimum dose and infusion rate practicable. Ensure adequate hydration before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.

Immunogenicity of Recombinant Human Hyaluronidase (rHuPH20): Non-neutralizing antibodies to the Recombinant Human Hyaluronidase component can develop. The clinical significance of these antibodies or whether they interfere with fertilization in humans is unknown.

Aseptic Meningitis Syndrome: Has been reported with use of IG and may occur more frequently in females. Conduct a thorough neurological exam on patients exhibiting signs and symptoms, to rule out other causes of meningitis. Discontinuing IG treatment has resulted in remission within several days without sequelae.

Hemolysis: HYQVIA contains blood group antibodies which may cause a positive direct antiglobulin reaction and hemolysis. Monitor patients for signs and symptoms of hemolysis and delayed hemolytic anemia and, if present, perform appropriate confirmatory lab testing.

Renal Dysfunction/Failure: Acute renal dysfunction/failure, acute tubular necrosis, proximal tubular nephropathy, osmotic nephrosis and death may occur with intravenous (IV) use of IG products, especially those containing sucrose. Ensure patients are not volume depleted prior to infusion. In patients at risk due to pre-existing renal insufficiency or predisposition to acute renal failure, assess renal function before initiation and throughout treatment, and consider lower, more frequent dosing. If renal function deteriorates, consider discontinuation.

Spread of Localized Infection: Do not infuse HYQVIA into or around an infected area due to potential risk of spreading a localized infection.

Transfusion-Related Acute Lung Injury: Non-cardiogenic pulmonary edema may occur with IV administered IG. Monitor patients for pulmonary adverse reactions. If suspected, perform appropriate tests for presence of anti-neutrophil and anti-HLA antibodies in both product and patient serum. May be managed using oxygen therapy with adequate ventilatory support.

Transmittable Infectious Agents: Because HYQVIA is made from human plasma, it may carry a risk of transmitting infectious agents (e.g. viruses, other pathogens). No cases of transmission of viral diseases or variant Creutzfeldt-Jakob disease (vCJD) have been associated with HYQVIA.

Interference with Lab Tests: False positive serological test results and certain assay readings, with the potential for misleading interpretation, may occur as the result of passively transferred antibodies.

The most common adverse reactions observed in >5% of patients in the clinical trials were: local adverse reactions including pain, erythema, edema, and pruritis, and systemic adverse reactions including, headache, antibody formation against Recombinant Human Hyaluronidase (rHuPH20), fatigue, nausea, pyrexia, and vomiting.

Passive transfer of antibodies may transiently interfere with the immune responses to live attenuated virus vaccines (e.g., measles, mumps, rubella, and varicella).

Please click for Full Prescribing Information.