Q:

10/16/2013
I have a patient who has CVID and is doing well on IVIG. He has osteoporosis and his endocrinologist wants to start him on denosumab which is a monoclonal antibody towards RANK ligand. There is no contraindications listed in the package inserts for taking IVIG and denosumab concomitantly. I have contacted the companies but am waiting to hear back. However I wanted to see from experts in the field of IVIG/immunodeficiency if there is any contraindication in receiving IVIG along with a monoclonal antibody?

A:

Thank you for your inquiry.

I can see no reason to be concerned about the simultaneous administration of a monoclonal antibody to a patient who has common variable immunodeficiency and is receiving immunoglobulin replacement; nor can I see any contraindication specifically regarding the use of denosumab in this context.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology