By Dr. Kamal Kant Kohli Ruchika Sharma
Japan: Takeda has received approval from the U.S. Food and Drug Administration (FDA) for GAMMAGARD LIQUID ERC [immune globulin infusion (human)] with less than or equal to 2 碌g/mL IgA in a 10% solution, a ready-to-use liquid immunoglobulin (IG) therapy with low immunoglobulin A (IgA) content, as replacement therapy for people two years of age and older with primary immunodeficiency (PI).As a ready-to-use liquid, GAMMAGARD LIQUID ERC may help ease the administration burden for patients and their health care providers by eliminating the need for reconstitution and can be administered intravenously or subcutaneously.鈥淭he approval of GAMMAGARD LIQUID ERC reinforces our commitment to supporting individualized treatment approaches for people with primary immunodeficiency, including a therapeutic option that has the lowest IgA content of any ready-to-use liquid immunoglobulin therapy, and can be administered intravenously or subcutaneously,鈥 said Kristina Allikmets, senior vice president and head of Research & Development for Takeda鈥檚 Plasma-Derived Therapies Business Unit. 鈥淕AMMAGARD LIQUID ERC uses the same state-of-the-art manufacturing process as our other ready-to-use liquid immunoglobulin formulations and is aligned with our forward-looking strategy to prioritize reliable supply while offering a broad range of immunoglobulin therapies to address varied patient needs.鈥”With this approval, Takeda continues to be the only manufacturer of IG therapy with low IgA content less than or equal to 2 碌g/mL in a 10% solution,” claimed Takeda.It is anticipated that commercialization of GAMMAGARD LIQUID ERC will begin in the U.S. in 2026, followed by the European Union in 2027, where GAMMAGARD LIQUID ERC is approved by the European Medicines Agency (EMA) as DEQSIGA. The timeline to commercial launch is consistent with the time it takes to ramp up manufacturing and supply for plasma-derived therapies.In parallel to this approval, and after thorough analysis, Takeda has decided to discontinue GAMMAGARD S/D [Immune Globulin Intravenous (Human)] IgA less than 1 碌g/mL in a 5% solution, the company鈥檚 first-generation low IgA product. As the only lyophilized (freeze-dried) preparation in Takeda鈥檚 IG portfolio, GAMMAGARD S/D uses a different, older manufacturing process. For GAMMAGARD S/D, this process is no longer able to reliably meet the future needs of the patient community. Therefore, Takeda has informed the FDA and other health authorities that manufacturing of GAMMAGARD S/D will be discontinued at the end of December 2027. Beyond that date, Takeda intends to maintain GAMMAGARD S/D inventory until it is depleted or expired.鈥淲e understand the impact that this news may have on patients who currently rely on GAMMAGARD S/D for their treatment,鈥 said Kristina Allikmets. 鈥淲e are communicating this information now to allow time for patients to work closely with their health care teams to develop alternative treatment plans.鈥滸AMMAGARD LIQUID ERC shares its manufacturing process with GAMMAGARD LIQUID [Immune Globulin Infusion (Human)], with the modification of parameters in a single process step to improve IgA reduction. This enhanced removal capability (ERC) results in a product with IgA less than or equal to 2 碌g/mL in a 10% solution.While GAMMAGARD LIQUID ERC is not indicated specifically for IgA sensitivity in people with primary immunodeficiency, it may be an appropriate option for them based on their physician鈥檚 clinical judgment. GAMMAGARD LIQUID ERC is contraindicated in patients with a history of severe systemic hypersensitivity or anaphylactic reactions to the product. It also carries warnings and precautions regarding the potential for severe hypersensitivity reactions, including in patients who have previously tolerated immune globulin products. Despite containing low levels of IgA (鈮2 碌g/mL in a 10% solution), the risk of anaphylaxis remains.Primary immunodeficiency (PI) is a group of more than 550 rare and chronic disorders, where a part of the body鈥檚 immune system is missing or does not function the way it should. These conditions result from genetic mutations, which are usually inherited. The symptoms of PI vary and can include frequent and/or persistent infections and unusual autoimmunity, often leading to prolonged periods of misdiagnosis despite consultations with multiple specialists. In the United States, PI affects about 1 in 1,200 people.