The U.S. Food and Drug Administration has approved Takeda's GAMMAGARD LIQUID ERC [immune globulin infusion (human)], marking a significant advancement in primary immunodeficiency treatment. The therapy represents the only ready-to-use liquid immunoglobulin therapy with low immunoglobulin A (IgA) content, containing less than or equal to 2 µg/mL IgA in a 10% solution, approved as replacement therapy for patients two years of age and older with primary immunodeficiency.
Enhanced Administration Flexibility
GAMMAGARD LIQUID ERC offers notable clinical advantages through its ready-to-use liquid formulation, eliminating the need for reconstitution that characterizes traditional immunoglobulin therapies. The treatment can be administered both intravenously and subcutaneously, providing healthcare providers and patients with greater flexibility in treatment delivery and potentially reducing administration burden.
"The 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," said Kristina Allikmets, senior vice president and head of Research & Development for Takeda's Plasma-Derived Therapies Business Unit.
Manufacturing Innovation and Product Transition
The new therapy utilizes the same state-of-the-art manufacturing process as Takeda's other ready-to-use liquid immunoglobulin formulations, with modifications to a single process step to enhance IgA reduction capability. This enhanced removal capability (ERC) results in the significantly reduced IgA content while maintaining therapeutic efficacy.
In parallel with this approval, Takeda announced the discontinuation of GAMMAGARD S/D [Immune Globulin Intravenous (Human)] IgA less than 1 µg/mL in a 5% solution, the company's first-generation low IgA product. As the only lyophilized preparation in Takeda's immunoglobulin portfolio, GAMMAGARD S/D uses an older manufacturing process that can no longer reliably meet future patient community needs. Manufacturing will cease at the end of December 2027, with Takeda maintaining inventory until depletion or expiration.
Clinical Considerations and Safety Profile
While GAMMAGARD LIQUID ERC is not specifically indicated for IgA sensitivity in primary immunodeficiency patients, it may represent an appropriate treatment option based on physician clinical judgment. The therapy carries contraindications for patients with a history of severe systemic hypersensitivity or anaphylactic reactions to the product, and warnings regarding potential severe hypersensitivity reactions persist despite the low IgA content.
The treatment carries standard immunoglobulin therapy warnings, including risks of thrombosis and renal dysfunction. Risk factors for thrombosis include advanced age, prolonged immobilization, hypercoagulable conditions, and cardiovascular risk factors, requiring careful patient monitoring and appropriate dosing strategies.
Market Timeline and Patient Impact
Commercialization of GAMMAGARD LIQUID ERC is anticipated to begin in the United States in 2026, followed by European Union availability in 2027, where the therapy has been approved by the European Medicines Agency as Deqsiga.
Primary immunodeficiency encompasses more than 550 rare and chronic disorders where components of the immune system are missing or dysfunctional, typically resulting from inherited genetic mutations. These conditions affect approximately 1 in 1,200 people in the United States and often present with frequent infections and unusual autoimmunity, frequently leading to prolonged diagnostic delays despite multiple specialist consultations.
The approval addresses a significant unmet need in the primary immunodeficiency treatment landscape, offering patients and healthcare providers a more convenient administration option while maintaining the low IgA profile important for certain patient populations who may experience sensitivity to standard immunoglobulin preparations.
