Secondary immunodeficiencies: Analysis of the use of agents with immunotropic activity in clinical practice

IIntroduction. The increase in the number of secondary immunodeficiency conditions, driven by population aging, the rise in chronic pathology, and the active use of immunosuppressive therapy for a number of diseases (hematological, oncological, rheumatological, neurological, etc.), dictates the need for timely comprehensive diagnosis and treatment.

Aim. To analyse the experience of using agents with immunotropic activity in various forms of secondary immunodeficiency (SID) in clinical practice.

Materials and methods. A retrospective analysis of medical records of 153 patients seeking medical help with a diagnosis of SID was performed.

Results. An induced form of SID was verified in 98.7% of patients. The most common causes were oncohematological diseases, chronic viral and bacterial infections, and to a lesser extent autoimmune and chronic diseases with metabolic disorders, gastrointestinal lesions, reduced nutritional status, and chronic kidney disease. In 1.3% of patients referred with a diagnosis of SID, the diagnosis of Common Variable Immune Deficiency was established. The leading clinical manifestation of SID was frequent infections refractory to standard therapy regimens. Immunological examination of patients revealed abnormalities predominantly in the phagocytic component of the immune system, which justified the inclusion of drugs affecting the phagocytosis system in the comprehensive treatment. In 53% of patients, the high-molecular-weight immunomodulator azoximer bromide was the drug of choice.

Conclusions. A significant number of patients had an induced form of SID with impairment of the phagocytic component of the immune response. The inclusion of immunotropic drugs targeting the phagocytic immunity, including azoximer bromide, in the comprehensive therapy is justified. This approach contributes to the resolution of SID symptoms and improves the course of the underlying disease.

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