• The primary efficacy endpoint is the incidence of acute serious bacterial infections meeting FDA criteria (bacterial pneumonia, bacteremia/sepsis, bacterial meningitis, visceral abcess, osteomyelitis/septic arthritis). The upper 99% one-sided confidence [ Time Frame: one year ]
• The following pharmacokinetic parameters of total IgG will be determined in at least 20 patients: AUC0-t, Cmax, Tmax, t1/2, Vd and elimination rate constants. [ Time Frame: after 5th or 6th month on study ]
• The primary safety endpoint is the incidence of adverse events that occur during or within 1 hour, 24 hours and 48 hours following an infusion . [ Time Frame: one year ]

• The number of hospitalizations and days of hospitalization per subject per year for PID related infections [ Time Frame: during treatment with study drug-1 year ]
• The incidence of infections other than acute serious bacterial infections [ Time Frame: during treatment with study drug-1 year ]
• The number of days lost from work/school/usual activities [ Time Frame: during treatment with study drug-1 year ]
• The number of days of antibiotic therapy (prophylactic and treatment) [ Time Frame: during treatment with study drug-1 year ]
• Pharmacokinetic parameters of IgG subclasses and specific antibodies will be determined in at least 20 patients: AUC0-t, Cmax, Tmax, t1/2, Vd and elimination rate constants. [ Time Frame: after 5th or 6th month on study ]
• Trough levels of IgG subclasses and specific antibodies will be estimated for each subject in the pharmacokinetic study at defined intervals. [ Time Frame: Months 0, 5, 9, 12 ]
• The number of patients whose trough IgG levels fall below the target of 500 mg/dL at any time will be recorded. [ Time Frame: one year ]
• All adverse events that occur during the study regardless of the investigator’s assessment of the relationship to the investigational product. [ Time Frame: one year ]
• Laboratory assessments on blood and urine samples including direct antiglobulin (Coomb’s) tests. [ Time Frame: one year ]
• Markers of blood borne virus infections at baseline and up to 3 months after the last infusion i.e. HIV (serology), HCV (serology and NAT), HBV (HbsAg). [ Time Frame: Months -1, 14, 16 ]

The purpose of this study is to measure the pharmacokinetics, efficacy and safety of Immune Globulin Intravenous (Human) [IGIV], 5% Solution Omr-IgG-am™ in patients with primary immunodeficiency diseases.

This is an open label, single-arm, prospective, multi-center, uncontrolled Phase III clinical study to evaluate the efficacy, pharmacokinetics and safety of Omr-IgG-am™ in patients with primary immunodificiency diseases.

Approximately 50 subjects will be enrolled for 16 Months:

screening- 1 month treatment-12 months follow-up-3 months

Subjects will be infused every 21 to 28 days according to their previous IVIG treatment schedule. Subjects treated every 28 days will receive 13 study IGIV infusions. Subjects treated every 21 days will receive 17 study IGIV infusions.

We will record the incidence of acute infections, especially actute serious bacterial infections, during the year each subjet is on study.

We will record the incidence of adverse events that occur during each infusion and up to 48 hours after each infusion.

At the time the study is explained to the subjects, each investigator will ask all subjects whose body weight is above 37 kg (or greater as defined by local standards) about their willingness to participate in the pharmacokinetic (PK) portion of the study. This will involve 4 additional visits after the 5th or 6th study IGIV infusion in order to draw blood samples for analysis.

• Ten RM. Primary immunodeficiencies. Mayo Clin Proc. 1998 Sep;73(9):865-72. Review.
• Bonilla FA, Geha RS. 12. Primary immunodeficiency diseases. J Allergy Clin Immunol. 2003 Feb;111(2 Suppl):S571-81. Review. Erratum in: J Allergy Clin Immunol. 2003 Aug;112(2):267.
• Bonilla FA, Bernstein IL, Khan DA, Ballas ZK, Chinen J, Frank MM, Kobrynski LJ, Levinson AI, Mazer B, Nelson RP Jr, Orange JS, Routes JM, Shearer WT, Sorensen RU; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol. 2005 May;94(5 Suppl 1):S1-63. No abstract available. Erratum in: Ann Allergy Asthma Immunol. 2006 Mar;96(3):504.
• Chapel HM. Consensus on diagnosis and management of primary antibody deficiencies. Consensus Panel for the Diagnosis and Management of Primary Antibody Deficiencies. BMJ. 1994 Feb 26;308(6928):581-5. Review. No abstract available. Erratum in: BMJ 1994 Apr 2;308(6933):913.
• Roifman CM, Levison H, Gelfand EW. High-dose versus low-dose intravenous immunoglobulin in hypogammaglobulinaemia and chronic lung disease. Lancet. 1987 May 9;1(8541):1075-7.
• Eijkhout HW, van Der Meer JW, Kallenberg CG, Weening RS, van Dissel JT, Sanders LA, Strengers PF, Nienhuis H, Schellekens PT; Inter-University Working Party for the Study of Immune Deficiencies. The effect of two different dosages of intravenous immunoglobulin on the incidence of recurrent infections in patients with primary hypogammaglobulinemia. A randomized, double-blind, multicenter crossover trial. Ann Intern Med. 2001 Aug 7;135(3):165-74.
• Roifman CM, Schroeder H, Berger M, Sorensen R, Ballow M, Buckley RH, Gewurz A, Korenblat P, Sussman G, Lemm G. Comparison of the efficacy of IGIV-C, 10% (caprylate/chromatography) and IGIV-SD, 10% as replacement therapy in primary immune deficiency. A randomized double-blind trial. Int Immunopharmacol. 2003 Sep;3(9):1325-33.
• Berger M. A history of immune globulin therapy, from the Harvard crash program to monoclonal antibodies. Curr Allergy Asthma Rep. 2002 Sep;2(5):368-78.

The following list is incomplete. A complete list is in the protocol.

Inclusion Criteria:

• Ages 3 to 75 years and weigh at least 27 kg.
• Confirmed clinical diagnosis of a Primary Immune Deficiency disease including hypogammaglobulinemia, preferably with documented antibody deficiency, or agammaglobulinemia.
• Has been receiving licensed IGIV for at least 3 months prior to this study.
• Trough IgG levels, dose of IGIV, and treatment intervals for the last 2 consecutive licensed IGIV treatments must be documented.
• The subject or legal guardian has signed the informed consent form. If appropriate, the subject has signed a child assent form.
• The subject or legal representative has signed the HIPAA declaration.

Exclusion Criteria:

• Subjects with isolated IgG subclass deficiency or specific antibody deficiency without hypogammaglobulinemia will not be eligible.
• The subject has a history of hypersensitivity or persistent or repeated adverse reactions to human immunoglobulin.
• The subject has selective IgA deficiency, history of reaction to products containing IgA, or is known to have antibodies to IgA.
• The subject is currently participating, or has participated within the previous 30 days, in another clinical study of an investigational product or device.
• The subject is pregnant or is nursing. Women of childbearing potential must agree to using a method of contraception.
• The subject has had an acute bacterial infection within 28 days of screening.
• The subject is seropositive for any of the following at screening:
• Antibodies to HIV 1&2
• Antibodies to HCV
• HbsAg
• The subject, at screening, has alanine aminotranferase (ALT) levels greater than 2.5 times the upper limit of normal.
• The subject has severe renal impairment.
• The subject has a history of DVT, thrombotic or thrombo-embolic complications of IGIV therapy.
• The subject suffers from any acute or chronic medical condition that, in the opinion of the investigator, may interfere with the conduct of the study.
• The subject has an acquired medical condition known to cause secondary immune deficiency or otherwise increase the subject’s risk of infection.