Improved Quality of Life, Immunoglobulin G Levels, and Infection Rates in Patients with Primary Immunodeficiency Diseases during Self-Treatment with Subcutaneous Immunoglobulin G

Abstract

Home SCIG therapy was safe and led to improved perceptions of general health, higher serum IgG levels, and very low rates of infections and days missed from work/school.

Intravenous and Subcutaneous Immunoglobulin Replacement: A Two-Way Road. Optimizing Healthcare Quality in Patients with Primary Immunodeficiencies

“…Although several studies have reported that SCIG improves the patients' quality of life while displaying an efficacy and safety profile comparable to IVIG [18][19][20][21][22], some patients continue to prefer definitive IVIG administration, as was seen in our study. In 50 % of these patients, the reason was convenience and patient preference whereas in the remainder, it was used because intercurrent clinical situations required high IgG doses with the aim of immunomodulation or there were contraindications to SCIG because of thrombocytopenia or severe systemic AE.…”

“…Several studies have shown that SCIG administration results in better health-related quality of life (HRQoL) in both children and adults with PID, in comparison with IVIG [7,10,[13][14][15][16][17][18][19][20][21][22]. In our center, SCIG use has been used since 2006 and there is a possibility to change the administration route temporarily depending on the circumstances, or to definitively switch to IVIG for medical reasons or the wishes of the patient or family.…”

Efficacy and tolerability of 16% subcutaneous immunoglobulin compared with 20% subcutaneous immunoglobulin in primary antibody deficiency

“…Hizentra and Vivaglobin have similar viscosities (Hizentra 14Á7 mPa.s; Vivaglobin 14Á4 mPa.s) [33]; however, the higher IgG concentration of Hizentra allowed it to be delivered faster, with larger volumes per site into fewer injection sites [11,34]. Although the rate of local reactions typically declines over time during SCIG treatment, the observation that Hizentra was better tolerated following the transition from Vivaglobin was unexpected [10,34]. The improved tolerability of Hizentra may be due to a lower IgA content and/or other physical characteristics, such as the use of proline as a stabilizer, which has been shown to reduce IgG dimer content and raise IgG purity [11,35].…”

“…Treatment satisfaction can be measured using a standardized self-reported measurement of outcome comparing patients' subjective treatment experience with subjective standards [14,40]. While repeated measures using the same quality of life survey may introduce an intrinsic bias into the results, this quality-of-life tool has been applied previously to subjects with PAD and has been fully validated in the domains of flexibility, independence and sense of self-control [7,8,10,[39][40][41]. This is the first study, to our knowledge, to demonstrate differences in quality of life between two formulations of SCIG.…”

“…Vivaglobinbeen shown to have efficacy similar to that of IVIG in preventing acute serious bacterial infections (aSBIs), and is well tolerated [9]. In order to maintain similar area under the curve (AUC) of serum IgG concentration versus time when transitioning from IVIG, the preceding IVIG dose was multiplied by 1Á37 to determine the dose of Vivaglobin [10]. However, some patients receiving Vivaglobin need to change SCIG products, as Vivaglobin is no longer marketed in the United States.…”