Subcutaneous immunoglobulin: rapid push vs. infusion pump in pediatrics

Abstract

Administration of replacement Ig via SC rapid push is a safe and viable option in pediatric patients with PIDD.

Rapid push: new opportunities in subcutaneous immunoglobulin replacement therapy

“…Peak and trough serum IgG levels with SCIG generally vary less than ±10% from the mean in contrast to the high peaks and low troughs experienced with IVIG doses. Similar findings reported in other studies support the argument that it may not be necessary to increase the dose when switching to SCIG [21][22][23]. European regulatory guidelines advocate the same monthly doses for both IVIG and SCIG [25].…”

“…No major differences were noted in safety, tolerability, or the number of AEs between these two methods. Most AEs were local, mild, and tended to subside over time with no obvious associations between infusion rates and AEs [21][22][23]. Convenience is one of the primary driving forces behind, which obviates the need for venous access and avoids infusion-related systemic side effects.…”

“…Some patients prefer administration at two sites and less frequent infusions [17]. Some studies compared the rapid push versus infusion pump in patients with PAD [21]. No major differences were noted in safety, tolerability, or the number of AEs between these two methods.…”

Intravenous IgG (IVIG) and subcutaneous IgG (SCIG) preparations have comparable inhibitory effect on T cell activation, which is not dependent on IgG sialylation, monocytes or B cells

“…These effects 34 were not affected by depletion of sialic acid containing IgG using neuraminidase treatment or 35 lectin affinity chromatography. With anti-CD3 or Candida stimulation, IL-1β, IL-2, IL-5, IL-6, 36 IL-13, GMCSF, TNF-α, interferon-γ (with anti-CD3) and IL-17 (with Candida) levels were 37 suppressed by IVIG or SCIG, with no effect on IL-4, IL-10, IL-12, IL-15 or TGFβ. Monocytes or B [38].…”

Subcutaneous Immunoglobulin in Refractory Juvenile Dermatomyositis

“…6, 7 SCIG can be administered at home, avoiding hospital admissions and reducing the number of lost work and school days, thus becoming more cost-effective than IVIG. SCIG can be administered by rapid push or by infusion pump 8 ; the first method may be very useful in areas with limited access to medical technology, further reducing the costs of the therapy.…”