Efficacy and patient satisfaction in the use of subcutaneous immunoglobulin immunotherapy for the treatment of auto-immune neuromuscular diseases

Sala, Taylor Pindi; Crave, Jean-Charles; Duracinský, Martin; Bompeka, François Lepira; Tadmouri, Abir; Chassany, Olivier; Chérìn, P.

doi:10.1016/j.autrev.2018.03.010

Cited by 18 publications

(19 citation statements)

References 65 publications

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“…A systematic review and meta-analysis reported a significant reduction of 28% in the relative risk ratio of systemic adverse events of SCIg compared to IVIg; this is comparable to a significant reduction in systemic adverse events of fSCIg versus IVIg in our study [15]. Overall, similar to previous studies, muscle strength, disability and treatment satisfaction in our study remained stable, showing equal muscle strength and disability and unchanged or improved quality of life and treatment satisfaction for SCIg compared to IVIg in patients with MMN [5–7, 13, 14, 16]. Therefore, fSCIg could be a favorable alternative to IVIg treatment in MMN, as systemic adverse events may decrease, muscle strength, disability and treatment satisfaction remains stable, and there is the advantage of independence and flexibility of administration.…”

Section: Discussionsupporting

confidence: 88%

“…Regarding safety of fSCIg, we found similar results compared to previous publications on SCIg in MMN or to fSCIg in primary immunodeficiencies, and to a recently published study that compared fSCIg with conventional SCIg in 20 patients with MMN [5–7, 9, 11, 13–16]. We reported local reactions at the injection sites in 64.7% of the patients, which is in accordance with previous studies that described local adverse reactions of fSCIg in 44–100% of the patients [5–7, 16, 17].…”

Section: Discussionsupporting

confidence: 87%

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Human immune globulin 10% with recombinant human hyaluronidase in multifocal motor neuropathy

et al. 2019

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ObjectiveThe primary aim was to determine the safety of treatment with human immune globulin 10% with recombinant human hyaluronidase (fSCIg) compared to intravenous immunoglobulin (IVIg) in a prospective open-label study in patients with multifocal motor neuropathy (MMN).MethodsOur study consisted of two phases: the IVIg phase (visits 1–3; 12 weeks), in which patients remained on IVIg treatment, and the fSCIg phase (visits 4–7; 36 weeks), in which patients received fSCIg treatment. After visit 3, IVIg was switched to an equivalent dose and frequency of fSCIg. Outcome measures were safety, muscle strength, disability and treatment satisfaction.ResultsEighteen patients were enrolled in this study. Switching to fSCIg reduced the number of systemic adverse events (IVIg 11.6 vs. fSCIg 5.0 adverse events/per person-year, p < 0.02), and increased the number of local reactions at the injection site (IVIg 0 vs. fSCIg 3.3 local reactions/per person-year, p < 0.01). Overall, no significant differences in muscle strength and disability between fSCIg and IVIg were found. Treatment with fSCIg was perceived as optimal treatment option by 8 of the 17 patients (47.1%) and they continued with fSCIg after study closure because of improved independence and flexibility to administer treatment.ConclusionTreatment with fSCIg can be considered a safe alternative for patients with MMN on IVIg treatment. fSCIg could be a favorable option in patients who prefer self-treatment and more independency, and in patients who experience systemic adverse events on IVIg or have difficult intravenous access.Electronic supplementary materialThe online version of this article (10.1007/s00415-019-09475-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Human immune globulin 10% with recombinant human hyaluronidase in multifocal motor neuropathy

et al. 2019

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“…SCIg therapy has been used successfully for many years in patients with immune deficiency syndromes, and increasing data have shown that it may also be effective for autoimmune disease [28]. The administration of the higher doses required to treat autoimmune disease is technically more difficult, however, requiring more subcutaneous infusion sites and more frequent infusions than is required for patients with humoral immunodeficiency syndromes.…”

Section: Subcutaneous Immunoglobulin Therapymentioning

confidence: 99%

How We Treat Autoimmune Small Fiber Polyneuropathy with Immunoglobulin Therapy

Schofield

Chémali

2018

Eur Neurol

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Intravenous immunoglobulin therapy is FDA approved for the immune-mediated peripheral nerve disorders Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. Immunoglobulin therapy has been used increasingly with significant efficacy in the treatment of patients with disabling autoimmune forms of dysautonomia, which are most often small fiber (autonomic and/or sensory) polyneuropathies. It is recognized by most who treat these disorders, however, that patients with autonomic dysfunction treated with intravenous immunoglobulin therapy develop aseptic meningitis or severe lingering headache more frequently than other patient populations when this therapy is dosed in the traditional fashion. We discuss our combined 27 years of experience with the use of immunoglobulin and other immune modulatory therapy in patients with autoimmune small fiber polyneuropathy.

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“…The efficacy and safety of IVIG for induction and maintenance treatment of CIDP is well-established [14]. Completion of the PATH study showing the safety and efficacy of SCIG now provides immunoglobulin-dependent CIDP patients an additional alternative for maintenance therapy [21,30,51]. These new options provide additional considerations for selecting optimal therapy for each individual patient.…”

Section: Discussionmentioning

confidence: 99%

Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?

Allen

Gelinas

Freimer

et al. 2020

Journal of the Neurological Sciences

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Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired neurological disorder characterized clinically by weakness and impaired sensory function evolving over 2 months or more, loss or significant decrease in deep tendon reflexes, and by electrophysiological evidence of peripheral nerve demyelination. Expeditious diagnosis and treatment of CIDP early in the disease course is critical such that irreversible disability can be avoided. Intravenous immunoglobulin (IVIG) is one first-line and maintenance therapy option for CIDP. The US Food & Drug Administration's (FDA's) approval of subcutaneous immunoglobulin (SCIG) in 2018 provides patients with CIDP more treatment options for maintenance therapy. The different options for administration of IG treatment create the need for information to assist clinicians and patients in choosing the optimal therapeutic approach. Considerations for pharmacokinetics, administration procedures, adverse events, patient variables, and cost will all be discussed in this article.

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Efficacy and patient satisfaction in the use of subcutaneous immunoglobulin immunotherapy for the treatment of auto-immune neuromuscular diseases

Cited by 18 publications

References 65 publications

Human immune globulin 10% with recombinant human hyaluronidase in multifocal motor neuropathy

Human immune globulin 10% with recombinant human hyaluronidase in multifocal motor neuropathy

How We Treat Autoimmune Small Fiber Polyneuropathy with Immunoglobulin Therapy

Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?

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