Subcutaneous Infusion of Gammaglobulins in Management of Agammaglobulinaemia

Ugazio, A. G.; Duse, Marzia; Re, Rosenthal; Mangili, Giorgia; Burgio, G. R.

doi:10.1016/s0140-6736(82)90793-0

Cited by 33 publications

(10 citation statements)

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“…16 An alternative approach, the subcutaneous administration of immunoglobulins (SCIg) via a small portable pump, has been initiated for these disorders. 3,4,23,30 This regimen is well established for children with PID and SCIg results in well-balanced IgG plasma levels while lowering peak concentrations in comparison to IVIg. 31 Further data from these studies speak for reduced side effects and significant cost savings with SCIg.…”

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confidence: 99%

Subcutaneous immunoglobulin infusion: A new therapeutic option in chronic inflammatory demyelinating polyneuropathy

et al. 2007

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Intravenous application of immunoglobulins (IVIg) is an effective and usually well tolerated yet costly therapeutic regimen in chronic inflammatory demyelinating polyneuropathy (CIDP). We report two CIDP patients treated with subcutaneous infusion of immunoglobulins (SCIg) after IVIg therapy was shown to be effective. Application of SCIg was well tolerated, easy to manage, and led to stabilization of the disease course. SCIg may represent an effective new therapeutic option in CIDP and is associated with a cost reduction of at least 50% compared to IVIg therapy.

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confidence: 99%

Subcutaneous immunoglobulin infusion: A new therapeutic option in chronic inflammatory demyelinating polyneuropathy

et al. 2007

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“…Preparations for intramuscular immunoglobulin (IMIG) administration were the first products to be infused subcutaneously 8,9,52. Infusions were initially very slow (10–20 mL over several hours), but as the improved tolerability of SCIG was recognized, infusion rates were increased 3,11,53.…”

Section: Discussionmentioning

confidence: 99%

“…Positive treatment experience increased the popularity of the subcutaneous route among physicians and patients elsewhere 5,6. SCIG therapy obviates the need for venous access, maintains stable serum IgG levels, offers fewer systemic adverse events (AEs) when compared to IVIG, and is amenable to self-infusion 7–9. Self-infusion and home administration allow flexibility in adapting to the patient’s own schedule and are associated with improved quality of life compared to hospital or office-based intravenous treatment 10–12…”

Section: Introductionmentioning

confidence: 99%

New Frontiers in Subcutaneous Immunoglobulin Treatment

et al. 2011

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Subcutaneous immunoglobulin (SCIG) treatment provides stable serum immunoglobulin G (IgG) levels, is associated with fewer systemic adverse events than intravenous immunoglobulin (IVIG) treatment, and offers the convenience of home therapy. In clinical practice, IVIG is still used preferentially for initiation of treatment in newly diagnosed patients with primary immunodeficiency (PI) and for immunomodulatory therapy, such as treatment of peripheral neuropathies, when high doses are believed to be necessary. The authors discuss recent experience in using SCIG in place of IVIG in these settings. SCIG has been successfully used for initiation of therapy in previously untreated PI patients. Seventeen of 18 PI patients achieved serum IgG levels ≥5 g/L after the loading phase. Daily treatment was well tolerated and provided opportunities for patient/parent training in self-infusion. SCIG has been used for maintenance therapy in multifocal motor neuropathy (MMN) in three recent clinical trials, with good efficacy and tolerability results. Seven of eight MMN patients maintained serum IgG levels of 14–22 g/L with a mean dose of 272 mg/kg/week, had stable muscle strength, and felt comfortable with self-administration. Four patients with polymyositis or dermatomyositis achieved improvement in serum creatine kinase levels and muscle strength with SCIG therapy. Recent experience with SCIG suggests that traditional concepts of immunoglobulin therapy may be challenged to increase available therapy options. SCIG can be used to achieve high IgG levels within several days in untreated PI patients and to maintain high serum levels, as shown in patients with MMN.

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“…The original descriptions of the use of small pumps to give IM ISG emphasized slow administration, which was believed to be necessary to avoid local inflammatory reactions and/or the release of mediators from mast cells [4,6,19,20]. Subsequently, several groups showed that these infusions can be given much more rapidly and have reported rates as high as 20 mL per hour per site [8,15,21,22].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens

Chouksey

Duff

Wasserbauer

et al. 2005

All Asth Clin Immun

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For patients who require replacement therapy for primary immunodeficiency, subcutaneous infusions of immunoglobulin G (IgG) may be preferable to intravenous infusions for several reasons. However, at present, there is no preparation marketed for use by this route in North America. In this article, we describe the reasons patients have selected this route of therapy and the range of treatment regimens used. Approximately 20% of our patients have chosen the subcutaneous route, mainly because of adverse effects from intravenous (IV) infusions or difficulties with venous access. Unit dose regimens using whole bottles of currently available 16% intramuscular preparations or sucrose-containing lyophilized preparations intended for IV use but reconstituted to 15% IgG for subcutaneous administration were individually tailored to each patient. In most cases, self-infusions or home infusions were administered once or twice a week, most commonly requiring two subcutaneous sites and 2 to 3 hours per infusion. On average, patients took 0.18 mL of IgG per kilogram of body weight per site per hour. There were no systemic adverse effects. In patients for whom comparative data were available, trough serum IgG levels were higher with subcutaneous therapy than with IV therapy.

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Subcutaneous Infusion of Gammaglobulins in Management of Agammaglobulinaemia

Cited by 33 publications

References 1 publication

Subcutaneous immunoglobulin infusion: A new therapeutic option in chronic inflammatory demyelinating polyneuropathy

Subcutaneous immunoglobulin infusion: A new therapeutic option in chronic inflammatory demyelinating polyneuropathy

New Frontiers in Subcutaneous Immunoglobulin Treatment

Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens

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