Journal of Clinical Immunology

, Volume 34, Issue 8, pp 1015–1017 | Cite as

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

  • Pere Soler-Palacín
  • Ingrid Gasó-Gago
  • Aurora Fernández-Polo
  • Andrea Martín-Nalda
  • María Oliveras
  • Julio Martinez-Cutillas
  • Concepció Figueras
Brief Communication

Abstract

Purpose

To evaluate the alternate use of subcutaneous immunoglobulin (SCIG) and intravenous immunoglobulin (IVIG) in patients with primary immunodeficiencies (PID) in a third-level Pediatric University Hospital.

Methods

Retrospective study of all patients receiving SCIG from 2006 to 2012. Data collected included demographics, date SCIG was started, date of switch to IVIG and reasons, administration tolerance, and related adverse events. Effectiveness was defined as the lack of severe infections.

Results

Twenty-three patients (15 male, 8 female) with PID were studied. SCIG was initiated at a median age of 14.2 years (8.4 months-25.7 years) and median duration on SCIG treatment was 41 months (4-68). Nine patients (39.1%) temporarily switched from SCIG to IVIG for the following reasons: vacation (8), administration issues (1), and transient need for immunomodulatory therapy (1). A mean of 5.2 IVIG infusions/patient (SD=2.86) was administered while on SCIG. IVIG-related adverse events were documented in 3 patients with 6 infusions. Eight (34.8%) patients definitively discontinued SCIG use for the following reasons: convenience (5), adverse effects (1), coagulopathy (1), and autoimmune thrombocytopenia (1). There were no severe infections requiring hospital admission in any patient during the study period.

Conclusions

Alternating SCIG and IVIG use in patients with PID was associated with considerable advantages in terms of convenience for the patients and their caregivers, while maintaining the effectiveness and safety of this therapy. Healthcare units treating these patients should show flexibility with this dual therapy in order to optimize patients’ quality of life.

Keywords

Intravenous immunoglobulins primary immunodeficiency quality of life subcutaneous immunoglobulins 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Pere Soler-Palacín
    • 1
  • Ingrid Gasó-Gago
    • 2
  • Aurora Fernández-Polo
    • 2
  • Andrea Martín-Nalda
    • 1
  • María Oliveras
    • 2
  • Julio Martinez-Cutillas
    • 2
  • Concepció Figueras
    • 1
  1. 1.Pediatric Infectious Diseases and Immunodeficiencies UnitHospital Universitari Vall d’Hebron. Institut de Recerca Vall d’Hebron. Universitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Pharmacy DepartmentVall d’Hebron HospitalBarcelonaSpain

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