Research Article
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Year 2023, Volume: 2 Issue: 4, 237 - 242, 02.10.2023
https://doi.org/10.5505/achmedj.2023.24119

Abstract

References

  • 1. Tangye SG, Al-Herz W, Bousfiha A, etal. Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee [published correction appears in J Clin Immunol. 2020 Feb 22]. J Clin Immunol. 2020;40(1):24-64. doi:10.1007/s10875-019-00737-x
  • 2. Orange JS, Hossny EM, Weiler CR, et al. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology [published correction appears in J Allergy Clin Immunol. 2006 Jun;117(6):1483. Dosage error in article text]. J Allergy Clin Immunol. 2006;117(4 Suppl):S525-S553. doi:10.1016/j.jaci.2006.01.015
  • 3. Jolles S, Chapel H, Litzman J. When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach. Clin Exp Immunol. 2017;188(3):333-341. doi:10.1111/cei.12915
  • 4. Berger M. Choices in IgG replacement therapy for primary immune deficiency diseases: subcutaneous IgG vs. intravenous IgG and selecting an optimal dose. Curr Opin Allergy Clin Immunol. 2011;11(6):532-242 538. doi:10.1097/ACI.0b013e32834c22da
  • 5. Berger M. Subcutaneous immunoglobulin replacement in primary immunodeficiencies. Clin Immunol. 2004 Jul;112(1):1-7. doi: 10.1016/j.clim.2004.02.002. PMID: 15207776.
  • 6. Chapel HM, Spickett GP, Ericson D, et al.The comparison of the efficacy and safety of intravenous versus subcutaneous immunoglobulin replacement therapy. J ClinImmunol. 2000;20(2):94–100.
  • 7. Abolhassani H, Sadaghiani MS, Aghamohammadi A, Ochs HD, Rezaei N. Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: systematic review and meta analysis. J Clin Immunol. 2012;32(6):1180–1192.
  • 8. Chouksey A, Duff K, Wasserbauer N, Berger M. Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens. Allergy, Asthma & Clinical Immunology 2005; Vol.1,pp:120.
  • 9. Gardulf A, Nicolay U, Math D, et al. Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home. J Allergy Clin Immunol. 2004 Oct;114(4):936-42. doi: 10.1016/j.jaci.2004.06.053. PMID: 15480339.
  • 10. Fasth A, Nyström J. Quality of Life and Health-Care Resource Utilization Among Children with Primary Immunodeficiency Receiving Home Treatment with Subcutaneous Human Immunoglobulin. J ClinImmunol 2008; 28:370–378.
  • 11. Orange JS, Belohradsky BH, Berger M, et al.Evaluation of correlation between dose and clinical outcomes in subcutaneous immunoglobulin replacement therapy. Clin Exp Immunol 2012;169(2):172-81.
  • 12. Patel NC, Gallagher JL, Ochs HD, et al. Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age. J Clin Immunol. 2015 Aug;35(6):558-65. doi: 10.1007/s10875-015-0190-0.
  • 13. Karakoç Aydıner E, Kıykım A, Barış S, Özen A, Barlan I. Use of subcutaneous immunoglobulin in primary immune deficiencies. Turk Pediatri Ars. 2016;51(1):8-14. Published 2016 Mar 1. doi:10.5152/TurkPediatriArs.2016.3058
  • 14. Shrestha P, Karmacharya P, Wang Z, Donato A, Joshi AY. Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies. World Allergy Organ J. 2019 Oct 9;12(10):100068. doi: 10.1016/j.waojou.2019.100068.
  • 15. Roifman CM, Levison H, Gelfand EW. High-dose versus lowdose intravenous immunoglobulin in hypogammaglobulinaemia and chronic lung disease. Lancet. 1987;1(8541):1075–1077.
  • 16. Yong PL, Boyle J, Ballow M, et al. Use of intravenous immunoglobulin and adjunctive therapies in the treatment of primary immunodeficiencies. Clin Immunol. 2010;135(2):255– 263.
  • 17. Lucas M, Lee M, Lortan J, et al. Infection outcomes in patients with common variable immunodeficiency disorders: relationship to immunoglobulin therapy over 22 years. J Allergy Clin Immunol. 2010;125(6):1354–1360. https://doi.org/10.1016/j. jaci.2010.02.040. e4.
  • 18. Orange JS, Belohradsky BH, Berger M, et al. Evaluation of correlation between dose and clinical outcomes in subcutaneous immunoglobulin replacement therapy. Clin Exp Immunol. 2012;169(2):172–181. https://doi.org/10.1111/j. 1365-2249.2012.04594.x
  • 19. Roifman CM, Berger M, Notarangelo LD. Management of primary antibody deficiency with replacement therapy: summary of guidelines. Immunol Allergy Clin N AM. 2008;28(4): 875–876.
  • 20. Moschese V, Canessa C, Trizzino A, et al. Pediatric subset of primary immunodeficiency patients treated with SCIG: post hoc analysis of SHIFT and IBIS pooled data. Allergy Asthma Clin Immunol. 2020;16:80. doi:10.1186/s13223-020-00478-2
  • 21. Kobayashi R.H, Litzman J, Rizvi S, Kreuwel H, et al. Overview of subcutaneous immunoglobulin 16.5% in primary and secondary immunodeficiency diseases. Immunotherapy 2021;13:10, 813-824.
  • 22. Ochs HD, Gupta S, Kiessling P, Nicolay U, Berger M; Subcutaneous IgG Study Group. Safety and efficacy of self-administered subcutaneous immunoglobulin in patients with primary immunodeficiency diseases. J Clin Immunol. 2006 May;26(3):265-73. doi: 10.1007/s10875-006-9021-7.
  • 23. Eltan SB, Keskin O, Deveci MF. Safety, efficiency, and treatment satisfaction in children with primary immunodeficiency receiving subcutaneous immunoglobulin treatment. North Clin Istanb 2022;9(3):228–234
  • 24. Gür-Çetinkaya P, Çağdaş-Ayvaz DN, Öksüz AB, et al. Advantage of the subcutaneous immunoglobulin replacement therapy in primary immunodeficient patients with or without secondary protein loss. Turk J Pediatr. 2018;60(3):270-276. doi: 10.24953/turkjped.2018.03.006
  • 25. Martin A, Lavoie L, Goetghebeur M, Schellenberg R. Economic benefits of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency. Transfusion Medicine 2013 vol: 23 (1) pp: 55-60.

The Comparison of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin Treatments in Primary Immunodeficiency Diseases

Year 2023, Volume: 2 Issue: 4, 237 - 242, 02.10.2023
https://doi.org/10.5505/achmedj.2023.24119

Abstract

Introduction: Primary immunodeficiency diseases (PIDD) cause increased sensitivity against infections. The main treatment of PIDD is regular immunoglobulin (Ig) replacement therapy. IgG replacement therapy can be administered intravenously (IVIG) or subcutaneously (SCIG). SCIG and IVIG treatments are similarly effective in preventing infections in PIDD
Methods: This retrospective study was conducted in tertiary pediatric immunology department during the 3 years. We compared the cost-effectiveness, adverse reactions, serum IgG
trough levels, infection rates, antibiotic usage, infection-related hospitalization, effectiveness, safety and tolerability of SCIG and IVIG in PIDD.
Results: We enrolled 51 patients and the median ages were 10.3 and 17.5 years of IVIG and SCIG groups (p<0.001). The patients who received SCIG treatment were significantly older and the duration of treatment was longer than the IVIG group (p=0.003 and p=0.004,respectively). There was no significant difference in the frequency of hospitalization between the two groups (in IVIG and SCIG groups, 26.4% vs 5.8%,respectively) (p=0.08). The annual median number of infections in patients requiring outpatient treatment were 6.0 and 4.0 in the IVIG and SCIG groups (p<0.001). Although,
the incidence of systemic side effects was statistically significantly higher in the IVIG group(p=0.002), local side effects were significantly more frequent in the SCIG (35.9% vs. 5.9%,respectively)(p=0.012). The total average costs incurred were statistically significantly higher in the group receiving IVIG in all three years compared to those receiving SCIG (p<0.001).
Conclusion: SCIG treatment had more lower systemic adverse effects, cost, infection rates, antibiotic usage and duration of hospitalization than IVIG treatment in PIDD.

References

  • 1. Tangye SG, Al-Herz W, Bousfiha A, etal. Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee [published correction appears in J Clin Immunol. 2020 Feb 22]. J Clin Immunol. 2020;40(1):24-64. doi:10.1007/s10875-019-00737-x
  • 2. Orange JS, Hossny EM, Weiler CR, et al. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology [published correction appears in J Allergy Clin Immunol. 2006 Jun;117(6):1483. Dosage error in article text]. J Allergy Clin Immunol. 2006;117(4 Suppl):S525-S553. doi:10.1016/j.jaci.2006.01.015
  • 3. Jolles S, Chapel H, Litzman J. When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach. Clin Exp Immunol. 2017;188(3):333-341. doi:10.1111/cei.12915
  • 4. Berger M. Choices in IgG replacement therapy for primary immune deficiency diseases: subcutaneous IgG vs. intravenous IgG and selecting an optimal dose. Curr Opin Allergy Clin Immunol. 2011;11(6):532-242 538. doi:10.1097/ACI.0b013e32834c22da
  • 5. Berger M. Subcutaneous immunoglobulin replacement in primary immunodeficiencies. Clin Immunol. 2004 Jul;112(1):1-7. doi: 10.1016/j.clim.2004.02.002. PMID: 15207776.
  • 6. Chapel HM, Spickett GP, Ericson D, et al.The comparison of the efficacy and safety of intravenous versus subcutaneous immunoglobulin replacement therapy. J ClinImmunol. 2000;20(2):94–100.
  • 7. Abolhassani H, Sadaghiani MS, Aghamohammadi A, Ochs HD, Rezaei N. Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: systematic review and meta analysis. J Clin Immunol. 2012;32(6):1180–1192.
  • 8. Chouksey A, Duff K, Wasserbauer N, Berger M. Subcutaneous Immunoglobulin-G Replacement Therapy with Preparations Currently Available in the United States for Intravenous or Intramuscular Use: Reasons and Regimens. Allergy, Asthma & Clinical Immunology 2005; Vol.1,pp:120.
  • 9. Gardulf A, Nicolay U, Math D, et al. Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home. J Allergy Clin Immunol. 2004 Oct;114(4):936-42. doi: 10.1016/j.jaci.2004.06.053. PMID: 15480339.
  • 10. Fasth A, Nyström J. Quality of Life and Health-Care Resource Utilization Among Children with Primary Immunodeficiency Receiving Home Treatment with Subcutaneous Human Immunoglobulin. J ClinImmunol 2008; 28:370–378.
  • 11. Orange JS, Belohradsky BH, Berger M, et al.Evaluation of correlation between dose and clinical outcomes in subcutaneous immunoglobulin replacement therapy. Clin Exp Immunol 2012;169(2):172-81.
  • 12. Patel NC, Gallagher JL, Ochs HD, et al. Subcutaneous Immunoglobulin Replacement Therapy with Hizentra® is Safe and Effective in Children Less Than 5 Years of Age. J Clin Immunol. 2015 Aug;35(6):558-65. doi: 10.1007/s10875-015-0190-0.
  • 13. Karakoç Aydıner E, Kıykım A, Barış S, Özen A, Barlan I. Use of subcutaneous immunoglobulin in primary immune deficiencies. Turk Pediatri Ars. 2016;51(1):8-14. Published 2016 Mar 1. doi:10.5152/TurkPediatriArs.2016.3058
  • 14. Shrestha P, Karmacharya P, Wang Z, Donato A, Joshi AY. Impact of IVIG vs. SCIG on IgG trough level and infection incidence in primary immunodeficiency diseases: A systematic review and meta-analysis of clinical studies. World Allergy Organ J. 2019 Oct 9;12(10):100068. doi: 10.1016/j.waojou.2019.100068.
  • 15. Roifman CM, Levison H, Gelfand EW. High-dose versus lowdose intravenous immunoglobulin in hypogammaglobulinaemia and chronic lung disease. Lancet. 1987;1(8541):1075–1077.
  • 16. Yong PL, Boyle J, Ballow M, et al. Use of intravenous immunoglobulin and adjunctive therapies in the treatment of primary immunodeficiencies. Clin Immunol. 2010;135(2):255– 263.
  • 17. Lucas M, Lee M, Lortan J, et al. Infection outcomes in patients with common variable immunodeficiency disorders: relationship to immunoglobulin therapy over 22 years. J Allergy Clin Immunol. 2010;125(6):1354–1360. https://doi.org/10.1016/j. jaci.2010.02.040. e4.
  • 18. Orange JS, Belohradsky BH, Berger M, et al. Evaluation of correlation between dose and clinical outcomes in subcutaneous immunoglobulin replacement therapy. Clin Exp Immunol. 2012;169(2):172–181. https://doi.org/10.1111/j. 1365-2249.2012.04594.x
  • 19. Roifman CM, Berger M, Notarangelo LD. Management of primary antibody deficiency with replacement therapy: summary of guidelines. Immunol Allergy Clin N AM. 2008;28(4): 875–876.
  • 20. Moschese V, Canessa C, Trizzino A, et al. Pediatric subset of primary immunodeficiency patients treated with SCIG: post hoc analysis of SHIFT and IBIS pooled data. Allergy Asthma Clin Immunol. 2020;16:80. doi:10.1186/s13223-020-00478-2
  • 21. Kobayashi R.H, Litzman J, Rizvi S, Kreuwel H, et al. Overview of subcutaneous immunoglobulin 16.5% in primary and secondary immunodeficiency diseases. Immunotherapy 2021;13:10, 813-824.
  • 22. Ochs HD, Gupta S, Kiessling P, Nicolay U, Berger M; Subcutaneous IgG Study Group. Safety and efficacy of self-administered subcutaneous immunoglobulin in patients with primary immunodeficiency diseases. J Clin Immunol. 2006 May;26(3):265-73. doi: 10.1007/s10875-006-9021-7.
  • 23. Eltan SB, Keskin O, Deveci MF. Safety, efficiency, and treatment satisfaction in children with primary immunodeficiency receiving subcutaneous immunoglobulin treatment. North Clin Istanb 2022;9(3):228–234
  • 24. Gür-Çetinkaya P, Çağdaş-Ayvaz DN, Öksüz AB, et al. Advantage of the subcutaneous immunoglobulin replacement therapy in primary immunodeficient patients with or without secondary protein loss. Turk J Pediatr. 2018;60(3):270-276. doi: 10.24953/turkjped.2018.03.006
  • 25. Martin A, Lavoie L, Goetghebeur M, Schellenberg R. Economic benefits of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency. Transfusion Medicine 2013 vol: 23 (1) pp: 55-60.
There are 25 citations in total.

Details

Primary Language English
Subjects Traditional, Complementary and Integrative Medicine (Other)
Journal Section Research Articles
Authors

Meltem Çetin 0000-0002-9652-900X

Ayşe Metin 0000-0002-0731-5799

Publication Date October 2, 2023
Published in Issue Year 2023 Volume: 2 Issue: 4

Cite

EndNote Çetin M, Metin A (October 1, 2023) The Comparison of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin Treatments in Primary Immunodeficiency Diseases. ACH Medical Journal 2 4 237–242.