PMID- 20082124
OWN - NLM
STAT- MEDLINE
DCOM- 20100903
LR  - 20220316
IS  - 1573-2592 (Electronic)
IS  - 0271-9142 (Linking)
VI  - 30
IP  - 2
DP  - 2010 Mar
TI  - Subcutaneous immunoglobulin therapy by rapid push is preferred to infusion by 
      pump: a retrospective analysis.
PG  - 301-7
LID - 10.1007/s10875-009-9352-2 [doi]
AB  - BACKGROUND: Subcutaneous immunoglobulin (SCIg) replacement therapy for primary 
      immune deficiency disease (PIDD) is a safe, effective, and convenient alternative 
      to intravenous Ig (IVIg) therapy. Although SCIg is typically administered weekly 
      by infusion pump, administration by a rapid push technique may provide a greater 
      degree of convenience. Rapid push administration has been an option at the 
      author's clinic for several years. We report experience with a cohort of patients 
      given a choice between rapid push and standard pump administration. METHODS: This 
      was a retrospective chart review of PIDD patients at a single site who initiated 
      treatment with SCIg (16% solution) therapy between January 1, 2006 and April 1, 
      2008. Patients selected either infusion pump or rapid push administration after 
      receiving a description and demonstration of each method and training for home 
      self-administration. Demographics, dose, adverse events (AEs), serum 
      immunoglobulin G (IgG) levels, and therapy disposition (discontinued, switched 
      technique) were recorded on a standardized data collection form. RESULTS: Charts 
      for 104 patients (45 male, 59 female; mean age, 21.1 years; range, 0.5-67.6 
      years; SD = 17.9 years) were reviewed. Seventy-four patients (71%) chose rapid 
      push. Mean SCIg dose was 32.11 g/month (range, 1.92-89.6 g/month; SD = 8.3 
      g/month) split into an average of 3.11 times per week. Volume per site ranged 
      from 3 to 20 mL, typically administered over 5-20 min and at one site. Mean serum 
      IgG levels did not differ significantly by administration method: pump, 1,153.06 
      mg/dL (SD = 240.8); rapid push, 1,225.8 mg/dL (SD = 299.8). Local infusion-site 
      reactions were the most common AEs and were experienced by one third of patients 
      in each group. Only two patients discontinued therapy because of an AE. 
      CONCLUSION: The results suggest that PIDD patients prefer SCIg administered as a 
      rapid push rather than as conventional pump infusion. Serum IgG levels were 
      comparable between methods, and safety was similar, if not slightly better, with 
      rapid push. Rapid push offers the potential for even greater convenience than the 
      pump infusion technique, although these results should be confirmed in 
      prospective studies.
FAU - Shapiro, Ralph
AU  - Shapiro R
AD  - Midwest Immunology Clinic, Plymouth, MN 55446-3399, USA. rsshapi@hotmail.com
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100115
PL  - Netherlands
TA  - J Clin Immunol
JT  - Journal of clinical immunology
JID - 8102137
RN  - 0 (Immunoglobulin G)
SB  - IM
MH  - Adolescent
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - *Immunization, Passive
MH  - Immunoglobulin G/blood
MH  - Immunologic Deficiency Syndromes/blood/immunology/*therapy
MH  - Infant
MH  - Infusion Pumps/statistics & numerical data
MH  - *Infusions, Subcutaneous
MH  - *Injections, Subcutaneous
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Retrospective Studies
EDAT- 2010/01/19 06:00
MHDA- 2010/09/04 06:00
CRDT- 2010/01/19 06:00
PHST- 2009/08/19 00:00 [received]
PHST- 2009/11/20 00:00 [accepted]
PHST- 2010/01/19 06:00 [entrez]
PHST- 2010/01/19 06:00 [pubmed]
PHST- 2010/09/04 06:00 [medline]
AID - 10.1007/s10875-009-9352-2 [doi]
PST - ppublish
SO  - J Clin Immunol. 2010 Mar;30(2):301-7. doi: 10.1007/s10875-009-9352-2. Epub 2010 
      Jan 15.