PMID- 21904101
OWN - NLM
STAT- MEDLINE
DCOM- 20111108
LR  - 20220409
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 123
IP  - 5
DP  - 2011 Sep
TI  - Safety and efficacy of home-based subcutaneous immunoglobulin G in elderly 
      patients with primary immunodeficiency diseases.
PG  - 186-93
LID - 10.3810/pgm.2011.09.2474 [doi]
AB  - BACKGROUND: Subcutaneous immunoglobulin (SCIG) is as effective as intravenous 
      immunoglobulin (IVIG) in minimizing infections in patients with primary 
      immunodeficiency diseases (PIDD) and is associated with fewer systemic adverse 
      events (AEs). Self-infusion/home-based infusion of SCIG improves quality of life 
      and may lower treatment costs compared with hospital or office-based IVIG 
      therapy, but its suitability has not been assessed in elderly patients (>/= 65 
      years). METHODS: We conducted a retrospective chart review of 47 elderly patients 
      with PIDD in a single clinical practice in the United States to evaluate the 
      practicality, safety, and efficacy of home-based SCIG infusions in elderly 
      patients with PIDD over a 13-month period. Measurements included baseline disease 
      characteristics, previous and current immunoglobulin G (IgG) replacement 
      regimens, self-administered versus assisted SCIG infusions, SCIG infusion 
      parameters, serum IgG levels, infections, and AEs. RESULTS: Forty-seven of 111 
      elderly patients (42%) treated with IgG in this practice elected to receive SCIG. 
      All 47 patients received SCIG infusions at home; 39 (83.0%) self-infused the 
      medication. Most patients (n = 46; 98%) received weekly infusions, requiring a 
      mean duration of 65.3 minutes. The mean SCIG dose of 103 mg/kg/week resulted in a 
      mean steady-state serum IgG concentration of 1074 mg/dL. Two patients experienced 
      serious infections on SCIG: an exacerbation of chronic obstructive pulmonary 
      disease/bronchitis, and an abscess. There were no serious systemic AEs. Local 
      injection site reactions, including swelling, redness, burning, or itching, were 
      considered mild or moderate by the patients and resolved within 24 hours. No 
      bruising, bleeding, or skin breakdown occurred, despite concomitant anticoagulant 
      or platelet inhibitor treatment in 45% of patients. Two patients discontinued 
      home-based SCIG, but did not continue any IgG treatment. No patient switched from 
      SCIG to another route of IgG treatment. CONCLUSIONS: Home-based SCIG is safe and 
      effective in elderly patients with PIDD, most of whom can self-infuse. Infection 
      rates were low, and no AEs or difficulties in administering SCIG occurred that 
      resulted in treatment discontinuation.
FAU - Stein, Mark R
AU  - Stein MR
AD  - Allergy Associates of the Palm Beaches, North Palm Beach, FL, USA.
FAU - Koterba, Alan
AU  - Koterba A
FAU - Rodden, Linda
AU  - Rodden L
FAU - Berger, Melvin
AU  - Berger M
LA  - eng
PT  - Journal Article
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Immunoglobulin G)
SB  - IM
CIN - Postgrad Med. 2013 Jan;125(1):169-71. PMID: 23391683
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - *Home Care Services
MH  - Humans
MH  - Immunoglobulin G/administration & dosage/adverse effects/*therapeutic use
MH  - Immunologic Deficiency Syndromes/therapy
MH  - Immunotherapy/adverse effects/methods
MH  - Infusions, Subcutaneous/adverse effects/methods
MH  - Male
MH  - Retrospective Studies
MH  - Self Care/adverse effects/methods
MH  - Treatment Outcome
EDAT- 2011/09/10 06:00
MHDA- 2011/11/09 06:00
CRDT- 2011/09/10 06:00
PHST- 2011/09/10 06:00 [entrez]
PHST- 2011/09/10 06:00 [pubmed]
PHST- 2011/11/09 06:00 [medline]
AID - 10.3810/pgm.2011.09.2474 [doi]
PST - ppublish
SO  - Postgrad Med. 2011 Sep;123(5):186-93. doi: 10.3810/pgm.2011.09.2474.