PMID- 37796840
OWN - NLM
STAT- Publisher
LR  - 20231005
IS  - 1462-0332 (Electronic)
IS  - 1462-0324 (Linking)
DP  - 2023 Oct 5
TI  - Subcutaneous immunoglobulin for patients with idiopathic inflammatory myopathies: 
      a real-world single centre experience.
LID - kead521 [pii]
LID - 10.1093/rheumatology/kead521 [doi]
AB  - OBJECTIVES: Idiopathic inflammatory myopathies (IIMs) are heterogeneous diseases 
      characterized by skeletal muscle inflammation associated with cutaneous, 
      pulmonary, and/or other visceral organ involvement. Intravenous immunoglobulin 
      (IVIG) has been recommended as an adjunct therapy for IIM patients refractory to 
      conventional therapy. However, IVIG has high resource needs and increased risk of 
      adverse reactions. Subcutaneous immunoglobulin (SCIG) therapy has been used as an 
      alternative to IVIG in primary immunodeficiencies and neuroinflammatory 
      disorders. We assessed the satisfaction, patient preference and effectiveness in 
      IIM patients transitioned from IVIG to SCIG. METHODS: We retrospectively reviewed 
      consecutive 20 patients with IIM who were transitioned from IVIG to SCIG therapy 
      for >12 months. Patient preference between IVIG vs SCIG was surveyed using a 
      questionnaire previously used in studies with neuroinflammatory conditions. In 
      addition, disease flares, changes in immunosuppression, cumulative prednisone 
      doses and global disease activity were evaluated using the Myositis Intention to 
      Treat Index (MITAX) 12-months prior to- and post-SCIG initiation. RESULTS: Most 
      patients (78.9%) preferred SCIG over IVIG and preferred home-based therapies to 
      hospital-based therapies. There was no significant difference in global disease 
      activity (MITAX 3.31 vs 3.02) nor in cumulative steroid doses 12-months prior to- 
      or post-SCIG initiation. Three patients experienced disease flares, 5 escalated 
      in immunosuppression, while 4 patients deescalated in immunosuppressive 
      medications. CONCLUSIONS: SCIG is preferred by most patients over IVIG without a 
      substantial increased disease activity or need for additional corticosteroids. 
      Future cost effectiveness studies may provide an additional rationale for 
      utilizing SCIG over IVIG for maintenance therapy for IIM.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      British Society for Rheumatology. All rights reserved. For permissions, please 
      email: journals.permissions@oup.com.
FAU - Ma, Zechen
AU  - Ma Z
AD  - Divsion of Rheumatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Johnson, Dylan
AU  - Johnson D
AD  - Divsion of Rheumatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Gniadecki, Robert
AU  - Gniadecki R
AD  - Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Ritchie, Bruce
AU  - Ritchie B
AD  - Division of Hematology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Keeling, Stephanie
AU  - Keeling S
AD  - Divsion of Rheumatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Cohen Tervaert, Jan Willem
AU  - Cohen Tervaert JW
AD  - Divsion of Rheumatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
FAU - Osman, Mohammed
AU  - Osman M
AD  - Divsion of Rheumatology, Department of Medicine, University of Alberta, Edmonton, 
      Alberta, Canada.
LA  - eng
PT  - Journal Article
DEP - 20231005
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
SB  - IM
OTO - NOTNLM
OT  - idiopathic inflammatory myositis
OT  - immunomodulation
OT  - patient satisfaction
OT  - subcutaneous immunoglobulin
EDAT- 2023/10/05 18:42
MHDA- 2023/10/05 18:42
CRDT- 2023/10/05 13:37
PHST- 2023/07/10 00:00 [received]
PHST- 2023/08/09 00:00 [revised]
PHST- 2023/09/09 00:00 [accepted]
PHST- 2023/10/05 18:42 [medline]
PHST- 2023/10/05 18:42 [pubmed]
PHST- 2023/10/05 13:37 [entrez]
AID - 7291863 [pii]
AID - 10.1093/rheumatology/kead521 [doi]
PST - aheadofprint
SO  - Rheumatology (Oxford). 2023 Oct 5:kead521. doi: 10.1093/rheumatology/kead521.