Subcutaneous immunoglobulin in patients with common variable immunodeficiency
Le résumé fourni par la source
Background: We have recently reported that primary and secondary immunodeficiency patients have different perspectives on the clinical and quality of life impact of immunoglobulin therapy (unpublished data). Purpose: This study compares the clinical efficacy of the first against the second year of home‐based subcutaneous immunoglobulin (SCIG) treatment option in patients with common variable immunodeficiency (CVID). Methods: Retrospective data was collected on the first two years of SCIG treatment in 21 CVID patients at the Sunshine Coast Hospital and Health Services. Results: The mean age of the cohort was 48.2 years (range 23‐84) and included 9 females and 12 males. Three patients had bronchiectasis and one patient had chronic obstructive pulmonary disease from beginning of study period, two developed bronchiectasis during study period. SCIG dosage ranged from 3.2 to 13.6 g/week, with mean cohort (n=21) dose of 8.6g/week in the first year and 8.3g/week in the second year. Over two years, the dose of three patients was increased and for another three was decreased. The mean serum IgG trough level (n=18) was 9.19 g/L in the first year and 9.24 in the second year. The mean annual infection rate (n=18) was 2.00 in the first year and 1.44 in the second. Total number of infections in year one was 31 episodes with 22 respiratory infections, and in year two it was 25 episodes with 13 respiratory infections. At the end of the second year on SCIg one patient died and one patient was returned to intravenous immunoglobulin due to compliance issues. Conclusion: Overall, there was no statistical difference in dosage, serum IgG trough levels and annual infection rate between first and second year on SCIG. This indicates that SCIG is an effective treatment mode for minimising the risk of recurrent infection in patients with CVID in Australia.
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