Immunoglobulin (IgG) replacement is a life-saving treatment for individuals with primary immunodeficiency disease (PIDD). Today, there are many options for IgG replacement, and the choice is an individual one based on many factors. My preference for most patients is the subcutaneous (SCIG) route. It offers many advantages not offered by the intravenous (IVIG) route. These include: 1) independence from hospital-based infusion settings; 2) an alternative for patients with poor venous access; 3) better tolerability in those patients who are not able to tolerate IVIG; 4) flexibility of dosing; 5) ease of administration; 6) a very low side-effect profile; 7) a comparatively more even, almost physiological, IgG level; 8) less cost to administer than IVIG; and 9) improved quality of life in patients treated with SCIG compared with those treated with IVIG. For most patients with PIDD who require IgG replacement, SCIG offers advantages not available with IVIG.
WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.
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