Subcutaneous self-infusions of immunoglobulins as a potential therapeutic regimen in immune-mediated neuropathies

Excerpt

Sirs: Intravenous immunoglobulins (IVIg) represent one of the mainstays in the treatment of chronic immune mediated neuropathies [1‐4]. Although numerous studies demonstrated clinical efficacy of IVIg over the short-term, the appropriate dose and route of administration for long-term maintenance therapy are not fully established [5]. Based on a small number of unblinded clinical trials and case reports clinical improvement is maintained with periodic application of IVIg. In clinical practice a regime of 0.4 g/kg BW every 4 weeks is usually chosen, which most of the patients receive by health care providers. Rapid subcutaneous infusions of immunoglobulins (SCIg), currently labelled and used for patients with primary immune deficiencies (PIDD), result in high and consistent serum IgG levels, are safe with very few systemic adverse reactions, whereas local tissue reactions are common, but usually mild and transitional. SCIg are comparable in the composition of their antibody spectrum to IVIg. The subcutaneous application can be easily learned by patients [6, 7]. In a recent study a preference for the subcutaneous route and for home therapy could be established in chronically treated patients with PIDD, when comparing IVIg with SCIg [8]. …