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Journal of Clinical Immunology
Published in: Journal of Clinical Immunology 2/2019

Open Access 01-02-2019 | Immunodeficiency | Original Article

Health-Related Quality of Life in Patients with CVID Under Different Schedules of Immunoglobulin Administration: Prospective Multicenter Study

Authors: Federica Pulvirenti, Francesco Cinetto, Antonio Pecoraro, Maria Carrabba, Ludovica Crescenzi, Raffaella Neri, Livia Bonanni, Giovanna Fabio, Carlo Agostini, Giuseppe Spadaro, Stefano Tabolli, Albert Farrugia, Isabella Quinti, Cinzia Milito

Published in: Journal of Clinical Immunology | Issue 2/2019

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Abstract

Objective

We assessed the health-related quality of life (HRQoL) in CVID adults receiving different schedules of immunoglobulin replacement therapy (IgRT) by intravenous (IVIG), subcutaneous (SCIG), and facilitated (fSCIG) preparations. For these patients, IgRT schedule was chosen after a period focused on identifying the most suitable individual option.

Methods

Three hundred twenty-seven participants were enrolled in a prospective, observational, 18-month study. Participants received IgRT for at least 2 years. The first 6 months were devoted to the educational process during which the choices related to IgRT were regularly re-assessed, and the shift to alternative regimen was permitted. During the following 12 months, clinical data were prospectively collected, and only patients who did not further modify their IgRT schedule were included in the analysis of HRQoL measured by CVID_QoL, a specific instrument, and by GHQ-12, a tool to assess minor psychiatric nonpsychotic disorders.

Results

Three hundred four patients were included in the analysis. CVID_QoL global score and its dimensions (emotional functioning, relational functioning, gastrointestinal symptoms) were similar in IVIG, SCIG, and fSCIG recipients. Patients receiving IgRT by different routes of administration reported similar capacity to make long-term plans, discomfort due to therapy, and concern to run out of medications. Multivariate analysis revealed the GHQ-12 status, but not the IgRT mode of administration, as the major factor impacting on treatment-related QoL items, and a significant impact of age on discomfort related to IgRT.

Conclusions

IgRT schedules do not impact the HRQoL in CVID if the treatment is established after an extensive educational period focused on individualizing the best therapeutic regimen.
Appendix
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Metadata
Title
Health-Related Quality of Life in Patients with CVID Under Different Schedules of Immunoglobulin Administration: Prospective Multicenter Study
Authors
Federica Pulvirenti
Francesco Cinetto
Antonio Pecoraro
Maria Carrabba
Ludovica Crescenzi
Raffaella Neri
Livia Bonanni
Giovanna Fabio
Carlo Agostini
Giuseppe Spadaro
Stefano Tabolli
Albert Farrugia
Isabella Quinti
Cinzia Milito
Publication date
01-02-2019
Publisher
Springer US
Published in
Journal of Clinical Immunology / Issue 2/2019
Print ISSN: 0271-9142
Electronic ISSN: 1573-2592
DOI
https://doi.org/10.1007/s10875-019-0592-5

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