Abstract:
OBJECTIVES:To assess clinical outcomes and patient satisfaction in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) or multifocal motor neuropathy (MMN) who were switched from intravenous immunoglobulin (IVIG) to subcutaneous immunoglobulin (SCIG). METHODS:Eight consecutive patients, four with MMN and four with CIDP, already on long-term, hospital-based IVIG were switched to home-based SCIG. These patients were selected on the basis of their requirement for relatively low treatment doses, problems experienced with IVIG, and their willingness to switch to SCIG. RESULTS:After a mean 33 [standard deviation (SD) 19] months receiving SCIG, 7 patients remained neurologically stable and 6 remained on a similar mean weekly immunoglobulin dose relative to their original intravenous dose. A good outcome was reported by 7 of the 8 patients: there were improvements in nausea and headache (n = 4), need to travel to hospital (n = 4), venous access problems (n = 3), immunoglobulin-induced neutropenia (n = 3), treatment wearing-off fluctuations (n = 2), IVIG-induced allergy requiring antihistamine/hydrocortisone (n = 1) and time taken off work (n = 1). The eighth patient required increasing doses of immunoglobulin to maintain strength but still wanted to continue SCIG. Seven patients completed a questionnaire: there was a very high overall satisfaction level with immunoglobulin treatment [mean 96 (SD 5), visual analogue scale (VAS) where 0 = very unsatisfied, 100 = very satisfied]; and very strong preference for subcutaneous over intravenous immunoglobulin (VAS mean 93 [SD 12] where 0 = prefer IVIG, 100 = prefer SCIG). CONCLUSIONS:In seven of the eight patients, SCIG gave improved tolerability and patient satisfaction with similar efficacy compared with IVIG.
journal_name
Ther Adv Neurol Disordjournal_title
Therapeutic advances in neurological disordersauthors
Hadden RD,Marreno Fdoi
10.1177/1756285614563056subject
Has Abstractpub_date
2015-01-01 00:00:00pages
14-9issue
1eissn
1756-2856issn
1756-2864pii
10.1177_1756285614563056journal_volume
8pub_type
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