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Direct Intraventricular Delivery of Drugs to the Rodent Central Nervous System
Published on: May 12, 2013
Subcutaneous immunoglobulin: rapid push vs. infusion pump in pediatrics
1Midwest Immunology Clinic, Plymouth, MN, USA. rshapiro@midwestimmunology.com
Summary
Subcutaneous immunoglobulin (SCIG) therapy is effective for primary immunodeficiency disease (PIDD). SC rapid push offers a safe and viable administration option for pediatric patients, with fewer adverse events and higher IgG levels compared to intravenous immunoglobulin (IVIG).
Area of Science:
- Immunology
- Pharmacology
Background:
- Subcutaneous immunoglobulin (SCIG) therapy is increasingly utilized for managing primary immunodeficiency disease (PIDD) in both pediatric and adult populations.
- SCIG offers an alternative to traditional intravenous immunoglobulin (IVIG) treatments.
Purpose of the Study:
- To evaluate the safety and efficacy of SCIG in a pediatric cohort with PIDD.
- To compare SCIG administration via infusion pump versus SC rapid push.
- To assess the impact of SCIG concentration (16% vs. 20%) on dosing efficiency.
Main Methods:
- Retrospective chart review of 96 pediatric patients with PIDD receiving SCIG (16% or 20%).
- Data collected over 620 clinic visits, including administration method (infusion pump or SC rapid push) and prior IVIG use.
- Patients were converted to SCIG on a 1:1 basis, with administration technique chosen voluntarily.
Main Results:
- Mean serum IgG levels were higher with SCIG compared to IVIG troughs.
- SC rapid push resulted in significantly faster infusion times (≤9 min for 49% of patients) compared to infusion pumps (median 45 min).
- 20% SCIG demonstrated increased dosing efficiency, requiring smaller volumes and fewer weekly administrations than 16% SCIG. Adverse event rates were lower in pediatric patients (15.8%) versus adults (18.8%), with most AEs being local. Only one pediatric patient switched back to IVIG.
Conclusions:
- SCIG, particularly via SC rapid push, is a safe and effective treatment option for pediatric patients with PIDD.
- SC rapid push is a viable and efficient administration method for pediatric SCIG therapy.
- Higher concentration SCIG (20%) improves treatment efficiency.
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