Immunodeficient patient experience of emergency switch from intravenous to rapid push subcutaneous immunoglobulin replacement therapy during coronavirus disease 2019 shielding. Issue 6 (27th December 2022)

• Record Type: Journal Article
• Authors: Morgan, Clare; Jolles, Stephen; Ponsford, Mark J.; Evans, Kimberly; Carne, Emily
• Is Part Of: Current opinion in allergy and clinical immunology. Volume 22:Issue 6(2022)
• Page Start: 371
• Page End: 379
• Publication Date: 2022-12-27
• Subjects: coronavirus disease 2019 -- immunoglobulin replacement therapy -- intravenous immunoglobulin -- patient reported outcome measures -- rapid push subcutaneous immunoglobulin; Allergy -- Periodicals; Clinical immunology -- Periodicals; Hypersensitivity; Immunity; Immune System Diseases; Allergy and Immunology; 616.079
• DOI: 10.1097/ACI.0000000000000864
• Languages: English
• ISSNs: 1528-4050

Abstract

Abstract : Purpose of review: Welsh immunodeficient patients on immunoglobulin replacement therapy (IgRT) who were considered high risk for severe coronavirus disease 2019 (COVID-19) were directed to shield. Consequently, patients receiving hospital-based intravenous immunoglobulin (IVIg) quickly transitioned to home-based self-administered subcutaneous immunoglobulin (SCIg). This evaluation aimed to assess patients' perceptions and experiences and laboratory outcomes of emergency IgRT transition during COVID-19. Recent findings: A quick transition from in-hospital IVIg to home-based rapid push SCIg is achievable, however, patient IgRT administration preference remains key outside of emergency shielding measures. Summary: Subjective self-reported experiences ( n = 23) and objective immunoglobulin G (IgG) concentration ( n = 28) assessments were prospectively collected from patients pre/post-IgRT switch. In total, 41/55 (75%) patients transitioned from IVIg to rapid push SCIg and all completed training to self-administer subcutaneously within 24 days. Twenty-two percent ( n = 5) of patients preferred SCIg and 35% ( n = 8) wanted to return to hospital-based IVIg at 6 weeks post-transition. Mean IgG levels were similar pre vs. post-SCIg switch (10.3 g/l vs. 10.6 g/l, respectively). Patients reported greater infection anxiety during COVID-19 and adapted behaviours to mitigate risk. Although a third of patients wished to return to IVIg following cessation of shielding, over time the percentage electing to remain on SCIg rose from 22% to 59%.