Feasibility and Tolerability of Subcutaneous Immunoglobulin via Manual Push Pre‐Filled Syringes for Inflammatory Neuropathies: A Retrospective Cohort Study

ABSTRACT Introduction/Aims Subcutaneous immunoglobulin (SCIG) is available as vials or pre‐filled syringes (PFS) and can be administered via pump or manual push to treat inflammatory neuropathies, such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). There are limited data on PFS‐SCIG manual push in this population, and this administration method may be perceived as challenging as large volumes of SCIG are required for immunomodulation. Here, we evaluated the feasibility of PFS‐manual push SCIG in patients with inflammatory neuropathies. Methods Patients with inflammatory neuropathies receiving immunoglobulin therapy in a single center were identified via the National Immunoglobulin Database. Case notes were retrospectively evaluated for patient characteristics and immunoglobulin use data. Results Thirty‐six patients with inflammatory neuropathies being treated with PFS‐SCIG were identified (CIDP: n  = 29; multifocal motor neuropathy: n  = 2; other: n  = 5). Overall, 27 patients initiated SCIG with PFS‐manual push. The remaining patients initiated SCIG with PFS‐pump administration but, during the study, most ( n  = 7) switched to PFS‐manual push, while one switched from PFS‐manual push to PFS‐pump. Five patients experienced adverse events, mostly associated with infusion‐site swelling that could be managed by reducing infusion rates. Patient perception of PFS‐manual push was positive, with multiple patients commenting on its convenience. Discussion PFS‐manual push SCIG appeared to be feasible and generally well‐tolerated in patients with inflammatory neuropathies. Further studies should confirm PFS‐SCIG manual push as a viable option for patients with inflammatory neuropathies and explore whether PFS might enhance treatment satisfaction and quality of life.