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Impact of subcutaneous immunoglobulin on quality of life in patients with chronic inflammatory demyelinating polyneuropathy previously treated with intravenous immunoglobulin
Author(s) -
Vu Tuan,
Anthony Natalie,
Alsina Raul,
Harvey Brittany,
Schleutker Allison,
Farias Jerrica,
Dang Samuel,
Suresh Niraja,
Gooch Clifton
Publication year - 2021
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.27345
Subject(s) - medicine , chronic inflammatory demyelinating polyneuropathy , clinical endpoint , quality of life (healthcare) , adverse effect , polyradiculoneuropathy , physical therapy , sf 36 , patient satisfaction , polyneuropathy , antibody , surgery , clinical trial , pediatrics , immunology , health related quality of life , guillain barre syndrome , disease , nursing
Abstract Introduction/Aims Intravenous immunoglobulin (IVIg) is a common therapy for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). IVIg may cause systemic adverse events (AEs); therefore, infusion of subcutaneous immunoglobulin (SCIg) may be preferred by some patients. In this study we document the experiences of patients transitioning from IVIg to SCIg. Methods Transitioning subjects with CIDP were followed in a 6‐month prospective, open‐label study. The primary endpoint was percentage of subjects who withdrew for any reason (including significant AEs). The secondary endpoint was symptom progression or relapse requiring a change in management. Quality of life (QOL) and treatment satisfaction were assessed using the Short Form 36‐item Health Survey (SF‐36), Treatment Satisfaction Questionnaire for Medication (TSQM), and Chronic Acquired Polyneuropathy Patient‐Reported Index (CAP‐PRI). Efficacy was assessed using the Inflammatory Rasch‐built Overall Disability Scale, hand‐held dynamometry, limb motor strength testing (LMST), and timed 25‐ft walk (T25‐FW). Results Fifteen CIDP subjects transitioned from IVIg to SCIg. Of these, three (20%) met the primary endpoint and one (7%) met the secondary endpoint. The SF‐36 showed a statistically significant improvement for the domain of role limitations‐physical after 24 weeks ( P = .03), with no significant differences observed in other domains. TSQM and CAP‐PRI showed significant differences in favor of SCIg ( P = .003 and .02, respectively). No significant differences were observed in efficacy after 24 weeks, except for LMST, which favored SCIg ( P = .003). Eight of the 12 study completers (67%) continued with SCIg. Discussion Transition to SCIg was associated with maintained efficacy and improved QOL.