Open AccessSubcutaneous Immunoglobulin Therapy for Chronic Inflammatory Demyelinating Polyneuropathy: A Nursing Perspective
Author(s) -
Jennifer M Watkins,
Mazen M. Dimachkie,
Patty Riley,
Elyse Murphy
Publication year - 2019
Publication title -
the journal of neuroscience nursing/journal of neuroscience nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 43
eISSN - 1945-2810
pISSN - 0888-0395
DOI - 10.1097/jnn.0000000000000451
Subject(s) - chronic inflammatory demyelinating polyneuropathy , medicine , adverse effect , intensive care medicine , clinical trial , placebo , polyradiculoneuropathy , antibody , physical therapy , immunology , guillain barre syndrome , alternative medicine , pathology
Chronic inflammatory demyelinating polyneuropathy (CIDP), an immune-mediated peripheral neuropathy, is frequently treated with long-term maintenance intravenous immunoglobulin (IVIG). However, disadvantages of IVIG are the systemic adverse reactions, lengthy infusions, and need for vascular access. Subcutaneous immunoglobulin (SCIG) addresses many of the issues encountered by those unable, or unwilling, to tolerate the treatment burden of long-term IVIG. Subcutaneous immunoglobulin, a 20% solution stabilized with L-proline, is US Food and Drug Administration-approved for CIDP maintenance therapy in patients after being stabilized with IVIG. Approval was based on a randomized, double-blind, placebo-controlled trial where SCIG demonstrated superiority over placebo and was safe and efficacious in maintaining function. In addition to reviewing the primary efficacy results from the clinical trial, this article aims to update the neurology nursing community on a new option for long-term management of CIDP, including the practicalities of initiating and maintaining patients on SCIG therapy.