Subcutaneous immunoglobulin infusion as an alternative to intravenous immunoglobulin

Abstract

Immunoglobulin replacement therapy is the standard treatment for patients with primary B-cell immunodeficiencies. Providing passive immunity by using intravenous immunoglobulin (IVIG) has decreased the susceptibility to life-threatening infections in these patients.1 However, although the intravenous route for IgG replacement is overwhelmingly preferred in the United States, subcutaneous administration of IgG is the route of choice in Scandinavia and England.2 There are rare reports of subcutaneous replacement of IgG in the United States3; however, in some clinical immunology practices, such as ours, subcutaneous immunoglobulin (SCIG) replacement is a commonly offered option for adolescents and adults with primary immunodeficiency diseases. Despite the economic and quality-of-life benefits provided by SCIG replacement, in the United States, SCIG is rarely offered to B-cell–deficient patients who could benefit by this replacement modality.