Subcutaneous immunoglobulin infusion to treat infants and toddlers with antibody deficiencies

Abstract

IgG replacement in children with primary or secondary antibody deficiencies (ADs) clearly prevents recurrent bacterial infections, particularly in the respiratory tract. 1 Rosen F.S. Eible M. Roifman C. et al. Primary immunodeficiency diseases: report of an IUIS Scientific Committee. Clin Exp Immunol. 1999; 118: 1-28 Google Scholar Although the efficacy and safety of intravenous immunoglobulin (IVIG) replacement have been well documented, 2 Church J.A. Leibl H. Stein M.R. et al. Efficacy, safety and tolerability of a new 10% liquid intravenous immune globulin [IGIV 10%] in patients with primary immunodeficiency. J Clin Immunol. 2006; 26: 388-395 Crossref PubMed Scopus (67) Google Scholar intravenous access, central catheter infections, and systemic untoward effects associated with IVIG 3 Gardulf A. Andersen V. Bjorkander J. et al. Subcutaneous immunoglobulin replacement in patients with primary antibody deficiencies: safety and costs. Lancet. 1995; 345: 365-369 Abstract Full Text PDF PubMed Scopus (266) Google Scholar , 4 Gardulf A. Nicolay U. Asensio O. et al. Rapid subcutaneous IgG replacement therapy is effective and safe in children and adults with primary immunodeficiencies: a prospective, multi-national study. J Clin Immunol. 2006; 26: 177-185 Crossref PubMed Scopus (165) Google Scholar , 5 Fasth A. Nystrom J. Safety and efficacy of subcutaneous human immunoglobulin in children with primary immunodeficiency. Acta Paediatr. 2007; 96: 1474-1478 Crossref PubMed Scopus (56) Google Scholar can be especially problematic in infants and toddlers with Although subcutaneous immunoglobulin (SCIG) therapy has gained wider acceptance in the United States, parents of infants and toddlers with ADs are rarely offered SCIG as an alternative to IVIG, and infants younger than 2 years are excluded from pharmaceutical clinical trials of new SCIG preparations, even though SCIG has successfully been given in children and adults since the 1970s. 4 Gardulf A. Nicolay U. Asensio O. et al. Rapid subcutaneous IgG replacement therapy is effective and safe in children and adults with primary immunodeficiencies: a prospective, multi-national study. J Clin Immunol. 2006; 26: 177-185 Crossref PubMed Scopus (165) Google Scholar , 5 Fasth A. Nystrom J. Safety and efficacy of subcutaneous human immunoglobulin in children with primary immunodeficiency. Acta Paediatr. 2007; 96: 1474-1478 Crossref PubMed Scopus (56) Google Scholar , 6 Abrahamsen T.G. Sandersen H. Bustnes A. Home therapy with subcutaneous immunoglobulin infusions in children with congenital immunodeficiencies. Pediatrics. 1996; 98: 1127-1131 PubMed Google Scholar