Children and adults with primary antibody deficiencies gain quality of life by subcutaneous IgG self-infusions at home.
BACKGROUND
A large number of children and adults with primary antibody deficiencies need lifelong IgG replacement therapy. It is mostly unknown what effect the choice of replacement therapy has on the patients' health-related quality of life (HRQOL) and treatment satisfaction (TS).


OBJECTIVE
To investigate whether a switch from hospital-based intravenous IgG (IVIG) to home-based subcutaneous IgG (SCIG) therapy would improve the HRQOL and TS.


METHODS
Fifteen children (<14 years; hospital-based IVIG therapy at enrollment) and 32 adults (> or =14 years; 22 on hospital-based IVIG and 10 on home-based SCIG therapy at enrollment) were included. Questionnaires were completed at baseline and at 6 and 10 months: the Child Health Questionnaire-Parental Form 50 (children) or Short Form 36 (adults), the Life Quality Index, and questions regarding therapy preferences.


RESULTS
The SCIG home therapy was reported to give better health (P=.001) and improved school/social functioning (P=.02) for the children, reduced emotional distress (P=.02) and limitations on personal time for the parents (P=.004), and fewer limitations on family activities (P=.002). Adults switching therapy reported improved vitality (P=.04), mental health ( P=.05), and social functioning ( P=.01). Adults already on SCIG home therapy at enrollment retained high HRQOL and TS scores. The SCIG home therapy improved TS because it led to greater independence and better therapy convenience ( P <.05). The patients preferred the SCIG administration route and having the treatment at home.


CONCLUSIONS
Home-based SCIG therapy improves several important aspects of HRQOL and provides the patients with primary antibody deficiencies and their families with greater independence and better control of the therapy situation and daily life. SCIG home therapy is an appreciated therapeutic alternative for adults and children in need of lifelong IgG replacement therapy.
Swedish Centre for Immunodeficiencies, Division of Clinical Immunology at the Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden. ann.gardulf@labmed.ki.se
Ann
A
Gardulf
Uwe
U
Nicolay
Dipl
D
Math
Oscar
O
Asensio
Ewa
E
Bernatowska
Andreas
A
Böck
Beatriz T
BT
Costa-Carvalho
Carl
C
Granert
Stefan
S
Haag
Dolores
D
Hernández
Peter
P
Kiessling
Jan
J
Kus
Nuria
N
Matamoros
Tim
T
Niehues
Sigune
S
Schmidt
Ilka
I
Schulze
Michael
M
Borte
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007153:Immunologic Deficiency Syndromes / Q000276:immunology / Q000628:therapy*; D007167:Immunotherapy / Q000379:methods; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012646:Self Administration
D007074:Immunoglobulin G