Prospective study on CVID patients with adverse reactions to intravenous or subcutaneous IgG administration.
BACKGROUND
The multicenter prospective study provides information on adverse reactions to intravenous and subcutaneous immunoglobulin treatment in a cohort of 262 patients with common variable immunodeficiency. Severe adverse reactions are a rare but unpredictable event that might occur also in patients who tolerate substitutive intravenous or subcutaneous immunoglobulin therapy for months or years.


RESULTS
Subcutaneous therapy has been proved to be a safe option in the 13 patients who had to stop intravenous treatment and who remained out of immunoglobulin replacement for long periods of time. However, severe reactions to subcutaneous therapy occurred at the first or after several subcutaneous immunoglobulin administrations in 2 out of 13 patients.


CONCLUSIONS
Therefore, patients with previous severe reactions to intravenous immunoglobulin should be considered at particularly high risk for reaction to subcutaneous administration. In these cases, switching from in-hospital administration to home self-administration should be done with extreme care.
Quinti
Isabella
I
Department of Clinical Immunology, University of Rome La Sapienza Rome, Viale dell'Università 37, 00186 Rome, Italy. isabella.quinti@uniroma1.it
Soresina
Annarosa
A
Agostini
Carlo
C
Spadaro
Giuseppe
G
Matucci
Andrea
A
Sfika
Ifigeneia
I
Martini
Helene
H
Borghese
Federica
F
Guerra
Andrea
A
Alessandra
Vultaggio
V
Visentini
Marcella
M
Plebani
Alessandro
A
Fiorilli
Massimo
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D017074:Common Variable Immunodeficiency / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous