title: Safety and Efficacy of Subcutaneous Immunoglobulin in the Treatment of Neuromuscular Disorders.
abstract: Many neuromuscular diseases may be treated with immunoglobulins. In the United States, the major form of immunoglobulin used is intravenous (IV). Recently, there has been an increased interest in research regarding the use of subcutaneous immunoglobulin (SCIg), mainly for improved patient quality of life, convenience, potential for fewer systemic adverse events, and avoiding wear-off. The widespread use of the subcutaneous formulation in neurology has been affected by some limitations, mainly the smaller volume and higher frequency of infusions compared to IV administration. Also, there are different pharmacokinetic properties that should be considered to evaluate whether they change the immunomodulatory effect. There are several formulations available that address some limitations. Several studies have assessed efficacy, safety, and quality of life of SCIg in neurology. This review article summarizes the current evidence for the use of SCIg in neuromuscular diseases. It also addresses the pharmacokinetic differences and the different formulations available. The current available preliminary evidence indicates that SCIg is at least as effective as the IV formulations.
authors.affiliation: *Department of Neurology, University of Massachusetts Medical Center, Worcester, MA; †Innovative Research Associates, Philadelphia, PA; and ‡Department of Neurology and Neurosciences, New Jersey Medical School, Newark, NJ.
authors.forename: Johnny S
authors.initials: JS
authors.lastname: Salameh
authors.forename: Wissam
authors.initials: W
authors.lastname: Deeb
authors.forename: Lauren
authors.initials: L
authors.lastname: Burawski
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wright
authors.forename: Nizar
authors.initials: N
authors.lastname: Souayah
mesh_terms: D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous / Q000493:pharmacokinetics / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors