title: High dose subcutaneous immunoglobulin for idiopathic inflammatory myopathies and dysimmune peripheral chronic neuropathies treatment: observational study of quality of life and tolerance.
abstract: BACKGROUND
  In patients with autoimmune diseases who still derive benefit from high dose intravenous immunoglobulin (IVIg) treatment, some physicians resort to subcutaneous (SC) Ig as a replacement therapy.
  
  
  OBJECTIVE
  To collect quality of life (QoL) and tolerance data on SCIg in patients for whom the switch from IVIg to SCIg is essential to maintain treatment.
  
  
  METHODS
  This observational study included patients with either idiopathic inflammatory myopathies (IIM) or chronic dysimmune peripheral neuropathies (CDPN) treated with IVIg, who had been switched to SCIg administration for at least three months. The main objective was to describe the impact of SCIg on QoL after six months, using the generic Short-Form 36 questionnaire (SF-36). The secondary objectives were to evaluate SCIg tolerance and clinical efficiency.
  
  
  RESULTS
  Eight centres recruited 12 IIM patients and two centres recruited 11 CDPN patients. Neither the physical nor the mental health SF-36 component summaries showed any QoL deterioration during the six-month study period and all IIM and CDPN patients remained clinically stable during the same period. The most frequent adverse effects were injection site reactions (50%), cutaneous tissue disorders (18.2%), and nervous system disorders (13.6%). Two serious adverse events (myocarditis and cerebrovascular accident) occurred in two patients.
  
  
  CONCLUSIONS
  In these rare inflammatory diseases, high dose SCIg administration (which can be home based) has no deleterious effect on patient QoL. It appears to be a safe and efficient alternative to hospital-based IVIg.
authors.affiliation: a Internal Medicine Department , University Hospital Claude Huriez , Lille , France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: b Internal Medicine Department , University Hospital Pitié Salpêtrière , Paris , France.
authors.forename: O
authors.initials: O
authors.lastname: Benveniste
authors.affiliation: c Internal Medicine Department , University Hospital Hôtel Dieu , Nantes , France.
authors.forename: M
authors.initials: M
authors.lastname: Hamidou
authors.affiliation: d Internal Medicine Department , University Hospital Cochin , Paris , France.
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
authors.affiliation: e Département de médecine interne , Hôpital de la Timone, Aix Marseille Université , Marseille , France.
authors.forename: N
authors.initials: N
authors.lastname: Schleinitz
authors.affiliation: f Service de physiologie clinique-Explorations fonctionnelles , Hôpital Lariboisière , Paris , France.
authors.forename: P
authors.initials: P
authors.lastname: Lozeron
authors.affiliation: g Neurology Department 2 , University Hospital Pitié-Salpêtrière , Paris , France.
authors.forename: J M
authors.initials: JM
authors.lastname: Léger
authors.affiliation: h Service d'électroneuromyographie et pathologies neuromusculaires , Hôpital Pierre Wertheimer , Bron , France.
authors.forename: C
authors.initials: C
authors.lastname: Vial
authors.affiliation: i Neurophysiology Department , University Hospital Pitié-Salpêtrière , Paris , France.
authors.forename: K
authors.initials: K
authors.lastname: Viala
mesh_terms: D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000188:drug therapy* / Q000523:psychology*; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D003402:Creatine Kinase
keywords: SF-36; chronic dysimmune peripheral neuropathies; idiopathic inflammatory myopathies; intravenous immunoglobulin; subcutaneous immunoglobulin