Immunodeficient patient experience of emergency switch from intravenous to rapid push subcutaneous immunoglobulin replacement therapy during coronavirus disease 2019 shielding
Published in:Current Opinion in Allergy & Clinical Immunology
Language:
English
DOI:
10.1097/aci.0000000000000864
ISSN:
1528-4050;
1473-6322
Origination:
Footnote:
Description:
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<jats:title>Purpose of review</jats:title>
<jats:p>Welsh immunodeficient patients on immunoglobulin replacement therapy (IgRT) who were considered high risk for severe coronavirus disease 2019 (COVID-19) were directed to shield. Consequently, patients receiving hospital-based intravenous immunoglobulin (IVIg) quickly transitioned to home-based self-administered subcutaneous immunoglobulin (SCIg). This evaluation aimed to assess patients’ perceptions and experiences and laboratory outcomes of emergency IgRT transition during COVID-19.</jats:p>
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<jats:sec>
<jats:title>Recent findings</jats:title>
<jats:p>A quick transition from in-hospital IVIg to home-based rapid push SCIg is achievable, however, patient IgRT administration preference remains key outside of emergency shielding measures.</jats:p>
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<jats:title>Summary</jats:title>
<jats:p>Subjective self-reported experiences (<jats:italic toggle="yes">n</jats:italic> = 23) and objective immunoglobulin G (IgG) concentration (<jats:italic toggle="yes">n</jats:italic> = 28) assessments were prospectively collected from patients pre/post-IgRT switch. In total, 41/55 (75%) patients transitioned from IVIg to rapid push SCIg and all completed training to self-administer subcutaneously within 24 days. Twenty-two percent (<jats:italic toggle="yes">n</jats:italic> = 5) of patients preferred SCIg and 35% (<jats:italic toggle="yes">n</jats:italic> = 8) wanted to return to hospital-based IVIg at 6 weeks post-transition. Mean IgG levels were similar pre vs. post-SCIg switch (10.3 g/l vs. 10.6 g/l, respectively). Patients reported greater infection anxiety during COVID-19 and adapted behaviours to mitigate risk. Although a third of patients wished to return to IVIg following cessation of shielding, over time the percentage electing to remain on SCIg rose from 22% to 59%.</jats:p>
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