IgG Therapy for the Home-Based Patient: Administration and ... - NHIA

It’s important that patients are educated about the
types of adverse reactions associated with SCIG and how
to recognize them. Symptoms, such as warmth, redness,
and itching may be associated with a less­serious site reaction
and may be resolved by working with their clinical
team to strategize a pre­treatment plan or re­examine
needle length, administration procedure, or other variables.
See the “SCIG Administration” section on page 5
for more information.
Case Study
Converting IVIG patient to SCIG
Mr. D was a 46­year­old male with CIPD. He
was experiencing pain and decreased
strength in his lower extremities. For four
years, he had been receiving the same IVIG
formulation (off­label) at an infusion center.
To be treated, he needed to travel 60 minutes
(each way) monthly, in addition to wait
and infusion time at the hospital­based infusion
clinic.
Following his infusions, he experienced
severe chronic reactions, including migraine,
vomiting, and flu­like symptoms
and was bed­ridden for up to three days
post­infusion. Overall, his disease state
was poorly controlled and his quality of life
was greatly diminished.
The specialty infusion team worked with
Mr. D’s physician to find an alternative IVIG
formulation that might reduce the side effects
Actual patient not shown. Photo courtesy of Melvin Berger, M.D. and CSL Behring
he was experiencing. The team educated the
physician on recognizing patient­specific product
intolerances as well as rate­related side effects
that can be abated by using a standard IVIG infusion rate (which the center was not doing).
Mr. D successfully switched to a different IVIG product without incident and received his infusions at home. His infusion
reactions resolved—he was no longer bedbound for three days with flu­like symptoms each month—and his trips to the
infusion center were also eliminated which conservatively saved his payer $20,000 per year in infusion suite costs. Mr. D
also reported decreased pain in his limbs and neck.
Mr. D then expressed his desire to move to SCIG in order to become even more autonomous. He converted successfully
after three nurse­teaching visits, and reports having improved energy levels and quality of life. He has regular monthly
assessments with his physician, and the specialty pharmacy infusion team follows his progress.
Subcutaneous immune globulin therapy offers a safe, less invasive alternative to intravenous IG therapy to those patients
and caregivers willing to self­administer in the home setting.
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IgG Therapy for the Home­Based Patient: Administration and Delivery Method Considerations