Highlights
- •Subcutaneous immunoglobulin (SCIG) maintains and improves muscle strength in CIDP and MMN.
- •SCIG maintains quality of life in CIDP and MMN.
- •SCIG is more cost-effective than intravenous immunoglobulin (IVIG).
- •SCIG has fewer systemic side-effects compared to IVIG.
Abstract
Subcutaneous administration of immunoglobulin (SCIG) in chronic inflammatory demyelinating
polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) has been reported in several
case reports and in a few randomized trials during the last decade. In this review
we present the studies on SCIG in CIDP and MMN with special focus on the clinical
effects. Moreover, the effect on quality of life, side effects to SCIG and the health
economic perspectives are reviewed. Nine case studies, three randomized trials and
six long-term, follow-up studies were identified. Most of the studies are conducted
in patients switched from regular IVIG to SCIG treatment; one study involves treatment-naïve
patients. The review shows that none of the studies have been powered to demonstrate
an effect on disability. SCIG can maintain muscle strength for a period of 1 to 2 years and ability seems preserved for a similar period. Quality of life is generally
unchanged or improved after switch to SCIG and generalized side-effects seem fewer,
whereas local reactions at the injection site occur. Health economic analyses favour
SCIG at the doses used in the reviewed studies.
Keywords
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Article info
Publication history
Published online: April 24, 2017
Accepted:
April 22,
2017
Received in revised form:
April 21,
2017
Received:
December 30,
2016
Identification
Copyright
© 2017 Published by Elsevier B.V.
