Immunoglobulin replacement
therapy (IRT) has an important role in minimizing
infections and improving the health-related quality of life (HRQoL) in patients with immunodeficiency, who would otherwise experience
recurrent infections. These plasma-derived products are available as
intravenous immunoglobulin (
IVIg) or subcutaneous
immunoglobulin (SCIg). The global demand for these products is growing rapidly and has placed pressure on supply. Some
malignancies and their treatment (as well as other medical
therapies) can lead to secondary
hypogammaglobulinemia or secondary immunodeficiency (
SID) requiring IRT. Although
IVIg use in this cohort has well-established therapeutic benefits, little is known about SCIg use. A literature search in July 2015 found only 7 published articles on SCIg use. These articles found that both IRT modes had equivalent efficacy in regard to reduction of
bacterial infections. In addition, SCIg was reported to produce higher serum
IgG trough levels compared with
IVIg on equivalent dosage with the added benefit of fewer adverse effects. Patient HRQoL reports demonstrate preference for SCIg because of reduced adverse effects and hospital visits. There are no health economic models published on SCIg use in
SID, but models on
primary immunodeficiency disease and IRT conclude that SCIg provided greater economic benefits than
IVIg. The findings of this small number of reports suggest that SCIg
therapy for patients with
SID is likely to be beneficial for both the patient and health care providers. To substantiate wider use of SCIg in
SID, larger and more detailed studies are needed to accurately quantify the effectiveness of SCIg.