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Subcutaneous immunoglobulin replacement therapy: the European experience

Chapel, Helen; Gardulf, Ann

Current Opinion in Allergy and Clinical Immunology: December 2013 - Volume 13 - Issue 6 - p 623–629
doi: 10.1097/ACI.0000000000000013
PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by Ramsay L. Fuleihan and Bruce D. Mazer

Purpose of review Rapid subcutaneous immunoglobulin (SCIg) infusions have been used as an important method of delivering replacement immunoglobulin (Ig) to patients with primary immune deficiencies (PIDs) in Europe over the last 25 years. This review provides a comprehensive interpretation of the literature relating to the administration of SCIg and the services that have been developed alongside.

Recent findings Using rates of at least 20 ml/h per infusion site and simultaneous sites, the infusion time once per week is short (1–2 h in adults) and using small portable pumps, the child or adult is free for other activities during the therapy. The rapid SCIg infusions have been documented as well tolerated, efficacious and acceptable to infants and their parents, children, adults and elderly patients, and more recently to patients with autoimmunity requiring immunomodulatory Ig doses.

Summary As part of PID diagnostic and management services, educational programmes for self-infusion of both intravenous Ig and SCIg at home have been developed throughout Europe, resulting in increased patient compliance and patient empowerment as well as cost-savings for healthcare providers.

aPrimary Immunodeficiency Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK

bDivision of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

Correspondence to Professor Helen Chapel, Level 7, Nuffield Department of Medicine, Oxford University Hospital, John Radcliffe Site, Headley Way, Oxford, OX3 9DU, UK. Tel: +44 1865 740361; e-mail:

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