Abstract
Objectives To review treatment efficacy, side effects and satisfaction among chronic inflammatory demyelinating polyneuropathy (CIDP) patients treated at the Royal Melbourne Hospital with subcutaneous immunoglobulin (SCIg).
Methods We performed a chart review of all CIDP patients transitioned from intravenous immunoglobulin (IVIg) to SCIg from 2019–2022. Prior maintenance dose of IVIg, starting dose of SCIg, SCIg dose at the end of the reviewed period (or at discontinuation) and side effects are presented. Patients using SCIg in December 2022 were interviewed regarding satisfaction, side effects, ease of use, convenience of SCIg.
Results 5 patients transitioned onto SCIg, age range 50–72 years. Maintenance dose of IVIg ranged 0.34–1.7g/kg/month. SCIg was commenced at a mean ratio to IVIg of 1.08:1, administered weekly or twice weekly. At the end of the reviewed period, the SCIg dose had increased in 2 patients, decreased in one, and remained unchanged in 2 patients. No relapse in CIDP occurred during transition to SCIg. Functional outcomes improved in 2 and remained unchanged in 3 patients. One significant side-effect occurred with skin necrosis at injection sites in one patient leading to treatment discontinuation. Four patients were interviewed, all reported satisfaction with SCIg efficacy, ease and convenience of use, with no negative impact on daily activities. One patient had died of unrelated illness.
Conclusions SCIg therapy was effective, easy and convenient for all CIDP patients treated at our centre. Skin necrosis has been reported in association with SCIg use but appears to be extremely rare.
