Abstract

Intravenous immunoglobulin (IVIg) therapy is often the mainstay of treatment for CIDP or MMN. However, subcutaneous immunoglobulin (SCIg) may offer a better tolerated, more convenient, more cost effective and equally effective alternative. Currently, electronic pumps are predominantly used to deliver SCIg, however a “rapid push” technique is gaining increasing popularity. We report our experiences converting 20 patients from regular IVIG to “rapid push” SCIg. Patients had a variety of neurological conditions (CIDP (15); MMN (3); stiff person syndrome (1); myositis (1)) and were clinically stable on IVIg at the time of the switch. Weekly doses ranged from 8–40 g (mean 18 g) given as injections of 4 g in 20 mls spaced over several days. Neurological symptoms, signs (e.g. MRC; vibration, joint positioned and pinprick awareness; 10 metre up-and-go timed walk) and quality of life (SF-36, Life Quality Index) were assessed at baseline and at 3 monthly intervals after switching to SCIg. Our outcomes demonstrate that SCIg is well tolerated, safe, and as effective as IVIG. Patients reported a better quality of life, when compared to previous IVIG treatment regimes. Importantly, this new service also results in significant cost savings shared between the CCG and the Trust.