Download i need to know about subcutaneous immunoglobulin

I NEED TO KNOW ABOUT
SUBCUTANEOUS IMMUNOGLOBULIN
Transfusion Fact Sheet Volume 5, Number 14
By Dr Carolyn Wilson
What is immunoglobulin?
Immunoglobulin (Ig) is another name for antibody. Antibodies
are molecules made by a specialised immune cell called the
plasma cell. Their role is to fight infection and disease.
What is subcutaneous immunoglobulin?
Subcutaneous immunoglobulin (SCIg) is made from
pooled human plasma by a process called fractionation.
It is used to treat patients who do not have enough of their
own immunoglobulin. It is administered under the skin
(subcutaneous) as opposed to being infused into the vein
(intravenous or IVIg). (See our fact sheet I Need to Know About
Intravenous Immunoglobulin, Vol 1, No 10.)
How is SCIg administered?
Most patients use a pump to deliver SCIg under the skin of the
lower abdomen or upper thigh, usually on a weekly basis. During
the infusion they can walk around and go about their normal
activities. SCIg can also be self-administered using a rapid push
method, where patients inject a small volume, up to three times
a week, using a special butterfly needle.
Is SCIg used in Australia?
Numerous studies have shown that SCIg is just as effective
as IVIg in protecting patients with immune deficiencies
against infection.
The vast majority of replacement immunoglobulin is given
intravenously in Australia. From 2 September 2013, SCIg has
been approved for ordering for eligible patients being treated
within a hospital-based SCIg program, for four conditions where
there is support for use cited in the Criteria for the clinical use
of intravenous immunoglobulin in Australia. It is anticipated
that the subcutaneous use of immunoglobulins will increase in
Australia over the coming years.
What are some of the advantages of SCIg?
What different SCIg products are available in Australia?
When administered subcutaneously, the immunoglobulin is
absorbed into the circulation at a slower rate, and because it
is more concentrated, smaller volumes are needed. SCIg is
therefore associated with fewer adverse effects for the patient.
SCIg can be infused by patients at home avoiding visits to
hospital for treatment, which can lead to an improved quality of
life. SCIg may also be particularly useful in patients with difficult
access to veins.
Three products are available for SCIg administration under the
National blood arrangements. Evogam® is a 16% concentration,
Gammanorm® is a 16.5% concentration and Kiovig® is a 10%
concentration. Which product is used depends on clinical and
individual patient suitability. Other SCIg products are available
on the Australian Register of Therapeutic Goods.
Is SCIg as effective as IVIg?
What are the disadvantages of SCIg?
Some patients may have difficulty infusing SCIg into themselves.
As the infusions need to be more frequent, local reactions
can occur. The most common adverse effect is swelling at the
infusion site which usually lasts 12 to 24 hours and becomes
less common after the first two months of therapy.
BLOOD FACT
Subcutaneous delivery of immunoglobulin may
result in less adverse reactions for patients who
need IVIg.
The information contained in this fact sheet is not intended to be medical or professional advice. The disclaimer found at transfusion.com.au applies to this fact sheet.
These fact sheets have been created for people without a health or science background.
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