Fasth Anders, Nyström Jeanette
Department of Paediatrics, Göteborg University, The Queen Silvia Children's Hospital, SE-416 85 Göteborg, Sweden.
Acta Paediatr. 2007 Oct;96(10):1474-8. doi: 10.1111/j.1651-2227.2007.00485.x. Epub 2007 Sep 10.
The primary objective of this prospective, open-label study was to evaluate the safety and tolerability of home treatment with a 16%, ready-to-use, human normal immunoglobulin solution for subcutaneous administration (SCIg 16%, Subcuvia, Baxter Medical AB, Kista, Sweden) in children with primary immunodeficiency (PI) previously receiving intravenous immunoglobulins (IVIg) treatment. Secondary objectives were to evaluate the efficacy of SCIg 16% through documented bacterial infections, IgG trough levels, quality of life (Child Health Questionnaire [CHQ]), healthcare resource utilization and patient preference. Twelve patients with PI were included in the study. There were no significant changes from baseline in vital signs or laboratory parameters. Most adverse events (311 of 328) were mild injection site reactions that, in most cases, resolved after 1-2 months. SCIg 16% maintained consistently high IgG trough levels, and the rate of bacterial infections was not different from that seen with previous IVIg treatment. SCIg treatment was also associated with significantly fewer lost work and school days and lower direct healthcare-related expenses and time consumed due to hospital or physician visits.
Home-based SCIg treatment was well tolerated, at least as effective as IVIg for preventing infections, and preferred by children with PI previously receiving IVIg treatment.
这项前瞻性、开放标签研究的主要目的是评估皮下注射用16%即用型人正常免疫球蛋白溶液(SCIg 16%,Subcuvia,百特医疗公司,瑞典基斯塔)在家中治疗原发性免疫缺陷(PI)儿童的安全性和耐受性,这些儿童此前接受过静脉注射免疫球蛋白(IVIg)治疗。次要目的是通过记录细菌感染情况、IgG谷浓度、生活质量(儿童健康问卷[CHQ])、医疗资源利用情况和患者偏好来评估16% SCIg的疗效。12例PI患者纳入研究。生命体征或实验室参数与基线相比无显著变化。大多数不良事件(328例中的311例)为轻度注射部位反应,多数情况下在1 - 2个月后缓解。16% SCIg持续维持较高的IgG谷浓度,细菌感染率与之前IVIg治疗时无差异。SCIg治疗还与更少的误工和缺课天数以及更低的直接医疗相关费用和因住院或看医生所消耗的时间相关。
在家中进行SCIg治疗耐受性良好,预防感染方面至少与IVIg一样有效,且受到之前接受IVIg治疗的PI儿童的青睐。