Shabaninejad Hosein, Asgharzadeh Asra, Rezaei Nima, Rezapoor Aziz
a Department of Health Management, School of Health Management & Information Sciences , Iran University of Medical Sciences , Tehran , Iran.
b School of Health Management & Information Sciences , Iran University of Medical Sciences , Tehran , Iran.
Expert Rev Clin Immunol. 2016;12(5):595-602. doi: 10.1586/1744666X.2016.1155452. Epub 2016 Mar 9.
Subcutaneous immunoglobulin (SCIG) is a new therapeutic procedure for patients with primary immunodeficiency (PI). This research is a systematic review of studies on the efficacy and safety of intravenous immunoglobulin (IVIG) and SCIG in adult patients with PI. This study includes a systematic review of cohorts and randomized clinical trials (24 articles) from 5 databases with no time limits. Random effects meta-analysis was performed for outcomes such as efficacy and safety. Standard mean difference (SMD) of serum immunoglobulin level was equal to 0.336 (P <0.01; 0.205-0.467) and the odds ratio (OR) of side effects was 0.497 (P=0.1; 0.180-1.371). The results indicate that SCIG leads to a higher level of immunoglobulin and a reduction in side effects but shows the same infection rate as IVIG. Our analysis shows that shifting from IVIG to SCIG therapy can have clinical benefits for PI patients.
皮下注射免疫球蛋白(SCIG)是一种针对原发性免疫缺陷(PI)患者的新型治疗方法。本研究是对静脉注射免疫球蛋白(IVIG)和SCIG在成年PI患者中的疗效和安全性研究的系统评价。本研究包括对来自5个无时间限制数据库的队列研究和随机临床试验(24篇文章)的系统评价。对疗效和安全性等结局进行随机效应荟萃分析。血清免疫球蛋白水平的标准平均差(SMD)等于0.336(P<0.01;0.205 - 0.467),副作用的比值比(OR)为0.497(P = 0.1;0.180 - 1.371)。结果表明,SCIG可使免疫球蛋白水平升高,副作用减少,但感染率与IVIG相同。我们的分析表明,从IVIG治疗转向SCIG治疗对PI患者可能具有临床益处。