Dept. of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff CF14 4XW, UK.
Clin Immunol. 2022 Mar;236:108938. doi: 10.1016/j.clim.2022.108938. Epub 2022 Feb 1.
Many patients with immunodeficiencies require lifelong immunoglobulin replacement therapy (IgRT). In a multicenter, randomized, open-label, crossover, non-inferiority 3-month-trial, we compared the impact of the subcutaneous immunoglobulin Gammanorm® administered via pump or syringe (rapid push). Primary endpoint was the life quality index (LQI), secondary endpoints were QoL (SF36v2), satisfaction (TSQM-11), disease and treatment burden (PRISM), incidence of infections and adverse events (AE), treatment costs, and IgG levels. 28/30 patients completed the study. Most of the endpoints were comparable. Drug administrations with rapid push were more frequent, but reduced total time expenditure and some costs. Of the TSQM-11/LQI/SF36 components only "treatment interference with daily activities" was superior with pump and two QoL domains with rapid push. Both delivery devices showed favorable safety. Rapid push was preferred by 34.5% of patients. It proved to be an efficacious and cost-effective alternative to pumps adding to patient choice and increasing flexibility during long-term IgRT.
许多免疫缺陷患者需要终身接受免疫球蛋白替代疗法(IgRT)。在一项多中心、随机、开放标签、交叉、非劣效性 3 个月试验中,我们比较了通过泵或注射器(快速推注)给药的皮下免疫球蛋白 Gammanorm®的影响。主要终点是生活质量指数(LQI),次要终点是生活质量(SF36v2)、满意度(TSQM-11)、疾病和治疗负担(PRISM)、感染和不良事件(AE)的发生率、治疗成本和 IgG 水平。28/30 名患者完成了研究。大多数终点是可比的。快速推注给药更频繁,但减少了总时间支出和一些成本。在 TSQM-11/LQI/SF36 成分中,只有“治疗对日常活动的干扰”在泵组中更优,而两个 QoL 领域在快速推注组中更优。两种给药装置均表现出良好的安全性。34.5%的患者更喜欢快速推注。它被证明是一种有效且具有成本效益的替代泵的方法,增加了患者的选择,并在长期 IgRT 期间增加了灵活性。