A Comparative Study of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin in Adult Patients with Primary Immunodeficiency Diseases: A Systematic Review and Meta-Analysis

Expert Rev Clin Immunol. 2016;12(5):595-602. doi: 10.1586/1744666X.2016.1155452. Epub 2016 Mar 9.

Abstract

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.

Keywords: Intravenous immunoglobulin; Subcutaneous immunoglobulin; efficacy; primary immunodeficiency; safety.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / standards
  • Immunologic Deficiency Syndromes / therapy*
  • Infusions, Subcutaneous / standards

Substances

  • Immunoglobulin G
  • Immunoglobulins, Intravenous